Type 1 Diabetes

Question 1

What is the onset of type 1 diabetes?

Answer 1

Sudden onset

Usually occurs in children (<18 years old)

Typically between ages 8-13 years old

Question 2

What is the prevalence of type 1 diabetes in diabetes diagnosis?

Answer 2

8%

Question 3

Is type 1 diabetes influenced by lifestyle?

Answer 3

No

Question 4

What causes type 1 diabetes?

Answer 4

Beta cell functions stops producing insulin

Beta cells are effected by autoimmune response

Causes attacking on pancreas, the organ which releases insulin and causes inhabitation of insulin production

Question 5

What are the main symptoms of type 1 diabetes prior to diagnosis?

Answer 5

Weight loss

Frequent urination

Irritability

Blurry vision

Fruity breath

Question 6

What is the main main symptom of type 1 diabetes?

Answer 6

Fruity breath

Question 7

How does type 1 diabetes control blood glucose ?

Answer 7

Exogenous insulin

Question 8

What is the issue of a HbAIc test for testing type 1 diabetes?

Answer 8

The timing range could differ but will still lead to same average

Does not show variability

Makes it inappropriate for type 1 diabetes

Question 9

How does the C-Peptide test determine type 1 diabetes?

Answer 9

Low C-Peptide (<0.51 ng/ml) and High blood glucose

Question 10

What is ELSA testing?

Answer 10

Antibody testing for children

Early diagnosis of Type 1 in Children

Question 11

How does ELSA testing determine likelihood of developing type 1 diabetes?

Answer 11

By the number of antibodies positive

1 antibody= lower risk
2 antibody= high risk
3 antibody= higher risk
4 antibody= highest risk

Question 12

Why is prescribing exercise to type 1 diabetes challenging?

Answer 12

Muscle energy source uses:
1) ATP from C-Peptide initially
2) Glucose from muscle glycogen
3) Glucose from liver glycogen
4) Glucose from gluconeogenesis

Prolonged aerobic metabolism
- FFA and Ketones are the main fuel

Increasing intensity and duration increases glucose usage
- Mediated by falling insulin, increasing glucagon
- Intense exercise causes increase in catecholamines and later growth hormone

Question 13

What are the effects of exercise on glucose in individuals with type 1 diabetes?

Answer 13

Aerobic exercise
- Expect a drop in glucose levels

Strength exercise
- Expect spikes in glucose levels

Mixed exercise
- Expect glucose levels to fluctuate, can drop or spike

Question 14

What are internal barriers to exercise for people with type 1 diabetes?

Kennedy et al. 2018

Answer 14

Time and environmental
Social and Personal
Psychological

Question 15

What are the medical barriers to exercise for people with type 1 diabetes?

Kennedy et al. 2018
Lascar 2014

Answer 15

Hypoglycaemia- Biggest fear
Lack of knowledge
Other health problems
Overwhelming by the diagnosis

Question 16

Is exercise beneficial at reducing HbAIc in people with type 1 diabetes?

Umpierre et al. 2013

Answer 16

Yes

Can also lead to a preservation of B-Cell function

Question 17

How does aerobic and resistance exercise effect glucose levels in individuals with type 1 diabetes?

Yardley et al. 2012

Answer 17

Resistance exercise resulted in much smaller declines in blood glucose during exercise than aerobic exercise or no exercise in individuals with type 1 diabetes

Resistance exercise was also associated with relatively stable early postexercise glucose concentration

Aerobic exercise was associated with greater increases in glucose levels during early recovery, which resulted in a trend toward higher glucose concentrations in late recovery

Question 18

How does repeated resistance exercise influence glucose levels?

Turner et al. 2015

Answer 18

Blood glucose significantly climbs above rest for 1hour after 1/2 sets of resistance exercise but a 3rd set attenuated the exercise-induced hyperglycaemia and returns blood glucose levels

Question 19

How does performing resistance exercise influence glucose levels depending if its performed before or after aerobic exercise?

Yardley et al. 2012

Answer 19

Perform resistance exercise first if they tend to develop exercise associated hypoglycaemia
- leads to lower reliance on glucose supplementation during exercise
- decreases the severity of potential nocturnal hypoglycaemia

Question 20

How does performing resistance exercise influence glucose levels and hypoglycaemia depending if its performed in the morning or afternoon?

Gomez et al. 2015

Answer 20

Significantly fewer hypoglycaemic events if the exercise was conducted in the morning

Most episodes of postexercise hypoglycaemia occur between 15 and 24 hours after the cessation of exercise

Exercise in the morning improves metabolic control on the subsequent day and maintains patients in the euglycemic range for a longer time

Question 21

How does intermittent high-intensity exercise influence glucose levels compared to moderate exercise?

Answer 21

The decline in blood glucose is less with intermittent high-intensity exercise during both exercise and recovery

however

the risk of hypoglycaemia is increased with moderate exercise

Question 22

What influences the effect of resistance exercise on glucose levels?

Answer 22

Volume of exercise
- sets
- volume

Question 23

What is ICE?

Answer 23

Insulin
Carbohydrate
Exercise type

Question 24

Why do you have fruity breath when you have type 1 diabetes?

Answer 24

Ketones level are higher when glucose levels are increased repetitively

Question 25

What is the energy source order during exercise?

Answer 25

Muscle energy source uses:
1) ATP from C-Peptide initially
2) Glucose from muscle glycogen
3) Glucose from liver glycogen
4) Glucose from gluconeogenesis

Question 26

What is Hyperinsulinemia?

Answer 26

Happens when you have a higher amount of insulin in your blood than what is considered normal