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Daha önce de ifade ettiğim gibi, diyabet gelişim riskini düşürmede en etkili stratejiler arasında egzersiz seçeneğinin en ön sıralarda yer almaktadır. Bu yazı da egzersizin diyabet önleme veya yönetmede etkinliğinden bahsetmeyeceğim. Öncelleyeceğim konulardan biri egzersiz zamanının glisemik kontrol üzerine etkisinin olup olmadığıdır. Egzersiz yapmanın farklı saatlerde yapılan egzersizler glisemik kontrolü değiştirebilir mi? sorusunu güncel bilimsel kanıtlar ışığında yanıtlamaya çalışacağım. Egzersiz uygulamalarının yoğunluğu, süresi, türü ve sıklığı gibi değişkenlere bağlı olarak hem akut hem de kronik adaptasyonlar aracılığıyla hepatik, nöral, immun ve endokrin sistemler üzerine etki ederek glisemik kontrol düzeyini etkileyebilmektedir (5). Bir diğer önemli başlık ise yemek yeme zamanına göre egzersiz zamanı tercihi glisemik kontrol düzeyini etkileyebilir mi? Bu soru benim için de oldukça heyecan verici bir başlıktır. Literatür, yemek sonrası egzersiz uygulamasının glisemik kontrolü iyileştirdiği yönünde genel bir öngörü içindedir. Dahası, diurnal ritim açısından sabaha karşı öğleden sonra yapılan egzersiz uygulamalarının hem atletik performansı geliştirme hem de glisemik kontrol açısından etkili olabileceği ifade edilmiştir (6,7,8). Glikoz toleransı, sağlıklı kişilerde, öğleden sonra veya akşama kıyasla sabahları günlük ritim açısından daha yüksektir (9,10). Ancak, glukoz toleransındaki bu ritim diyabetli bireylerde körelmekte olup, sabah glukoz toleransı öğleden sonraya benzer hale gelmektedir (11). Metabolik regülasyonlarda gözlemlenen diürnal ritim etkisinin patolojik durumlarda belirgin bir şekilde bozulması özellikle diyabetli kişilerde egzersiz zamanı açısından ilgi çekici bir başlık olarak düşünülmüştür (12,13,14). Bu bağlamda, literatürde güncel bir araştırma, diyabetli ve diyabetli olmayan kişilerde farklı zaman dilimlerinde (sabah: 08:00-10:00 ve akşam: 17:00-19:00) 12 hafta boyunca haftada 3 gün kombine olarak uygulanan hem aerobik (VO2maks=%60-70) hem de direnç egzersizlerinin (büyük kas gruplarına yönelik 1MT=%45-55) glisemik kontrol üzerine etki edip etmeyeceği araştırılmıştır. Araştırma sonuçları son derece ilgi çekici bulgulara sahipti. Elde edilen veriler incelendiğinde hem diyabetli hem de diyabetli olmayan kişilere uygulana kombine egzersizin glisemik kontrolü istatistiksel olarak anlamlı etkilediği saptanmıştır. Diğer taraftan yazımın ana konusu olan diurnal ritim açısından egzersiz uygulamalarının glisemik kontrolü etkileme potansiyeline ait bulgular ise istatistiksel olarak anlamsızdı. Başka bir ifadeyle, sabah veya akşam egzersiz yapmanın glisemik kontrol açısından benzer etkiye sahip olduğu kanısı güçlenmiştir (15).
Sonuç olarak ister diyabetli ister sağlıklı olun glisemik kontrolü geliştirmek ve glikoz duyarlılığını geliştirmek için haftada 3 gün aerobik ve direnç antrenmanı yapmak etkili bir araçtır. Haftaya bilimsel kanıtlar ışığında yeni bir konuyu tartışmak üzere…
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