Type 2 Diabetes

Question 1

When does T2D develop?

Answer 1

Gradually mostly in adults over 40

Question 2

What is the prevalence of T2D?

Answer 2

90%

Question 3

Does T2D effect lifestyle?

Answer 3

Yes

Question 4

What are the signs and symptoms of T2D?

Answer 4

Weight loss
excessive thirst
unceasing hunger
headaches
dry mouth

Question 5

What is the HbA1c figure to show pre-diabetes?

Answer 5

42mmol/mol

Question 6

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

Answer 6

5.6-6.9mmol/L

Question 6

What is the criteria for diagnosis of T2D?

Answer 6

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

Question 7

What is T2D?

Answer 7

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

Question 8

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

Answer 8

40%

Question 9

What are the internal barriers for people with T2D?

Answer 9

-No motivation
-Health problems
-Emotions

Question 10

What are the external barriers for people with T2D?

Answer 10

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

Question 11

What are the acute responses to a bout of exercise?

Answer 11

-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

Question 12

What happens in the pancreas as a result of exercise?

Answer 12

-decrease insulin
-increase glucagon secretion

Question 13

What happens in the liver as a result of exercise?

Answer 13

-increase glucose release

Question 14

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

Answer 14

-increase triacylglycerol breakdown
-increase NEFA release

Question 15

What occurs to the microvascular recruitment during exercise?

Answer 15

Increases

Question 16

What happens to the glucose uptake during exercise?

Answer 16

increases via AMPK, TBC1D1, ROS, Rac1

Question 17

What occurs to glycolysis during exercise?

Answer 17

increases

Question 18

What occurs to fatty acid oxidation during exercise?

Answer 18

increases

Question 19

What happens to energy expenditure during exercise?

Answer 19

increases

Question 20

What occurs to the microvascular after exercise?

Answer 20

microvascular recruitment

Question 21

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

Answer 21

increases

Question 22

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

Answer 22

increases

Question 23

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

Answer 23

increases

Question 24

What happens to the level of circulating factors after exercise?

Answer 24

increases

Question 25

What are the chronic effects of exercise on muscle adaptations?

Answer 25

-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

Question 26

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

Answer 26

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

Question 27

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

Answer 27

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

Question 28

What is the frequency prescription for an individual with T2D?

Answer 28

aerobic exercise 3x per week

Question 29

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

Answer 29

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

Question 30

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

Answer 30

Greater reductions in HBA1c

Question 31

What type of exercise is beneficial in decreasing HbA1c?

Answer 31

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

Question 32

How much exercise is the most beneficial?

Answer 32

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

Question 33

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

Answer 33

metformin

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

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

Answer 36

decrease (reference- Savikj et al, 2019)

Question 37

How much exercise is recommended for an individual with T2D?

Answer 37

150min, moderate intensity

Question 38

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

Answer 38

At least 2 days a week

Question 39

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

Answer 39

Aerobic and resistance

Question 40

What type of exercise if recommended for individuals with T2D?

Answer 40

flexibility

Question 41

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

Answer 41

3 days per week

Question 42

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

Answer 42

2 days per week

Question 43

What patients with T2D are safe to exercise?

Answer 43

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

Question 44

What patients with T2D are not safe to exercise?

Answer 44

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

Question 45

What T2D treatment causes a low risk of hypoglycaemia?

Answer 45

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

Question 46

What T2D treatment causes a high risk of hypoglycaemia?

Answer 46

-Glimepiride -Glipizide -Glyburide -Nateglinide -Insulin