Management of Diabetes and Exercise Flashcards
1
Q
health benefits of PA for people with diabetes
A
- reduced risk for CVD, obesity and overweight, neruopathy and nephropathy
- increased sense of well-being and control of self efficacy
2
Q
effects of PA on BG control
A
- increase peripheral insulin sensitivity
- reduces insulin requirements
- improves glucose tolerance
- ability to clear glucose from blood
- may produce rapid fluctuations in bg levels if dietary intake is not balanced with PA and oral hypoglycemic agents
3
Q
Diabetes mellitus type 1
A
- destruction of insulin producing beta cells of the islets of Langerhans in the pancreas
- treated with exogenous insulin or beta cell transplant
- usually autoimmune
4
Q
Diabetes mellitus type 2
A
- typified by insulin resistance rather than insulin inadequacy
- insulin response is blunted and glucose levels remain high
- most common type
- strongly related to exercise and diet
5
Q
pre-diabetes
A
- refers to blood glucose levels that are higher than normal but not yet high enough to be diagnosed as type 2
- fasting plasma glucose level of 6.1-6.9 mmol/L
6
Q
type 2 diabetes management
A
- bg levels are less labile in T2DM than T1DM
- individuals who control their diabetes with diet and exercise only are not at increased risk for hypoglycemia
- individuals who are being treated with oral hypoglycemic agents are at low to moderate risk for suffering from hypoglycemia
- monitoring is important
- need to monitor and scale insulin dosage
- adjust carb intake as needed for balance
7
Q
type 1 diabetes management
A
- individuals lack the ability to maintain fuel homeostasis during exercise
- hepatic glucose production may not match muscle glucose utilization
- results in fluctuating blood glucose levels
8
Q
glucagon
A
- from alpha cells in pancreas
- most efficient stimulator of gluconeogensis
- requires liver glycogen stores to acutely increase bg
9
Q
growth hormone
A
- from anterior pituitary
- promotes lipolysis
- increased hepatic glucose production
10
Q
cortisol
A
- from the adrenal cortex
- enhances gluconeogenesis
11
Q
epinephrine/norepinephrine
A
- inhibit insulin secretion
- increase glucose secretion from liver and lactate from muscle
12
Q
what factors are different in a person with diabetes?
A
- constant supply of insulin from exogenous source
- variable insulin absorption
- suboptimal release of counter-regulatory hormones
- increased skeletal muscle uptake of glucose following exercise
- increased insulin sensitivity after exercise
13
Q
CDA guidelines pre-exercise
A
- assess timing, mode, duration and intensity of exercise
- high intensity and/or long duration present greatest risk
- eat a carb containing meal 1-3 hours prior to exercise
- have at least 250ml of fluid in 20 min prior to start of activity
- assess metabolic control
- insulin doses may need to be decreased while carb intake may need to be increased during aerobic activity
- insulin dosages may need to be increased during aerobic activity as it causes an increase in bg levels
14
Q
CDA guidelines during exercise
A
- monitor bg levels every 30 mins
- maintain adequate fluid intake
- if indicated by the metabolic assessment then consume carb at 20-30 min intervals
15
Q
CDA guidelines for training diet
A
-55-60% carb
-25-30% fat
-12-15% protein
if less than 1 hour/day of moderate activity 0.8-1g/protein/kg
if more than 1 hour/day up to 1.7g/protein/kg
16
Q
CDA guidelines for pre-event eating
A
- pre event meal 3-4 hours prior to start of exercise (should contain carb)
- ideally a carb containing beverage providing 1-2g/carb/kg should be consumed 1 hour prior if bg
17
Q
CDA guidelines during exercise/competition
A
- 1-1.5g/carb/kg/hr for activity lasting more than 1 hour
- assumes an adequate pre-even meal was consumed
- maintain adequate fluid intake
18
Q
CDA guidelines for after exercise
A
- replete liver and muscle glycogen stores by consuming complex carbs
- should be started as soon as possible after the end of exercise
- eat to match hunger and maintain euglycemia
- monitor bg levels
