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Exercise as medicine exam > Type 2 Diabetes > Flashcards

Type 2 Diabetes Flashcards

1
Q

When does T2D develop?

A

Gradually mostly in adults over 40

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2
Q

What is the prevalence of T2D?

A

90%

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3
Q

Does T2D effect lifestyle?

A

Yes

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4
Q

What are the signs and symptoms of T2D?

A

Weight loss
excessive thirst
unceasing hunger
headaches
dry mouth

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5
Q

What is the HbA1c figure to show pre-diabetes?

A

42mmol/mol

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6
Q

What is the plasma glucose figure that shows pre-diabetes?

A

5.6-6.9mmol/L

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6
Q

What is the criteria for diagnosis of T2D?

A

-HbA1c > 42mmol/mol
-plasma glucose 5.6-6.9mmol/L
-symptoms

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7
Q

What is T2D?

A

a metabolic disorder characterised by hyperglycaemia due to disorders of insulin secretion and insulin action

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8
Q

What % of adults with T2D report being engaged in regular moderate to vigorous PA?

A

40%

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9
Q

What are the internal barriers for people with T2D?

A

-No motivation
-Health problems
-Emotions

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10
Q

What are the external barriers for people with T2D?

A

-Lack of social support
-Lack of facilities
-cultural barriers
-Poor weather

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11
Q

What are the acute responses to a bout of exercise?

A

-increased respiratory frequency
-increased tidal volume
-increased lung ventilation
-increased HR
-increased SV
-increased cardiac output
-increased cardiorespiratory function(= greater substrates+ oxygen delivery to muscles)
-NFTA oxidised at low intensities

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12
Q

What happens in the pancreas as a result of exercise?

A

-decrease insulin
-increase glucagon secretion

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13
Q

What happens in the liver as a result of exercise?

A

-increase glucose release

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14
Q

What occurs in the adipose tissue as a result of exercise?

A

-increase triacylglycerol breakdown
-increase NEFA release

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15
Q

What occurs to the microvascular recruitment during exercise?

A

Increases

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16
Q

What happens to the glucose uptake during exercise?

A

increases via AMPK, TBC1D1, ROS, Rac1

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17
Q

What occurs to glycolysis during exercise?

A

increases

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18
Q

What occurs to fatty acid oxidation during exercise?

A

increases

19
Q

What happens to energy expenditure during exercise?

A

increases

20
Q

What occurs to the microvascular after exercise?

A

microvascular recruitment

21
Q

What happens to the insulin-stimulated glucose uptake after exercise?

A

increases

22
Q

What happens to the transcription of HKII, GLUT4, PGC-1a after exercise?

A

increases

23
Q

What happens to glycogen synthesis and fatty acid oxidation after exercise?

A

increases

24
Q

What happens to the level of circulating factors after exercise?

A

increases

25
Q

What are the chronic effects of exercise on muscle adaptations?

A

-increased capillarisation
-increased basal insulin sensitivity
-increase protein expression of GLUT4, mitochondrial proteins
-increase substrate utilisation capacity
-altered expression of >170 proteins
-repeated effects of the last acute exercise bout during and after

26
Q

What people have a 26% lower risk of developing T2D?

A

the people that are moderately active for 150mins per week
(reference- Schellenberg et al 2013)

27
Q

What increases the % risk of developing T2D to 36% lower risk?

A

being active for 300mins per week
(reference- Blomster et al, 2013)

28
Q

What is the frequency prescription for an individual with T2D?

A

aerobic exercise 3x per week

29
Q

How much exercise was seen to improve insulin sensitivity regardless of the intensity?

A

170min per week
(reference- Houmard et al, 2004)

30
Q

What does an increase intensity of exercise elicit in an individual with T2D?

A

Greater reductions in HBA1c

31
Q

What type of exercise is beneficial in decreasing HbA1c?

A

-all of them
-aerobic- 0.73%
-resistance- 0.56%
-combined-0.67%

32
Q

How much exercise is the most beneficial?

A

The more you do the better
->150mins= -0.89%
-<150mins= -0.36%

33
Q

What medication is PA just as good at for treating T2D?

A

metformin

34
Q

What can exercise help to reset which is dysregulated in individuals with T2D? what is it mediated by?

A

-Dysregulated muscle clock
(circadian rhythm)
-mediated by the inner-mitochondrial membrane

35
Q

What occurs to blood glucose if an individual exercises in the morning?

A

increase in blood glucose (circadian levels already higher in the morning)

36
Q

What occurs to blood glucose if an individual exercises in the afternoon?

A

decrease
(reference- Savikj et al, 2019)

37
Q

How much exercise is recommended for an individual with T2D?

A

150min, moderate intensity

38
Q

How many times a week should adults undertake muscle strengthening activities?

A

At least 2 days a week

39
Q

What type of exercise is highly recommended for individuals with T2D?

A

Aerobic and resistance

40
Q

What type of exercise if recommended for individuals with T2D?

A

flexibility

41
Q

How many times a week should an individual with T2D be aerobically training?

A

3 days per week

42
Q

How many times a week should an individual with T2D be resistance training?

A

2 days per week

43
Q

What patients with T2D are safe to exercise?

A

-Normal Retinopathy
-Diabetic Retinopathy
-Stage 0,1, 2 diabetic foot ulcers
-chronic kidney disease stage 1, 2, 3, 4, 5,

44
Q

What patients with T2D are not safe to exercise?

A

-proliferative retinopathy
-stage 3, 4, 5, diabetic foot ulcers

45
Q

What T2D treatment causes a low risk of hypoglycaemia?

A

-metformin
-DPPIV inhibitor
-GLP-1
-SGLT-2
-Miglitoll
-Rosiglitizone

46
Q

What T2D treatment causes a high risk of hypoglycaemia?

A

-Glimepiride
-Glipizide
-Glyburide
-Nateglinide
-Insulin

Exercise as medicine exam (15 decks)

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