content impedes this. The reduced glycogen con-
centration after exercise in people with NIDDM
is important for improved glucose metabolism
and reduced glycogen stores will aid the disposal
of blood glucose.
Conclusion
NIDDM is often associated with obesity and
reduction of body mass is important to improve
glucose metabolism. Exercise increases energy
consumption and has an important role is any
weight-loss programme. Exercise increases also
insulin sensitivity in skeletal muscle, leading to
an improved regulation of the blood glucose
concentration. Exercise therefore has a central
position in the management of most people
with NIDDM. However, as most of the people
with NIDDM are overweight, it is important to
find types of exercise that can be performed.
Endurance training such as running may cause
joint and tendon problems because of the high
body mass. Cycling or swimming may be good
alternatives. Furthermore, strength training may
be effective to increase glucose tolerance in older
people. Most of the glucose is taken up by skele-
tal muscles during insulin stimulation and an
increased muscle mass will improve removal of
glucose from the blood.
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