Topic 12 (Diabetic Patients) Flashcards
Diabetes
- Impaired ability to use/burn _______ due to insulin
- high blood glucose (hyperglycemia)
- Deficits in insulin secretion, insulin action, or both
glucose
4 Types of Diabetes
1) Type 1
2) Type 2 (more lifestyle oriented)
3) Gestational (pregnancy)
4) Other Types
Type 1 (was referred to as juvenile)
- autoimmune disorder that destroys the cells (beta cells) of the pancreas that make _______.
-Always requires insulin dosage
Type 2 (was referred to as adult onset)
- cells become insulin insensitive, resulting in insufficient insulin utilization and glucose uptake
-receptor sites are damaged
insulin
Diabetes Symptoms
Type 1 & 2:
- Excessive urination
- Excessive thirst and _____
- Weight loss
- Fatigue, weakness, irritability
Type 2:
- Blurred vision
- Slowed healing
- Increased risk of infection
-Tingling in extremities
hunger
Diabetes Complications
- Heart Disease
- Stroke
- Mortality
- High __
- Blindness
- Kidney disease
- Peripheral neuropathy
- Amputations
- Periodontal disease
- Complications of pregnancy
BP
Diabetes Testing
1) Fasting Glucose
- >= 126 mg/dL = diabetic
- < ___ mg/dL = normal
2) Casual glucose (not fasting before testing)
- >= 200 mg/dL = diabetic
3) oral glucose tolerance test (OGTT)
- >= 200 mg/dL in 2 hr following glucose ingestion = diabetic
4) Glycosylated hemoglobin fraction A1c (HbA1C)
- >= 6.5 = diabetic
1) <100
Diabetes Treatment
food intake - glucose uptake = glycemic balance
- insulin and exercise impact glucose uptake
Type 1 diabetes
- regular and __________ lifestyle (eating times, amounts/types of food, physical activity)
- Insulin replacement therapy
Type 2 diabetes
- Address diet
- focus on exercise
- weight control
- some pharmaceutical therapy (__-__% of type 2 diabetics on insulin replacement)
consistent
30-40%
Type 2 Prevention
- weight loss, change in diet, exercise
- regular/consistent exercise significantly _______ the risk of developing type 2 diabetes (nothing voids these benefits)
reduces
Exercise and Diabetes Treatment
- Exercise increases insulin ___________. May last several hours. May last up to _ days following long duration, high intensity bout of exercise. Allows the cell to take in more _______.
- Exercise decreases insulin production and blood insulin levels: need to be careful, may take too much glucose from the blood.
- Exercise increases glucagon secretion (usage) when blood glucose levels drop
sensitivity
glucose
Type 2 Diabetes & Exercise
- Increases _______ sensitivity and can lead to improved glycemic control
- Best response in those with mild to moderately impaired glycemic control
insulin
Type 2 Diabetes and Exercise Prescription (Aerobic)
1) Frequency
- key factor (do not want to go more than _ days without an exercise bout)
2) Intensity
- moderate, 50-70% HRR
- duration is ____ important than intensity
3) duration
- aiming for __ minutes of continuous exericse
- > 45 min increases the risk of hypoglycemia (keep simple carb on hand)
4) Mode
- emphasis on _____ muscle groups
Diabetics tend to exercise ____ than normal individuals: need to educate to encourage compliance
1) 2
2) more
3) 20
4) large
less
Type 2 Diabetes and Exercise Prescription (Resistance)
1) Frequency
- 2-3x/wk, 8-10 exercises, 1-3 sets, 10-15 reps, moderate to vigorous intensity
- careful with vigorous intensity (val salva maneuver)
Resistance training important for building muscle mass, which will increase ________ metabolic rate, which helps decrease ___ mass.
resting, fat
Type 1 Diabetes and Exercise
- Physical activity does ___ improve long term glucose control (but does help with other long term health complications
Special considerations
- hyperglycemia and ketosis
- hypoglycemia: should not exercise within 1 hr of _______ injection, should not inject close to exercised muscle, consume carbs every 30 min, eat meal 1-3 hr prior to exercise
not
insulin
True or false: intermittent exercise can effectively improve glycemic control in a diabetic.
false
Han et al
Both resistance exercise and aerobic exercise may be effective on patients with type _ diabetes, evident by A1c, SBP, DBP, HDL, HOMA-IR (insulin resistance), TG (triglycerides) and TC (total cholesterol). There is __ significant difference in their impact on type _ diabetes.
2
no, 2
