Diabetes

Question 1

Type I Diabetes

Answer 1

• deficiency of insulin production from destruction of beta cells in pancreas
• typically insulin dependent

-5-10% of all diabetes

Question 2

Absolute Insulin Deficiency

Answer 2

body can’t make insulin

Question 3

Relative Insulin Deficiency

Answer 3

body can’t use insulin

Question 4

3 Types of Diabetes

Answer 4

• Type 1
• Type 2
• Gestational

Question 5

Diabetic Ketoacidosis

Answer 5

• lack of insulin causes build up of glucose in blood, so body uses fat for ATP
• ketones are a byproduct of using fats & they make blood acidic

-causes fruity (alcoholic) breath

Question 6

Type 2 Diabetes

Answer 6

• hyperglycemia due to incr insulin resistance in cells
• decrease insulin uptake
• pancreas keeps making insulin but Mm can’t use it

90-95% of all diabetes

Question 7

Patients with Type I Diabetes are prone to:

Answer 7

-diabetic ketoacidosis

Question 8

Ketones

Answer 8

• byproduct of fat metabolism
• make blood more acidic
• drink lots of water to flush out

Question 9

Gestational Diabetes

Answer 9

• due to contra-insulin effects of pregnancy
• diagnosed with oral test in 2nd trimester
• usually resolves post partum, but 50% develop type 2 diabetes

Question 10

Normal Glucose Levels

Answer 10

70-105 mg/dL

Question 11

Insulin

Answer 11

-allows glucose to enter cells of insulin sensitive tissue

Question 12

Retinopathy

Answer 12

• damage to small vessels in retina
• 90% of people with diabetes for ?25 years have some changes
• can be treated and prevented

Question 13

Type 2 Diabetes and GLUT 4

Answer 13

-insulin can’t make GLUT 4 transport to cell membrane

EXERCISE can stimulate GLUT 4 to go to membrane

Question 14

When to do Ex’s Testing

Answer 14

• Type 1 & >30 years old
• Type 1 for >15 years
• Type 2 & >35 years old
• Type 2 for >10 years
• any risk factor for CAD
• Suspected/Known CAD
• Microvascular/neurological diabetic complications
• PVD peripheral vascular disease

Question 15

How Insulin Controls Glucose Levels

Answer 15

• pancreatic beta cells release insulin in blood in response to glucose
• insulin binds to protein & cause GLUT 4 to move cell to edge
• GLUT 4 helps diffusion of glucose into cell

Question 16

Exercise & GLUT 4

Answer 16

exercise causes GLUT 4 to transfer to cell membrane so glucose can enter cell from blood

Question 17

Exercise Recommendation for Type 2

Answer 17

• no exercise if blood sugar is >400mg/dL
• burn 1000 kcal/week minimum
• burn >2000 kcal/week if goal is weight loss

Question 18

Type 1 Diabetes:

• if exercise is planned
• if exercise is unplanned

Answer 18

• planned: decrease insulin prior

- unplanned: eat additional (15g) CHO prior

Question 19

Benefits of Exercise with Type 2 Diabetes

Answer 19

-increase insulin sensitivity, may not lead to incr glycemic control

Question 20

Overall Exercise Benefits

Answer 20

• decr cardiovascular risk factors
• incr cardiovascular benefits
• decr body fat
• decr stress
• prevent type 2 diabetes

Question 21

For each hour of exercise:

Answer 21

additional 15g of CHO needed before or after exercise

Question 22

If exercising >60 min

Answer 22

-may need to test blood sugar during ex’s

Question 23

complete Exercise ____prior to bedtime to _____

Answer 23

• 2 hours

- prevent nocturnal hypoglycemia

Question 24

Hypoglycemia S/Sx

Answer 24

• drowsiness
• confusion
• irritability
• unable to concentrate
• loss consciousness
• convulsions
• poor coordination
• blurred/double vision
• slurred speech
• tremors
• nervousness
• sweating
• excessive hunger
• fatigue

Question 25

Kussmaul respiration

Answer 25

- fast and deep | - to compensate for ketoacidosis (breathing off excess CO2)

Question 26

Complications of Diabetes

Answer 26

- atherosclerosis - retinopathy - neuropathy

Question 27

S/Sx Diabetes

Answer 27

- polyuria - polydipsia - polyphagia - weight loss - fatigue - M cramps - irritability - blurry vision - headache - nausea

Question 28

Type 2 Risk Factors

Answer 28

- >40 years old - minorities - family Hx - decreased SES - inactivity - obesity (abdominal)

Question 29

Glucose Tests

Answer 29

- 2 hour glucose tolerance test | - glycosylated hemoglobin

Question 30

HbA1C

Answer 30

-glycosylated hemoglobin

Question 31

Glycosylated Hemoglobin

Answer 31

- HbA1C - average blood glucose over 3 months - measure how much Hb is bound to glucose -Normal: <6%

Question 32

Medications

Answer 32

- Insulin | - oral hypoglycemic agents

Question 33

Diabetic Ketoacidosis Occurs at:

Answer 33

- glucose levels of 300-700 mg/dL | - because too little insulin in conjunction with too much glucagon, catecholamines, cortisol or growth hormone

Question 34

1% Change in HbA1C=

Answer 34

-30mg glucose - 6%=135mg/dL - 9%=240mg/dL

Question 35

Hypoglycemic Shock

Answer 35

- glucose level s | - -Treatment: ingest glucose

Question 36

2 Stages of Retinopathy

Answer 36

- nonproliferative | - praliferative

Question 37

Nonproliferative Retinopathy

Answer 37

- (early stages) - clucose damage to vessels cause fluid to leak & cause retina to swell - blurred vision - treated with laser surgery

Question 38

Proliferative Retinopathy

Answer 38

(more severe) - abnormal blood vessels grow over retina surface & rupture & bleed into vitreous humor - scar tissue form & cause detachment of retina from back of eye - result in loss of vision - surgery can help

Question 39

Benefits of Exercise with Type 1 Diabetes

Answer 39

- incr insulin sensitivity - little/no effect on HbA1C - doesnt decr number of hypoglycemic events

Question 40

Do NOT ex's if:

Answer 40

-glucose >250mgdL & ketones are present

Question 41

symptoms of nocturnal hypoglycemia

Answer 41

-headache next morning -bad dreams -perspiring restless sleep

Question 42

Hyperglycemia S/Sx

Answer 42

- weakness - incr thirst - dry mouth - frequent bud decr volume of urine - abdominal tenderness - acetone breath - kussmaul respirations

Question 43

Contradincidations for Exercise

Answer 43

- glucose >250 - glucose <100mg/dL - illness/infection - active retinal hemorrage or Tx for retinopathy

Question 44

Exercise & Type I diabetes

Answer 44

- check glucose before and after to determine how much used | - end e's glucose should be >110mg/dL

Question 45

Ex's Type I a. frequency b. intensity c. time d. type

Answer 45

a. 7 days/week b. 45-80% MHR, 10-16 RPE c. 20-30 min d. large muscle groups

Question 46

Ex's Type 2 a. frequency b. intensity c. time d. type

Answer 46

a. 5 days/week b. 45-70% MHR, 10-14 RPE c. 40-60 min d. large Mm groups