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Principles Of Fitness Training (KPER 3512) Final Exam > Ch. 21 - Diabetes > Flashcards

Ch. 21 - Diabetes Flashcards

(71 cards)

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1
Q

How is diabetes characterized?

A

As a group of metabolic diseases characterized by hyperglycemia

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2
Q

What are some diagnostic tests for diabetes?

A
  • Fasting blood glucose levels
  • Oral glucose tolerance test
  • Hemoglobin A1C level
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3
Q

How does the prevalence of diabetes change with age?

A

The prevalence increased with age:
* 1-19 (0.3%)
* 20-39 (1.7%)
* 40-64 (10.9%)
* 65+ (27.0%)

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4
Q

What is the criteria for diagnosis of prediabetes?

A

FPG of 100 mg-dl (5.6 mmol) to 125 mg-dl (6.9 mmol)

Fasting plasma glucose

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5
Q

What is the criteria for diagnosis of diebetes?

A

FPG ≥126 mg-dl (7.0 mmol)

Fasting plasma glucose

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6
Q

What is the pathophysiology of type 1 diabetes?

A

Deficiency of insulin attributable to autoimmune destruction of beta cells of the pancreas

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7
Q

What is the pathophysiology of type 2 diabetes?

A

Insulin receptors on the cells of the body insensitive or resistant to insulin

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8
Q

What are some risk factors for type 2 diabetes?

A

Increased risk with:
* Age
* Obesity
* Lack of physical activity: Certain racial or ethnic groups also at higher risk

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9
Q

Why is screening important for individuals with diabetes regarding exercise?

A

Given higher risk for CVD

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10
Q

Do medical clearance recommendations for exercise testing differ?

(diabetes)

A

Yes, between the American Diabetes Association and the ACSM

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11
Q

What does the need for exercise testing depend on in individuals with diabetes?

A

An individual’s risk factors and on the intensity of the exercise program

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12
Q

Should individuals with diabetes follow general exercise guidelines for healthy adults?

A

Yes, with some considerations

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13
Q

What is the recommended frequency for aerobic exercise for individuals with diabetes?

A

3 to 7 days per week with no more than 2 days between exercise sessions to decrease insulin resistance

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14
Q

What is the recommended frequency for resistance training for individuals with diabetes?

A

2 or 3 days per week

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15
Q

What is the recommended frequency for flexibility exercises for individuals with diabetes?

A

At least 2 or 3 days per week

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16
Q

What are the recommendations for balance training for individuals with diabetes aged 50 years and older?

A

Recommended 2 or 3 times per week

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17
Q

What is the definition of hypoglycemia?

A

Blood glucose <70 mg-dL (<3.9 mmol/L)

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18
Q

What should be available for treatment of Hypoglycemia?

A

Carbohydrate sources

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19
Q

How can hypoglycemia be prevented in individuals with diabetes and exercise?

A
  • Client can work with physician to adjust diet and insulin use
  • Activities may need to be adjusted within the workout session
  • Minimize the risk of exercise-induced nocturnal hypoglycemia
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20
Q

When can hyperglycemia occur with exercise in individuals with diabetes?

A

Due to consuming too much carbohydrate before or during exercise or reducing insulin levels excessively

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21
Q

What types of exercise can promote hyperglycemia?

A
  • Sprinting
  • Brief intense exercise
  • Heavy powerlifting
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22
Q

What should be checked if blood glucose is ≥250 mg-dL/14.0 mmol/L?

A

Ketones

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23
Q

What action should be taken if ketones are elevated?

A

Postpone or suspend exercise

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24
Q

What are some additional considerations for individuals who have had diabetes for several years?

A
  • Peripheral neuropathy
  • Diabetic retinopathy
  • Autonomic neuropathy
  • Nephropathy
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25
What are some signs of type 1 diabetes?
* Fatigue * Thirst * Frequent urination * Hunger * Mood changes
26
What are symptoms of type 1 diabetes?
* Weight loss * Blurry vision * Prone to infections
27
What are some signs of type 2 diabetes?
May include: * Thirst * Frequent urination * Fatigue or frequently(?) There are **no overt signs**, usually **organ failure** is the **identifier**
28
What are symptoms for type 2 diabetes?
* Kidney failure * Heart disease * Blindness * Amputation
29
What percentage of diabetes cases are **type 1**?
5 – 10%
30
What is the underlying issue? | (type 1 diabetes)
* Absolute **insulin deficiency** * Abrupt onset * Can be caused by a virus, toxins or autoimmune stimulation
31
What is required for the treatment of **type 1** diabetes?
* Insulin required/pharmacotherapy * Dietary management
32
Are **oral hypoglycemics** effective for treating **type 1** diabetes?
**NOT** effective
33
What percentage of diabetes cases are **type 2**?
85 – 90%
34
What is the underlying issue? | (type 2 diabetes)
* A relative insulin deficiency * May have elevated, reduced or normal insulin levels
35
What are some treatments for **type 2** diabetes?
* **Nutrition** intake * Regular **daily exercise** * **Oral hypoglycemics** are **effective**
36
Do all patients require insulin? | (type 2 diabetes)
**20 – 30%** of patients require insulin
37
What monitoring is important for **type 2** diabetes?
Monitor BGL
38
What are three factors that influence **Gestational Diabetes**?
* Genetic predisposition * A decrease in insulin action * Impaired β cell function
39
How does glucose tolerance change during **gestation**?
Worsens
40
Can exercise training be effective in treating GD? | (gestational diabetes)
Yes
41
Whose involvement is critical in treating GD?
Physician involvement & direction
42
**1.** When does the risk of hypoglycemia increase with exercise? **2.** When might it occur after exercise?
**1.** As exercise intensity or duration **increases** **2.** May occur **4 – 6** hours **post-exercise**
43
What monitoring should occur around exercise to prevent hypoglycemia?
Measure BGL **before, during and after** exercise
44
When should exercise be **delayed**? | (hypoglycemia)
If blood glucose is **>14 mmol/l**
45
**1.** What should be consumed prior to exercise if BGL is low? **2.** What should be readily availible?
**1.** Consume CHO prior to exercise if BGL is <5.5 mmol/l **2.** CHO
46
Is **hyperglycemia** commonly seen during exercise in individuals with **Type 1** diabetes?
No, it is rarely seen
47
When should BGL be measured during exercise to monitor for **hyperglycemia**?
Before, during (30 min) and 15 min after exercise
48
When should exercise be **avoided** in relation to **insulin activity**?
**Avoid** exercise during periods of **peak insulin** activity
49
What might be needed before unplanned exercise? | (hyperglycemia)
Extra CHOs
50
What adjustments might be needed for planned exercise? (Diabetes)
Adjust insulin dosages accordingly
51
What are some factors to consider when prescribing exercise for individuals with diabetes?
* **Use and type of medication** to lower blood glucose (insulin or oral hypoglycemic agents) * **Timing** **of** medication **administration** * Blood glucose level prior to exercise * **Timing, amount, and type** of **previous food** intake * **Presence** and **severity** of diabetic **complications** * Use of **other medications** secondary to diabetic complications * Intensity, duration, and type of exercise
52
How might insulin dosage need to be adjusted around exercise?
The amount of insulin used surrounding exercise will usually have to be **decreased** to **prevent hypoglycemia**
53
What range of insulin types are available?
* **Rapid** acting * **Long** acting
54
Are there concerns with exercise when taking **Biguanides**?
No concerns
55
What concern might arise with exercise when taking **Glucosidase inhibitors**?
May produce **hypoglycemia** with **postprandial** exercise
56
What concern might arise with exercise when taking **Meglitinides**?
May produce **hypoglycemia** with **postprandial** exercise
57
What concern might arise with exercise when taking **Secretagogues**?
May produce **hypoglycemia** during or after exercise
58
What concern might arise with exercise when taking **Thiazoladinediones**?
No hypoglycemia **unless** taken with another drug
59
What concern might arise with exercise and treating **hypoglycemia** when taking **Exanitide** or **Pramlintide**?
May **interfere** with **absorption** of CHO
60
# Specific exercise testing Use proticols for populations at risk of CAD for: | (6)
* **Type I** diabetics **over 30 years** of age * Have **type I** diabetes **longer than 15 years** * **Type II** diabetics **over the age of 35** years * Have either **type I or type II** diabetes **and** one or more **other CAD risks** * Have **suspected** or **known CAD** * Have any **microvascular** or **neurological** diabetic **complications**
61
What is the recommendation if a diabetic client does not meet the criteria for specific exercise testing?
Exercise testing can proceed as it would in normal healthy population
62
What are some metabolic benefits of exercise training for individuals with diabetes?
* **Improved** insulin sensitivity * **Improved** blood lipids and lipoproteins * **Increased** caloric expenditure (decreased body weight & body fat, increased lean body mass) * **Improved** physical fitness * **Improved** flexibility and strength * **Decreased** blood pressure in client’s with hypertension * **Decreased** risk of CV disease * **Improved** wellbeing - quality of life & self-esteem
63
What are the recommended FITT principles for **aerobic** exercise for **type 2** diabetes?
* **F:** **3-7** days/wk (**no more than 2 consecutive days of rest** b/t sessions) * **I:** **40-89% HRR** (**11-17/20** Borg RPE) * **T:** **150-300** min/wk of **moderate** intensity; **75-150** min/wk of **vigorous** intensity * **T:** Any large muscle group & repetitive physical activities
64
What are the recommended FITT principles for **resistance** exercise for **type 2** diabetes?
* **F:** **2-3** days/wk; **non-consecutive** days * **I:** **50-85% 1RM** (moderate to vigorous) * **T:** **1-3 sets x 6-20+ repetitions**; **8-10 exercise** w/ major muscle groups * **T:** free weights, machines, elastic bands, body weight exercises
65
What are the recommended FITT principles for **flexibility** exercise for **type 2** diabetes?
* **F:** ≥2-3 days/wk * **I:** to the point of slight discomfort or tightness * **T:** 10-30 sec per stretch x 2-4 reps/stretch * **T:** static, dynamic, PNF
66
What are the recommended FITT principles for **balance** exercise for **type 2** diabetes?
* **F:** ≥2-3 days/wk * **I:** not prescribed * **T:** not prescribed * **T:** balance-based exercises; core stability Tx, Tai Chi, Yoga etc.
67
What level of **hyperglycemia** is a **contraindication** to exercise in diabetic clients?
>**14** mmol/l or **250** mg/dl
68
What level of **hypoglycemia** is a **contraindication** to exercise in diabetic clients?
<**5.5** mmol/l or **100** mg/dl
69
What eye condition is a **contraindication** to exercise in diabetic clients?
Active retinal hemmorrhage
70
When is illness or infection a **contraindication** to exercise in diabetic clients?
When present
71
What severe diabetic complications are contraindications to exercise?
* Neuropathy * Nephropathy * Evidence of underlying CV disease

Principles Of Fitness Training (KPER 3512) Final Exam (10 decks)

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