mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2021.034mes-173Research ArticleОБЗОРREVIEWСтратегии управления сахарным диабетом у спортсменовDiabetes mellitus management strategies in athletesДергачеваЛ. И.DergachevaL. I.

ул. Большая Дорогомиловская, д. 5, г. Москва, 121059

Bolshaya Dorogomilovskaya, 5, Moscow, 121059

ДеревоедовА. А.DerevoyedovA. A.

ул. Большая Дорогомиловская, д. 5, г. Москва, 121059

Bolshaya Dorogomilovskaya, 5, Moscow, 121059

ВыходецИ. Т.VykhodetsI. T.

ул. Большая Дорогомиловская, д. 5, г. Москва, 121059

Bolshaya Dorogomilovskaya, 5, Moscow, 121059

ПавловаА. А.PavlovaA. A.

Анна Александровна Павлова

ул. Большая Дорогомиловская, д. 5, г. Москва, 121059

Anna A. Pavlova

Bolshaya Dorogomilovskaya, 5, Moscow, 121059

dr_pavlova@hotmail.comПарастаевС. А.ParastayevS. A.

ул. Большая Дорогомиловская, д. 5, г. Москва, 121059

Bolshaya Dorogomilovskaya, 5, Moscow, 121059

Федеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентстваРоссияFederal Research and Clinical Center for Sports Medicine and Rehabilitation of the Federal Medical Biological AgencyRussian FederationУправление спортивной медицины и цифровизации Федерального медико-биологического агентстваРоссияOffice of the Sports Medicine Organization and digitalization of the Federal Medical and Biological AgencyRussian FederationФедеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства; Российский национальный исследовательский медицинский университет имени Н. И. ПироговаРоссияFederal Research and Clinical Center for Sports Medicine and Rehabilitation of the Federal Medical Biological Agency; Pirogov Russian National Research Medical UniversityRussian Federation202127102024233114122Copyright © Дергачева Л.И., Деревоедов А.А., Выходец И.Т., Павлова А.А., Парастаев С.А., 20242024Дергачева Л.И., Деревоедов А.А., Выходец И.Т., Павлова А.А., Парастаев С.А.Dergacheva L.I., Derevoyedov A.A., Vykhodets I.T., Pavlova A.A., Parastayev S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/173

Контроль гликемии — самая сложная проблема для получающих инсулин спортсменов с сахарным диабетом (СД). При хорошем управлении гликемией обмен гликогена может быть нормальным, а работоспособность повышена коррекцией доз инсулина в соответствии с физической нагрузкой и питанием. Интенсивность физической нагрузки, упражнения с сопротивлением, интервальные тренировки при СД 1-го и 2-го типов обеспечивают оптимальную физиологическую адаптацию в период тренировок и демонстрируют хорошие гликемические преимущества при однократных нагрузочных сетах. Но для получающих инсулинотерапию спортсменов с СД важно не только поддержание оптимального уровня глюкозы во время тренировок и соревнований. Нужно учитывать и потенциальные нарушения терморегуляции, увеличивающие риск теплового стресса во время тренировок/соревнований, знать возможное влияние применяемых спортсменами лекарств на гликемию, электролитный баланс и дегидратацию, знать порядок оформления направляемых в антидопинговую организацию документов для запроса на терапевтическое использование инсулина. Целью обзора было попытаться привлечь внимание спортивных врачей и тренеров к вышеописанным проблемам и к необходимости более широкого использования новых технологий по контролю СД; помочь применяющим инсулин спортсменам с СД сохранять высокую работоспособность и спортивное долголетие.

Glycemic control is the biggest challenge for athletes with diabetes mellitus (DM) on insulin therapy. Done well, it can keep glycogen metabolism normal and allow performance improvement through adjustment of the insulin doses to the specifics of nutrition and exercising. In DM Type 1 and Type 2 patients, intense physical activity and resistance exercising, as well as interval training, enable optimal physiological adaptation during the training period and prove to be beneficial when the athlete does one-time exercise sets. But for athletes with DM on insulin therapy, keeping blood glucose at the optimal level is not the only important issue. It is also necessary to factor in the potential body temperature regulation disturbances that increase the risk of heat stress during training/competition, learn the effects the drugs used by athletes may have on the glycemic status, control electrolyte balance and dehydration, know how to execute the application for permission to use insulin for therapeutic purposes submitted to the anti-doping organization. The purpose of this review was to draw attention of sports medicine physicians and coaches to the above problems and to the need for wider use of the new DM control technology; help athletes with DM on insulin therapy continuously perform well and ensure their athletic longevity.

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The authors declare that there are no conflicts of interest present.