Being active

Question 1

True or false: the risk for coronary death is significantly greater for women with DM then men

Answer 1

True

Question 2

When is stress testing recommended prior to advising a patient with DM to begin an exercise routine?

Answer 2

For previously sedentary people with DM who want to undertake activity that is more intense than brisk walking

Question 3

What is the criteria for conducting a graded stress test?

Answer 3

> 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

Question 4

In total number of steps, what is considered sedentary?

Answer 4

<5,000

Low active: 5,000-7,000
Somewhat active: 7,500-9,999
Active 10,000-12,500
Highly active: >12,500

Question 5

How often should physical activity be performed to achieve significant health benefits?

Answer 5

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

Question 6

How long does it take to build an exercise habit?

Answer 6

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

Question 7

what is the ideal frequency of resistance training?

Answer 7

2x week with a min of 48 hours of rest between sessions, more ideally 3 nonconsecutive days a week along with regular aerobic capacity

Question 8

For moderate-intense activity what is the body’s preferred fuel?

Answer 8

CHO, primarily muscle glycogen

Question 9

What is the body’s preferred fuel during low to moderate excercise?

Answer 9

FFA

Question 10

what are Ketones?

Answer 10

Fat that is not completely oxidized (byproduct of the incomplete combustion of fat)

Question 11

During physical activity, which hormones are considered glucose raising?

Answer 11

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

Question 12

What hormone decreases during physical activity?

Answer 12

Insulin

Question 13

What is the strongest reported barrier to regular physical activity in adults and youth with DM1?

Answer 13

Hypoglycemia

Question 14

What type of insulin, given within 2-3 hours before the onset of exercise increases the risk of hypoglycemia?

Answer 14

Short or rapid acting

Question 15

What dietary strategy may lower the risk of hypoglycemia for those prone to it after exercise?

Answer 15

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

Question 16

Which oral DM medication is associated with fracture risk in the elderly (thus worsening fall related outcomes)?

Answer 16

TZD

Question 17

If using insulin, what are the blood glucose targets while exercising?

Answer 17

> 110 mg/dL but <250 mg/dL

Question 18

If using an oral DM med with potential for hypoglycemia, what should exercise blood glucose targets be?

Answer 18

> 90 mg/dL

Question 19

If using oral DM med that does not cause hypoglycemia or if not on meds for DM, what are the glucose exercise targets?

Answer 19

No minimal blood glucose threshold necessary

Question 20

When should a patient with DM1 check for ketones?

Answer 20

When they have unexplained hyperglycemia >200 mg/dL that persists more than a couple of hours

Question 21

In what case may physical activity raise normal blood glucose levels?

Answer 21

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

Question 22

When determining the acute effect of exercise, when should blood glucose levels be checked?

Answer 22

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

Question 23

What dietary strategy may be considered for a patient with higher risk of lows during exercise?

Answer 23

Consume a snack containing 10-30 g CHO per every 30-45 minutes of moderate aerobic physical activity

Question 24

At what time post exercise do muscles take up blood glucose at the fastest rate to replace glycogen?

Answer 24

30-60 minutes; following physical activity, additional. snacks may be needed to prevent later onset hypoglycemia

Question 25

In insulin users, by what % should rapid or short acting insulin be reduced accompanying the meal consumed before exercise?

Answer 25

Reduce rapid or short acting by 20-30% prior to exercise > 30 mins of moderate activity

Question 26

Which disease is a major cause of morbidity and mortality in patients with DM?

Answer 26

CVD

Question 27

What will individuals with PVD experience during physical activity?

Answer 27

Ischemic pain in the LE due to an insufficient O2 supply in those active muscles

Question 28

How should physical activity recommendations be adjusted for those with retinopathy?

Answer 28

Severe to very severe: Limit increase in systolic BP and and avoid activities that jar the head–HR should not exceed that which elicits a systolic BP response >170 mmHg

Question 29

What is autonomic neuropathy?

Answer 29

Occurs when the nerves that control involuntary bodily functions are damaged. It can affect blood pressure, temperature control, digestion, bladder function and even sexual function.

Question 30

What is peripheral neuropathy?

Answer 30

Occurs as result of damage to the nerves located outside of the brain and spinal cord (peripheral nerves), often causes weakness, numbness and pain, usually in the hands and feet

Question 31

What is the physical activity guideline for all youths age 6-17?

Answer 31

60 mins/day or more of moderate or vigorous intensity aerobic activity, with equal parts of aerobic, muscle strengthening, and bone strengthening spread throughout the week

Question 32

What level of education should most educational materials be written?

Answer 32

Six grade