Diabetes

Question 1

Describe the epidemiology of Type 1 Diabetes

Answer 1

• Typically in early life peaking around puberty
• Both sexes are equally affected in childhood
• Males more prone in adult life

Question 2

Describe the epidemiology of Type 2 Diabetes

Answer 2

• 1 in 11 adults
• Older in age, physical inactivity, family history, history of gestational diabetes
• Highest in minority races and low-middle income countries
• 80-90% are overweight or obese

Question 3

What is Gestational Diabetes?

Answer 3

Glucose intolerance due to pregnancy

Question 4

What are normal values for fasting plasma glucose?

Answer 4

Less than:
100 mg.dL

Or 5.55mmol.L

Question 5

What is the criteria for Pre-diabetes?

Answer 5

Impaired Fasting Glucose
100-125 mg.dL or
5.55 - 6.94 mmol.L

Impaired Glucose Tolerance
140-199 mg.dL or
7.77 - 11.04 mmol.L

Question 6

What is the blood glucose criteria for Diabetes?

Answer 6

Fasting Plasma Glucose more than:
126 mg.dL (6.99 mmol.L)
Symptomatic with Casual Glucose more than:
200 mg.dL (11.10mmol.L)

Question 7

What factors could effect exercise response in diabetics?

Answer 7

Medication (timing and type)
Glucose levels before exercise
Diabetic complications
Intensity, duration and type of exercise

Question 8

What are medicated diabetics at risk of during or after exercise and why?

Answer 8

Hypoglycemia - BG is already lowered with medication exercise will further lower BG

Question 9

What are the aerobic exercise recommendations for diabetics?

Answer 9

F: 4-7 sessions a week,
I: 40-60% V02R, possibly better blood glucose control at high exercise intensities (>60%Vo2R)
T: 20-60 minutes session, 150 minutes week
T: Large muscle aerobic activity – in a rhythmic and continuous fashion
V: > 1000 kcal a week
P: Continue to increase volume to stimulate weight loss, progressively increase duration, and intensity as capacity increases

Question 10

What are the resistance exercise reconsiderations for diabetics?

Answer 10

F: 3x a week
I: Low resistance, high repetitions
T: n/a
T: Large muscle groups, using free weights, machine weights, or bands
P: Increase repetitions and weight, introduce different modes of exercise as client becomes more confident

Question 11

What is the goal of medical management in diabetes?

Answer 11

Normalize blood glucose levels

Question 12

Name 3 ways a diabetic could try to normalise their BG levels

Answer 12

1. Insulin (injection or pump) or oral agents
2. Individual nutrition care plan
3. Habitual physical activity

Question 13

What are the two mainstream treatments for diabetes?

Answer 13

• Insulin therapy

- BG lowering medications

Question 14

Symptoms of hypoglycemia:

Answer 14

Sweating 
Dizziness
Shaking
Fast HR
Irritable 
Headache
Impaired vision

Question 15

Symptoms of hyperglycemia:

Answer 15

Extreme thirst 
Dry Skin 
Drowsy 
Blurry vision 
Polyuria

Question 16

Describe 6 reasons to end an exercise test in diabetics

Answer 16

• serious dysrhythmias,
• > 2mm ST depression or elevation,
• Ischemic threshold,
• significant T-wave change,
• SBP >250mmHg, DBP >115mmHg,
• Onset of peripheral pain

Question 17

What are the expected outcomes of training in diabetics?

Answer 17

• Improved BG control in T2DM
• Improved insulin sensitivity
• Reduced body fat (which in turn increases insulin sensitivity)
• Improved cardiovascular benefits (in both types) therefore decreased risk of CVD