Exercise for diabetes

Question 1

What is used to diagnose metabolic syndrome?

Answer 1

Central obesity + two of: raised plasma TG >1.7mM; reduced HDL <40mM (male)/ <50mM (female); raised blood pressure >130/85; raised fasting plasma glucose >5.6mM

Question 2

How many diabetics have T2DM?

Answer 2

90%

Question 3

How is diabetes diagnosed?

Answer 3

Give fasted person a sugary drink, and take a series of blood samples to see insulin and glucose changes; by HbA1c being measured

Question 4

What are normal values for fasting and 2-hrs post OGTT blood glucose?

Answer 4

4-5mM when fasting; 5-8mM post OGTT

Question 5

What are IGT values for fasting and 2-hrs post OGTT blood glucose?

Answer 5

6-7mM when fasting; 8-10mM post OGTT

Question 6

What are T2DM values for fasting and 2-hrs post OGTT blood glucose?

Answer 6

7-8mM when fasting; 11mM+ post OGTT

Question 7

What is HbA1c?

Answer 7

Glycosylated Hb (addition of sugar molecules to Hb)

Question 8

What does HbA1c show?

Answer 8

Blood glucose over prolonged periods of time

Question 9

What is the cut-off of HbA1c for diabetes?

Answer 9

6.5%

Question 10

What are risk factors of T2DM?

Answer 10

PIA; ethnicity; obesity; abdominal obesity; age; genetics

Question 11

What are consequences of T2DM?

Answer 11

Kidney disease; peripheral artery disease; retinopathy; neuropathy; stroke; heart disease

Question 12

Why is skeletal muscle important for T2DM?

Answer 12

> 50% of blood glucose is taken up by skeletal muscle

Question 13

How does exercise cause glucose uptake into cells?

Answer 13

Increased AMP:ATP ratio trigger AMPK, leading to GLUT4 mobilisation; increased Ca2+ activates CAMP to CAMK, leading to GLUT4 mobilisation

Question 14

How does insulin cause glucose uptake into cells?

Answer 14

Insulin binds to IR; IR autophosphorylates with tyrosine; IRS molecule is activated; cascade of phosphorylation; GLUT4 mobilised

Question 15

What is insulin resistance associated with?

Answer 15

Obesity; ageing; occurs in a variety of tissues; precedes T2DM development; central to metabolic syndrome and increased CVD risk

Question 16

What are effects of skeletal muscle being insulin resistant?

Answer 16

Reduced glucose uptake; reduced rate of protein synthesis

Question 17

What are current PA recommendations to T2DM patients?

Answer 17

Aerobic training at 40-60% VO2max on >=3 days a week, summating to 150 minutes in bouts of at least 10 minutes; resistance training on >=2 days a week, with 5-10 exercises of major muscle groups

Question 18

What is HIIT?

Answer 18

All out intensity; 9 minutes of 30seconds with 4-6 reps; 3 days a week

Question 19

How might HIIT be an alternative to traditional PA recommendations?

Answer 19

Is equally effective at enhancing aerobic and mitochondrial capacity, as well as exercise performance; increased PGC1-alpha; regulates gene expression involved in energy metabolism and mitochondrial biogenesis; offers substantial improvements in glycaemic regulation with low time commitment

Question 20

What should be the key target for exercise interventions?

Answer 20

Increasing VO2max