Term
| What is the difference b/w PA and exercise? |
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Definition
-Physical activity: includes all movement that increases energy use
-Exercise: planned, structured PA |
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Term
| How is aerobic exercise defined? |
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Definition
| Aerobic exercise is the repeated and continuous movement of large muscle groups |
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Term
| What benefits does HIIT provider for DM2, is it safe for DM1? |
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Definition
For DM2 -
1. promotes rapid enhancement of skeletal muscle oxidative capacity
2. insulin sensitivity
3. glycemic control
For DM1 is safe to do |
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Term
| T/F: resistance exercise in DM1 can assist in minimizing risk of exercise-induced hypoglycemia |
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Definition
| True, although effect of resistance exercise on glycemic control in DM1 is unclear |
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Term
| What is the benefit of performing resistance exercise before aerobic exercise? |
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Definition
| When resistance exercise is performed before aerobic it results in less hypoglycemia |
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Term
| T/F: stretching affects glycemic control |
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Definition
| False, stretching does not affect glycemic control but does increase range of motion around joints and flexibility |
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Term
| T/F: the benefits of tai chi and yoga in DM have been well established |
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Definition
| False - high quality studies are lacking |
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Term
| A 13 yo w/ DM2 comes in to your office, his mom asks how active he should be. What should you tell her? |
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Definition
-Peds w/ and w/out DM have the same exercise recommendations
-want a min of 60min/d of moderate-vigorous PA and include strength-related exercise at least 3d/wk |
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Term
| A patient comes in and says they are interested in being active but only have 15-20min a day, they are physically fit w/ no health complications, what is the best exercise for the most benefit? |
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Definition
| If they do 20min of very high intensity (near-maximal effort)can improve glycemic control for up 24 hours |
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Term
| A patient w/ DM2 comes in, they are only able to do moderate intense PA, to get the most benefit what should their ultimate exercise goal be? |
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Definition
| If they are able to exercise for at least 60min at low-intensity it can enhance insulin action for up to 24 hours |
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Term
| T/F: in order to improve insulin action in sedentary adults they need to expend an additional 3500kcals/wk |
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Definition
| False - expending just 400kcal/week imrpoves insulin action in previously sedentary adults |
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Term
| What was the Look AHEAD study and what did it find? |
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Definition
-largest randomized trial looking at lifestyle intervention compared to usual care
-intensive lifestyle intervention had improved wt loss, BG control, BP, lipids, less meds, less sleep apnea, less severe diabetic kidney disease and retinopathy, less depression, sexual dysunftion, urinary incontinence, knee pain
-no difference present in major cardio events |
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Term
| T/F: for glycemic control, combined cardio and strength training is superior to either one alone |
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Definition
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Term
| T/F: for glycemic control, combined cardio and strength training is superior to either one alone |
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Definition
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Term
| By what % can resistance training improve A1c? |
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Definition
| Resistance exercise can improve A1c by 0.57% |
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Term
| T/F: there is currently insufficient evidence on the ideal type, timing, intensity and duration of exercise for optimal glycemic control |
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Definition
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Term
| A pt w/ DM2 on glipizide and metformin tells you they have started walking 45min 3 days a week, they check their BG before exercising and it is usually about 90, they've noticed they routinely go low during/after exercise, what can you tell them? |
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Definition
| Given the amt and intensity of exercise and BG before, they should consume about 10-15g carbs before, to avoid wt gain, see if they can time walking after a typical meal or snack. |
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Term
| A pt w/ DM2 comes in and is interested in starting weight training in the middle of the day, they want to know if they need to add in a snack before doing so, they aren't planning on doing any cardio or other low-intensity activity. |
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Definition
| Have them check their BG before weight training, if it is <90 they can try having 10-15g carbs and then check BG after, if BG is higher, likely don't need a snack |
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Term
| A patient comes in for a routine f/u, you notice they are wearing exercise clothes, they say they are planning on going for a run after the apt. They check their BG in the office and find it is 321, you check for ketones and a moderate amt are found, what should you/the patient do? |
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Definition
| -because BG is 250-350 and ketones are present, have the pt wait to exercise until glucose is <250 and ketones are no longer present |
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Term
| Why should a patient w/ BG >250 and ketones present not engage in intense exercise? |
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Definition
| Intense exercise can exaggerate hyperglycemica; intense exercise should be delayed until BG <250 |
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Term
| A pt w/ DM2 comes in and you are reviewing their BG logs, you notice their numbers before they walk are usually around 200, and they are having a piece of toast before walking, what change should you make? |
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Definition
| Since BG before walking is b/w 150-250, tell the pt to try not having toast before walking and then check BG after, they should take carbs and their meter w/ them, if BG become <150 can have a snack while exercising |
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Term
| A pt w/ DM2 comes in, you are reviewing their log book and notice they're numbers are mostly 90-140 with some lows while exercising, what should you do? |
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Definition
| See if pt can time exercise after a planned meal or snack, if they are on insulin consider reducing dose before activity, pt can also consume 0.5-1g/kg carbs per hr of activity |
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Term
| T/F: In DM1, a cardiac event is a possible exercise-induced adverse event |
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Definition
| False- the only common exercise-induced adverse event is hypoglycemia |
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Term
| What are the potential risks of PA for pts w/ DM2? |
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Definition
-cardiac events
-hypoglycemia
-hyperglycemia |
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Term
| A pt comes in and is interested in doing HIIT, they want to know what the optimal training plan for it is, can you give them one? |
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Definition
| No, currently the optimal HIIT training protocol has yet to be determined |
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Term
| How long should an aerobic bout ideally last for DM2? |
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Definition
| Aerobic activity bouts should ideally last at least 10min w/ goal of 30min/d on most days of the week |
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Term
| A patient asks you if they need to have a supervised exercise plan, what are some things you can tell them? |
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Definition
| -all exercise is beneficial, but doing supervised has been shown to lower A1c in absence of dietary changes, unsupervised has been shown to lower but only w/ dietary changes |
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