Physical Activity Flashcards
Aerobic training improves glycemic control in what type of diabetes?
Only type 2 but aso children and youth with type 1
Physical activity shows substantial decreases in CV disease and OVERALL mortality for what type of Diabetic patient!
Type one and two
AEROBIC exercise training slows peripheral neuropathy in which type of diabetes?
Type 1 and 2
What two types of exercise have evidence of benefit in diabetes?
Both aerobic and resistance exercise are beneficial for patients with diabetes, and it is optimal to do both types of exercise. At least 150 minutes per week of aerobic exercise, plus at least two sessions per week of resistance exercise, is recommended.
Is a supervised or unsupervised program better?
For people with type 2 diabetes, supervised exercise programs
Greater A1C, BP, BMI, waist circum, and est 10year CV risk reductions
AND greater increases in fitness, strength and HDL
What is the effect of very brief intense exercise?
Increased BG due to increased glucose production above the amount of glucose being used by the body.
What is the ideal exercise regimen? Ie: timing, and amount
Minimum 150 minutes of moderate intensity exercise. Can be broken up into 10 minute or greater intervals. Just as effective!! Spread over at least 3 days but not greater than 2 days in a row with NO exercise.
Fear of hypo is a common barrier in type one diabetes. What are some strategies to reduce this risk?
Do NOT exercise when insulin is peaking.
Increase CHO (just B4, during and imm after)
Reduce BOLUS
Reduce BASAL in pump user.
OR
Perform 10 second very intense sprints before or after or intermittently during moderate exercise.
OR Perform resistance just PRIOR to aerobic.
How can you prevent nocturnal hypo from exercising late in the day?
Decrease evening basal.
Or
Decrease basal pump by 20% until 3am.
If only short intense exercise is done, how do you manage BG?
Eg. sprinting. 10-15 min max aerobic to exhaustion.
Hyperglycemia occurs. Give small bolus or temporarily increase basal.
How can you motivate a patient to be physically active?
Develop Specific goals
Anticipate barriers
Develop strategies to overcome barriers.
Where and when to exercise (prescriptions)
Self monitoring ie
Recording activity can increase the level of activity.
When Is exercising a risk for DKA?
If BG is greater than 14 and ketones are present (urine >8 or blood >3) than SHOULD NOT exercise.
Caution if BG is greater than 17 with no ketones.
At what BG prior to exercise is there
Risk of hypo?
5.5. Though this can vary individually as people have varied response to exercise!
If a patient wants to move from sedentary to very active, what four areas should be assessed by a physician prior?
CV risk eg ECG, possible stress test
Pre-proliferative or proliferative retinopathy.
Severe autinomic neuropathy
Severe peripheral neuropathy- nees to inspect feet daily
Type 1. If BG greater than 16.7 Can they exercise??
blood or urine.
ketones should be tested prior to exercise. If negative can they exercise? Yes if they feel well they can. If Ketones are elevated they they should postpone exercise until insulin is given and ketones no longer elevated.
How does moderate exercise cause hypoglycemia? 2
Increased glucose use and increased insulin sensitivity.
What types of exercise should be avoided with a patient who has proliferative retinopathy?
Heavy lifting or jarring of the head. Both could lead to vitreous hemorrhage.
People with diabetes are particularly prone to dehydration when exercising. They must maintain hydration
And avoid exercising under what environmental conditions?
Hot and humid conditions. Increased risk of heat related morbidity
Why monitor BG before during and after exercise and record it?
It’s the most effective tool to determine a pattern of response to exercise. Thus allowing appropriate food and or insulin adjustments.
Moderate intensity exercise means your heart rate is at what percent of maximum? Biking Brisk waking Swimming Dancing Raking leaves
64-76%
Vigorous exercise means your heart rate is at what percent of maximum? Brisk walking up incline Jogging Arebica Hockey
> 76 percent
Is a 1 km walk intense enough to warrant extra CHO?
Not usually.
How many minutes per week is associatied with greater A1C reductions?
150 min
What are the benefits of interval training compared to continuous moderate intensity exercise?
Greater gains is cardiorespiratory fitness
Type 2 ~ graeter glycemic control
Type 1~ less risk if hypo DURING activity.
Prolonged aerobic activity increases insulin sensitivity in recovery for how long?
Up to 48 hours
If exercising LESS than two hours AFTER a meal, how much should you reduce prandial insulin?
25-75%. Anything MORE than 75% and you risk hyperg
If BG is > 16.7 for type TWO do they have to test ketones?? Can they exercise??
do not need to test ketones but need to ensure not dehydrated.
How often should prolonged sitting be interrupted?
Every 20-30 minutes.
Pedometer based prescription can reduce A1C by
0.38%
