Type 1 Diabetes

What is the pathophysiology?

Immune system destroys pancreatic beta cells
= hyperglycaemia as insulin is required for glucose uptake into cells

What are the treatments involved in T1DM

Insulin therapy
Lifestyle management (diet, exercise, education) 
Regular monitoring of HbA1c and blood glucose levels

What are the considerations for exercise

Precaution when exercising in extreme temperature
Ensure adequate hydration
Test BGL/ketones
Have glucose supply, medications, glucometer on hand
ensure optimal time for exercise

What is are the Change in Clinical Status

Can develop neuropathy, retinopathy, and cardiovascular disease 
Exercise tolerance may decrease

What are some barriers to exercise pt1

Complications or Co-morbidities

How can you address complications of comorbidities

Modify activities to avoid aggravating conditions
Collaborate with physicians and allied health professionals

What are some barriers to exercise pt2

Fear of Hypoglycemia

How can you address Fear of Hypoglycemia

Use continuous glucose monitoring (CGM)
Start with low-to-moderate intensity exercises easier to monitor and manage

What are some barriers to exercise pt3

Lack of Knowledge or Confidence leading to avoidance

How can you address Lack of Knowledge or Confidence leading to avoidance

Offer education sessions with diabetes educator
Discuss benefits with client on benefits of exercise (increase insulin sensitivity etc.)

What specific types of aerobic exercise can be completed

Walking
Cycling
Rowing

What is the justification for aerobic exercise

Improves insulin sensitivity and promotes glucose uptake into muscle.
Reduces cardiovascular risk
Lower blood glucose gradually

What is the justification of Resistance training

Increases muscle mass, which improves glucose uptake due to greater storage
Enhances Insulin Sensitivity insulin works more efficiently, lower BGL

What is an appropriate exercise plan

Aerobic: 150 minutes/week of moderate-intensity
Strength + balance: 2–3 sessions/week, major muscle groups, moderate intensity

What is a clinican based goal pt1

Improve Glycemic Control and Insulin Sensitivity

Justification for Improve Glycemic Control and Insulin Sensitivity

Contributes to lowering HbA1c over time reduces the risk of both short- and long-term diabetes complications

What is a clinican based goal pt2

Reduce Risk of Acute Hypoglycemia During/After Exercise

Justification for Reduce Risk of Acute Hypoglycemia During/After Exercise

major barrier to exercise in T1DM if able to reduce improves adherence and builds confidence

What is a clinican based goal pt3

Enhance Cardiovascular Fitness

Justification for Enhance Cardiovascular Fitness

reduces this risk of developing cardiovascular disease and supports better overall health and energy levels