EXERCISE THERAPY IN JAPAN

The purpose of this report is to outline the exercise therapy of diabe tes mellitus that has been administered in Japan during the past 10 ye ars, with special emphasis on the results of studies on metabolic and endocrine effects as well as on practical aspects of exercise therapy. The studies on the response to exercise clarified neuroendocrine mech anisms involved in the regulation of carbohydrate and fat metabolism i n exercise and provided a basis for the indication of exercise therapy in view of the pre-existing metabolic abnormalities. Concerning the t raining effects, changes of insulin sensitivity have been chiefly stud ied in relation to metabolic improvement by physical training using th e insulin clamp method. The improvement of glucose and lipid metabolis m obtained during the training program, consisting of fast walking or jogging corresponding to 40-60% of predictive VO2 max for 30-60 min da ily, was suggested to be related to improved insulin sensitivity in pa tients with NIDDM. Intensive studies have been made on exercise progra ms, and medical checks and guidelines for exercise prescription have b een provided. Aerobic exercises with stretching and low-level callisth enics are recommended, and the usefulness of a multi-stage exercise lo ading test and the necessity of self-monitoring of blood glucose are s tressed for the successful management of exercise therapy.