Physical Activity

Question 1

Aerobic training improves glycemic control in what type of diabetes?

Answer 1

Only type 2 but aso children and youth with type 1

Question 2

Physical activity shows substantial decreases in CV disease and OVERALL mortality for what type of Diabetic patient!

Answer 2

Type one and two

Question 3

AEROBIC exercise training slows peripheral neuropathy in which type of diabetes?

Answer 3

Type 1 and 2

Question 4

What two types of exercise have evidence of benefit in diabetes?

Answer 4

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.

Question 5

Is a supervised or unsupervised program better?

Answer 5

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

Question 6

What is the effect of very brief intense exercise?

Answer 6

Increased BG due to increased glucose production above the amount of glucose being used by the body.

Question 7

What is the ideal exercise regimen? Ie: timing, and amount

Answer 7

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.

Question 8

Fear of hypo is a common barrier in type one diabetes. What are some strategies to reduce this risk?

Answer 8

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.

Question 9

How can you prevent nocturnal hypo from exercising late in the day?

Answer 9

Decrease evening basal.
Or
Decrease basal pump by 20% until 3am.

Question 10

If only short intense exercise is done, how do you manage BG?
Eg. sprinting. 10-15 min max aerobic to exhaustion.

Answer 10

Hyperglycemia occurs. Give small bolus or temporarily increase basal.

Question 11

How can you motivate a patient to be physically active?

Answer 11

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.

Question 12

When Is exercising a risk for DKA?

Answer 12

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.

Question 13

At what BG prior to exercise is there

Risk of hypo?

Answer 13

5.5. Though this can vary individually as people have varied response to exercise!

Question 14

If a patient wants to move from sedentary to very active, what four areas should be assessed by a physician prior?

Answer 14

CV risk eg ECG, possible stress test
Pre-proliferative or proliferative retinopathy.
Severe autinomic neuropathy
Severe peripheral neuropathy- nees to inspect feet daily

Question 15

Type 1. If BG greater than 16.7 Can they exercise??

Answer 15

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.

Question 16

How does moderate exercise cause hypoglycemia? 2

Answer 16

Increased glucose use and increased insulin sensitivity.

Question 17

What types of exercise should be avoided with a patient who has proliferative retinopathy?

Answer 17

Heavy lifting or jarring of the head. Both could lead to vitreous hemorrhage.

Question 18

People with diabetes are particularly prone to dehydration when exercising. They must maintain hydration
And avoid exercising under what environmental conditions?

Answer 18

Hot and humid conditions. Increased risk of heat related morbidity

Question 19

Why monitor BG before during and after exercise and record it?

Answer 19

It’s the most effective tool to determine a pattern of response to exercise. Thus allowing appropriate food and or insulin adjustments.

Question 20

Moderate intensity exercise means your heart rate is at what percent of maximum? 
Biking
Brisk waking
Swimming
Dancing
Raking leaves

Answer 20

64-76%

Question 21

Vigorous exercise means your heart rate is at what percent of maximum? 
Brisk walking up incline
Jogging
Arebica
Hockey

Answer 21

> 76 percent

Question 22

Is a 1 km walk intense enough to warrant extra CHO?

Answer 22

Not usually.

Question 23

How many minutes per week is associatied with greater A1C reductions?

Answer 23

150 min

Question 24

What are the benefits of interval training compared to continuous moderate intensity exercise?

Answer 24

Greater gains is cardiorespiratory fitness
Type 2 ~ graeter glycemic control
Type 1~ less risk if hypo DURING activity.

Question 25

Prolonged aerobic activity increases insulin sensitivity in recovery for how long?

Answer 25

Up to 48 hours

Question 26

If exercising LESS than two hours AFTER a meal, how much should you reduce prandial insulin?

Answer 26

25-75%. Anything MORE than 75% and you risk hyperg

Question 27

If BG is > 16.7 for type TWO do they have to test ketones?? Can they exercise??

Answer 27

do not need to test ketones but need to ensure not dehydrated.

Question 28

How often should prolonged sitting be interrupted?

Answer 28

Every 20-30 minutes.

Question 29

Pedometer based prescription can reduce A1C by

Answer 29

0.38%