Mesa 2: diabetes mellitus tipo 1 y actividad física

Autores/as

  • Estrella Menéndez Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC); Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina
  • Martín Rodríguez Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
  • Carolina Muratore Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina
  • Matías Alberto Re Hospital San Juan de Dios y Hospital Italiano, La Plata, Provincia de Buenos Aires, Argentina
  • Mariana Andrea Burgos Sociedad Argentina de Diabetes; Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina
  • Susana Apoloni Sociedad Argentina de Diabetes; Hospital Universitario Austral, Pilar, Provincia de Buenos Aires, Argentina
  • María Celina Bertona Altieri Sociedad Argentina de Diabetes; Hospital Universitario, Universidad Nacional de Cuyo, Mendoza, Argentina
  • Claudia Karina Koleff Sociedad Argentina de Diabetes, Capítulo Noreste Argentino (NEA), Presidente Roque Sáenz Peña, Chaco, Argentina
  • María Laura Pomares Sociedad Argentina de Diabetes; Hospital Juan Pablo II, Corrientes, Argentina
  • Javier Agustín Remón Sociedad Argentina de Diabetes; Hospital Privado de Comunidad, Mar del Plata, Provincia de Buenos Aires, Argentina
  • Laura Elisa Roccatagliata Sociedad Argentina de Diabetes; Consultoría Privada Alberti, Provincia de Buenos Aires, Argentina
  • María Virginia Rodríguez Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina
  • Gabriela Scalitti Sociedad Argentina de Diabetes. Centro Sanitario, Santa Rosa, La Pampa, Argentina

DOI:

https://doi.org/10.47196/diab.v52i3Sup.123

Palabras clave:

diabetes tipo 1, control glucémico, ejercicio, tecnología y diabetes

Resumen

En personas con diabetes tipo 1 (DM1) el ejercicio físico realizado en forma regular brindaría protección cardiovascular y tendría propiedades inmunomoduladoras pero la compleja interacción entre los efectos del ejercicio sobre el metabolismo glucídico y la terapia con insulina exógena supone un verdadero desafío. El ejercicio aeróbico por la contracción muscular disminuye la glucemia, conduce a un estado de hiperinsulinemia relativa y genera hipoglucemia al inicio o después del mismo mientras que el  ejercicio anaeróbico se asocia a hiperglucemia por aumento de catecolaminas e  incremento de lactato que  favorece la neoglucogénesis hepática. El deterioro de la respuesta de hormonas contrarreguladoras existente en la DM1 amplifica la variabilidad glucémica y dificulta el control metabólico.

Existen guías y recomendaciones que buscan brindar un marco de seguridad para la prescripción de actividad física considerando la multiplicidad de disciplinas deportivas, la edad del paciente y la evaluación de las complicaciones crónicas de la diabetes antes del inicio de la misma. Entre las estrategias terapéuticas se encuentran la modulación con hidratos de carbono, la adecuación pre y pos ejercicio de la insulinoterapia y el control intensivo de glucemia y cetonas. Los nuevos infusores de insulina y monitoreo glucémico ofrecen la posibilidad del fraccionamiento y/o suspensión de dosis convirtiéndose en el gold standard entre los deportistas de alto rendimiento. A futuro modelos integrados con calculadoras de ejercicio inteligentes, capacidad predictiva y de “aprendizaje individualizado” (páncreas artificial) posibilitarán mantener la euglucemia y optimizar los beneficios del ejercicio como parte del tratamiento.

Biografía del autor/a

Estrella Menéndez, Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC); Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición, especializada en Diabetes, Servicio de Nutrición y Diabetes del Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC); Exdirectora de la Escuela de Graduados en Diabetes (Sociedad Argentina de Diabetes)

Martín Rodríguez, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina

Profesor Titular de Endocrinología, Metabolismo y Nutrición; Director del VI Curso Universitario de Posgrado en Diabetes

Carolina Muratore, Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición, especializada en Diabetes (SAD); Secretaria del Comité de Graduados (2015-2018)

Matías Alberto Re, Hospital San Juan de Dios y Hospital Italiano, La Plata, Provincia de Buenos Aires, Argentina

Médico especialista en Clínica Médica, especializado en Diabetes

Mariana Andrea Burgos, Sociedad Argentina de Diabetes; Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Medicina Familiar y Nutrición, especializada en Diabetes (Sociedad Argentina de Diabetes); Becaria en Servicio de Nutrición del Hospital Italiano

Susana Apoloni, Sociedad Argentina de Diabetes; Hospital Universitario Austral, Pilar, Provincia de Buenos Aires, Argentina

Médica Especialista en Clínica Médica y Nutrición, especializada en Diabetes (Sociedad Argentina de Diabetes); Servicio de Diabetes, Hospital Universitario Austral

María Celina Bertona Altieri, Sociedad Argentina de Diabetes; Hospital Universitario, Universidad Nacional de Cuyo, Mendoza, Argentina

Médica especializada en Diabetes

Claudia Karina Koleff, Sociedad Argentina de Diabetes, Capítulo Noreste Argentino (NEA), Presidente Roque Sáenz Peña, Chaco, Argentina

Médica especialista en Clínica Médica y Endocrinología, especializada en Diabetes (Sociedad Argentina de Diabetes SAD); Presidente del Capítulo Noreste Argentino (NEA) de la SAD (2018-2020)

María Laura Pomares, Sociedad Argentina de Diabetes; Hospital Juan Pablo II, Corrientes, Argentina

Médica especialista en Nutrición, especializada en Diabetes

Javier Agustín Remón, Sociedad Argentina de Diabetes; Hospital Privado de Comunidad, Mar del Plata, Provincia de Buenos Aires, Argentina

Especialista en Clínica Médica, especializado en Diabetes (Sociedad Argentina de Diabetes); Médico de Planta; Coordinador de la Residencia del Servicio de Nutrición y Diabetes del Hospital Privado de Comunidad

Laura Elisa Roccatagliata, Sociedad Argentina de Diabetes; Consultoría Privada Alberti, Provincia de Buenos Aires, Argentina

Médica especialista en Medicina Interna, especializada en Diabetes

María Virginia Rodríguez, Sociedad Argentina de Diabetes, Ciudad Autónoma de Buenos Aires, Argentina

Médica especialista en Nutrición y Endocrinología, especializada en Diabetes

Gabriela Scalitti, Sociedad Argentina de Diabetes. Centro Sanitario, Santa Rosa, La Pampa, Argentina

Médica especialista en Endocrinología, especializada en Diabetes

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10-01-2023

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Menéndez, E., Rodríguez, M., Muratore, C., Re, M. A., Burgos, M. A., Apoloni, S., Bertona Altieri, M. C., Koleff, C. K., Pomares, M. L., Remón, J. A., Roccatagliata, L. E., Rodríguez, M. V., & Scalitti, G. (2023). Mesa 2: diabetes mellitus tipo 1 y actividad física. Revista De La Sociedad Argentina De Diabetes, 52(3Sup), 14–29. https://doi.org/10.47196/diab.v52i3Sup.123

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Jornadas y congresos

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