Being active Flashcards
True or false: the risk for coronary death is significantly greater for women with DM then men
True
When is stress testing recommended prior to advising a patient with DM to begin an exercise routine?
For previously sedentary people with DM who want to undertake activity that is more intense than brisk walking
What is the criteria for conducting a graded stress test?
> 40, w/ or w/o CVD risk factors other than DM
> 30 with any of the following: DM1 or 2 > 10 years, HTN, smoking, dyslipidemia, proliferative or preproliferative retinopahty, nephropathy, including microalbuminuria
Any of the following, regardless of age: Known/suspected CAD, cerebrovascular disease, and/or PVD, autonomic neuropathy, advanced nephropathy w/ renal failure
In total number of steps, what is considered sedentary?
<5,000
Low active: 5,000-7,000
Somewhat active: 7,500-9,999
Active 10,000-12,500
Highly active: >12,500
How often should physical activity be performed to achieve significant health benefits?
3- 7 days per week
while 20 mins has been the min rec to provide CV fitness, multiple shorter bouts of 10 mins repeated to equal 30 total mins have resulted in measurable improvements
How long does it take to build an exercise habit?
4 weeks
In the first stage of beginning an exercise routine, the goal is not to achieve measurable` changes in fitness but rather to establish habits and baseline levels of endurance that will make fitness progress possible
what is the ideal frequency of resistance training?
2x week with a min of 48 hours of rest between sessions, more ideally 3 nonconsecutive days a week along with regular aerobic capacity
For moderate-intense activity what is the body’s preferred fuel?
CHO, primarily muscle glycogen
What is the body’s preferred fuel during low to moderate excercise?
FFA
what are Ketones?
Fat that is not completely oxidized (byproduct of the incomplete combustion of fat)
During physical activity, which hormones are considered glucose raising?
Epinephrine and norepinephrine; released in an exaggerated fashion in response to intense exercise
Glucagon, Growth hormone, and cortisol are also glucose increasing hormones that may be released during physical activity
What hormone decreases during physical activity?
Insulin
What is the strongest reported barrier to regular physical activity in adults and youth with DM1?
Hypoglycemia
What type of insulin, given within 2-3 hours before the onset of exercise increases the risk of hypoglycemia?
Short or rapid acting
What dietary strategy may lower the risk of hypoglycemia for those prone to it after exercise?
Consumption of moderate amounts of CHO (5-30 g, depending on the persons’s post exercise blood glucose, 30 mins- 2 hours after exhaustive, glycogen depletive exercise
Which oral DM medication is associated with fracture risk in the elderly (thus worsening fall related outcomes)?
TZD
If using insulin, what are the blood glucose targets while exercising?
> 110 mg/dL but <250 mg/dL
If using an oral DM med with potential for hypoglycemia, what should exercise blood glucose targets be?
> 90 mg/dL
If using oral DM med that does not cause hypoglycemia or if not on meds for DM, what are the glucose exercise targets?
No minimal blood glucose threshold necessary
When should a patient with DM1 check for ketones?
When they have unexplained hyperglycemia >200 mg/dL that persists more than a couple of hours
In what case may physical activity raise normal blood glucose levels?
When performed at high intensity; the catecholamine response to very intense activity results in exaggerated hepatic production of glucose for fuel, and after the activity is stopped, insulin need can double during the post activity period
When determining the acute effect of exercise, when should blood glucose levels be checked?
Within minutes of starting and ending physical activity
When later onset hypoglycemia is a concern, pts may need to monitor more frequently and make adjustments for 8 or more hours afterwards
What dietary strategy may be considered for a patient with higher risk of lows during exercise?
Consume a snack containing 10-30 g CHO per every 30-45 minutes of moderate aerobic physical activity
At what time post exercise do muscles take up blood glucose at the fastest rate to replace glycogen?
30-60 minutes; following physical activity, additional. snacks may be needed to prevent later onset hypoglycemia
