Exercise for diabetes Flashcards
What is used to diagnose metabolic syndrome?
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
How many diabetics have T2DM?
90%
How is diabetes diagnosed?
Give fasted person a sugary drink, and take a series of blood samples to see insulin and glucose changes; by HbA1c being measured
What are normal values for fasting and 2-hrs post OGTT blood glucose?
4-5mM when fasting; 5-8mM post OGTT
What are IGT values for fasting and 2-hrs post OGTT blood glucose?
6-7mM when fasting; 8-10mM post OGTT
What are T2DM values for fasting and 2-hrs post OGTT blood glucose?
7-8mM when fasting; 11mM+ post OGTT
What is HbA1c?
Glycosylated Hb (addition of sugar molecules to Hb)
What does HbA1c show?
Blood glucose over prolonged periods of time
What is the cut-off of HbA1c for diabetes?
6.5%
What are risk factors of T2DM?
PIA; ethnicity; obesity; abdominal obesity; age; genetics
What are consequences of T2DM?
Kidney disease; peripheral artery disease; retinopathy; neuropathy; stroke; heart disease
Why is skeletal muscle important for T2DM?
> 50% of blood glucose is taken up by skeletal muscle
How does exercise cause glucose uptake into cells?
Increased AMP:ATP ratio trigger AMPK, leading to GLUT4 mobilisation; increased Ca2+ activates CAMP to CAMK, leading to GLUT4 mobilisation
How does insulin cause glucose uptake into cells?
Insulin binds to IR; IR autophosphorylates with tyrosine; IRS molecule is activated; cascade of phosphorylation; GLUT4 mobilised
What is insulin resistance associated with?
Obesity; ageing; occurs in a variety of tissues; precedes T2DM development; central to metabolic syndrome and increased CVD risk
What are effects of skeletal muscle being insulin resistant?
Reduced glucose uptake; reduced rate of protein synthesis
What are current PA recommendations to T2DM patients?
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
What is HIIT?
All out intensity; 9 minutes of 30seconds with 4-6 reps; 3 days a week
How might HIIT be an alternative to traditional PA recommendations?
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
What should be the key target for exercise interventions?
Increasing VO2max
