Type 2 diabetes

Question 1

Overall prevalence of T2 diabetes and reference

Answer 1

90% all cases are type 2 - Ahmad et al 2022

Question 2

Definition of T2 and ref

Answer 2

A metabolic disorder and is a result of failed insulin response, known as insulin resistance, which heightens blood glucose levels out of normal range, called hyperglycaemia - Albert 1998

Question 3

Onset of T2 diabetes

Answer 3

Normally in midlife, >40 years old. However, can be presented in younger age groups, including children

Question 4

Causes of T2

Answer 4

Lifestyle

Question 5

Symptoms of T2

Answer 5

• excessive thirst
• weight loss
• unceasing hunger
• headaches
• dry mouth

Question 6

When is T2 diagnosed

Answer 6

Presenting symptoms and a random blood glucose test displaying >11 mmol/L

Question 7

Consequences of T2

Answer 7

• Micro and macrovascular problems, including nerve damage such as retinopathy and nephropathy
• CVD and other co-morbidities, such as obesity and hypertension

Question 8

How many people with T2 meet the ACSM guidelines - provide ref

Answer 8

<40% - Cassidy 2016

Question 9

What benefits are provided when the ACSM guidelines are meet, in terms of T2

Answer 9

• 150 mins/week reduces risk of T2 by 26%
• 300 mins/week reduces risk by 36%
  Schellenberg, 2013

Question 10

What physiological benefits are associated with T2 diabetes - provide ref

Answer 10

• Reduced HbA1c levels
• Improved glucose uptake and insulin sensitivity, due to improved beta cell function
• Decreased inflammation, CRP
• Reduces risk of CV event and co-morbidity
• Reduces risk of micro and macrovascular complications
  Kirwan 2017

Question 11

What type of exercise is best - with ref

Answer 11

• All intensities beneficial at reducing HbA1c (Houmard, 2004)
• HIIT exercise sees greatest improvements. 8 week programme effective (Dela 2004)
• 12 week aerobic programme also effective (Umpierre, 2013)
• Supervised exercise compared to PA guidance more effective (Umpierre, 2011)

Question 12

Physiological adaptations to exercise

Answer 12

• Greater recruitment of vasculature, including micro and macro eventually leads to capillarisation with regular training
• Acute bouts stimulates AMPK and TBC1D1, regular exercise improves insulin sensitivity

Question 13

Gaps in research

Answer 13

• LT interventions
• Effect of exercise and medication for T2, e.g. metformin
• Older people

Question 14

Blood glucose test ranges for fasting

Answer 14

Diabetic: >7
Pre: 5.6-7
Healthy 3.6-5.5

Question 15

Blood glucose test ranges for post-prandial

Answer 15

Diabetic: >11
Pre: 9-10.9
Healthy: 3.9-8.9

Question 16

Ranges for HbA1c

Answer 16

Diabetic: >48%
Pre: 42-48%
Healthy: <42%

Question 17

What type of test is a blood glucose test

Answer 17

Cross sectional

Question 18

What type of test is HbA1c

Answer 18

Longitudinal test, typically across 3 months

Question 19

Name 4 other tests for diabetes

Answer 19

1. Oral glucose test
2. Glucose clamp
3. C-peptide test
4. Continuous glucose monitor

Question 20

Acute responses to exercise

Answer 20

Pancreas
- reduced insulin release, increased glucagon release
Liver
- increased glucose release
Adipose
- TG breakdown