Physical Activity

Question 1

Aerobic exercise vs Resistance exercise vs Flexibility exercise

Answer 1

Aerobic exercise (like walking, bicycling, swimming or jogging) involves continuous, rhythmic movements of large muscle groups, normally at least 10 minutes at a time. At very high intensity, such as with high-intensity interval training, it also involves some anaerobic metabolism.

Resistance exercise involves brief repetitive exercises with weights, weight machines, resistance bands or body weight (e.g. push-ups) to increase muscle strength and/or endurance.

Flexibility exercise (like lower back or hamstring stretching) aims to enhance the ability to move through fuller ranges of motion. Some types of exercise, such as yoga, can incorporate elements of both resistance and flexibility exercise.

Question 2

How many minutes and sessions per week?

Answer 2

At least 150min aerobic exercise per week and 2 sessions of resistance training

Question 3

Benefits of exercise to diabetes

Answer 3

Glucose control, insulin sensitivity, weight loss/maintenance, improvement in lipid profile, BP reduction. Health benefits exist even if weight and glucose control do not change

Question 4

Recommendation re: sitting

Answer 4

Get up briefly at least every 20-30min
Habitual prolonged sitting is associated with increased risk of death and major cardiovascular events

Question 5

When is an ECG recommended

Answer 5

Resting ECG and exercise ECG stress test should be considered for people with typical or atypical chest discomfort, unexplained dyspnea, peripheral artery disease, carotid bruits, or those with a Hx of angina, MI, stroke, or TIA

Question 6

Recommendations for those with retinopathy

Answer 6

Preproliferative or proliferative retinopathy should be treated and stabilized before vigorous exercise could be considered

Question 7

Recommendations for those with neuropathy

Answer 7

Severe peripheral neuropathy- inspect feet daily, especially when active, wear appropriate foot ware

New evidence shows that people with peripheral neuropathy can safely participate in moderate-weight baring exercise if they do not have active foot ulcers

Daily weight baring activity could even decrease foot ulceration risk

Question 8

Patients at higher risk of heat related illness and recommendations for minimizing risk

Answer 8

Active adults >40 and people with diabetes
Those with reduced level of fitness and metabolic, CV, and neurological dysfunction

• exercise indoors, cool dry and ventilated space
• if outdoors in warm weather, aim for early or later in the day
• if active >15 min, take breaks

Question 9

Exercise can increase insulin sensitivity for up to…..

Answer 9

Exercise can increase insulin sensitivity for up to 48hours

Question 10

Glucose utilization increases with activity

Answer 10

Moderate intensity exercise can increase glucose utilization by 2 to 3 mg/kg per minute above usual requirements.

Moderate intensity exercise may require 10-15g more cars per hour and intense exercise might need 30 to 60 g/h

If BG is <5mmol/L before exercising, 10 to 20g of carbohydrate to be concerned

Question 11

Alcohol may… after exercising

Answer 11

Drinking alcohol after exercise might increase the right of hypoglycaemia