Diabetes and Exercise: Pathophysiology, Medications, and Guidelines

What happens to blood glucose and insulin levels during fasting?

Blood glucose drops, insulin decreases, and counter-regulatory hormones rise.

What processes does the body use to mobilize energy during fasting?

Glycogenolysis, gluconeogenesis, and ketogenesis.

What is Diabetic Ketoacidosis (DKA) and in which type of diabetes is it common?

DKA is common in Type 1 diabetes due to insulin deficiency, leading to ketone buildup, acetone breath, abdominal pain, and rapid breathing.

Is exercise recommended during Diabetic Ketoacidosis (DKA)?

Exercise is contraindicated during DKA.

What is Hyperglycemic Hyperosmolar Non-Ketotic Syndrome (HHNS) and who does it typically affect?

HHNS occurs in Type 2 diabetes, especially in the elderly with prolonged illness, characterized by extreme hyperglycemia and dehydration.

Is exercise recommended during Hyperglycemic Hyperosmolar Non-Ketotic Syndrome (HHNS)?

Exercise is contraindicated.

What are Sulfonylureas and what is their risk?

Sulfonylureas stimulate insulin release and have a risk of hypoglycemia.

What is the role of Biguanides (Metformin) in Type 2 diabetes treatment?

Biguanides reduce liver glucose production.

What do Thiazolidinediones (Glitazones) do?

They improve insulin sensitivity.

What is the function of DPP-4 inhibitors?

DPP-4 inhibitors enhance incretin hormones.

What is the purpose of SGLT2 inhibitors?

SGLT2 inhibitors promote glucose excretion via kidneys.

What types of insulin are used in Type 1 Diabetes?

Rapid-acting, short-acting, intermediate, and long-acting insulin.

What are the benefits of exercise for individuals with diabetes?

Exercise improves insulin sensitivity, reduces blood glucose, enhances cardiovascular health, and increases muscle strength.

How does exercise stimulate GLUT4 translocation?

Exercise stimulates GLUT4 translocation independently of insulin.

What is the recommended exercise duration for Type 2 Diabetes?

≥210 minutes/week of moderate or 125 minutes/week of vigorous intensity.

What is the recommended exercise duration for Type 1 Diabetes?

≥150 minutes/week of moderate intensity.

What should be included in a weekly exercise routine for individuals with diabetes?

At least 2 resistance training sessions weekly and avoid more than 2 consecutive days without exercise.

What should be reviewed in the pre-exercise checklist for diabetes management?

Type of diabetes, medications, blood glucose levels, and comorbidities.

What special considerations should be taken for individuals with Peripheral Neuropathy?

There is a risk of foot injuries; proper footwear should be used.

What is a professional practice tip for managing diabetes and exercise?

Collaborate with endocrinologists and dietitians to tailor exercise programs to individual needs.