EXSC 737 Exam 2

Diabetes mellitus

characterized as elevated blood glucose

diabetes imposes chemical trauma to vascular integrity

true

what causes diabetes mellitus

a defect in insulin serration or inability to use insulin

Type 1 DM

often caused by autoimmune destruction of insulin producing beta cells in pancreas

Type 2 DM

insulin resistant skeletal muscle

glycosylated hemoglobin (HbA1C)

reflects glucose control over a 2-3 month period goal of

Normal HbA1c levels

Normal FPG level (Fasting Plasma Glucose)

Normal HbA1c levels for DM

\>6.5%

Normal FBG (fasting blood glucose) for DM

\>126 mg dL

Benefits of exercise for Diabetes Mellitus

increased glucose tolerance
increased insulin sensitivity
decreased HbA1c

Acute and chronic exercised sensitizes skeletal muscle to insulin

True

True or false does exercise participation prevent or delay transition to T2DM for individuals with pre diabetes

true

What amount of exercise is recommended for patient with DM

Moderate intensity totaling 150 min per week

Proteome

the entire complement of proteins that is or can be expressed by a cell

Patient with DM who regularly participates in physical activity

Does not need clearance unless symptomatic

silent myocardial ischemia

patients with DM often goes undetected

What is metformin?

first line therapy for DM

side effects of metformin

increase HR and RPE

Frequency of Aerobic Exercise for DM

Aerobic 3-7 Days a week no more than 2 consecutive days

Intensity of aerobic exercise for DM

moderate to vigorous

Time for aerobic exercise for DM

Type 1 and Type 2 150 minutes per week

Type of aerobic exercise for DM

prolonged rhythmic using large muscle grounps

Frequency of resistance training for DM

minimum of 2 nonconsecutive days a week preferably 3

Intensity of resistance training for DM

Moderate (50-60% of 1 RM) to vigorous (70-85% of 1 RM) to improve strength

Time of resistance training for DM

at least 8-10 exercise. with 1-3 sets of 10-15 reps

Type of resistance training for DM

Resistance machines

Frequency of flexibility for DM

2-3 days a week

T2DM Frequency of aerobic exercise

no more than 2 consecutive days to prevent period of excessive decline of insulin action

What type of workouts are better for glucose control?

HIIT

How many grams of CHO will insulin user need to consume before exercise?

up to 15 g of CHO when starting blood glucose levels are

15 g CHO \= 1 serving CHO

is equal to 1 tablespoon

Why is exercising in the morning good for DM patients?

it elevates blood glucose levels instead of the usual decrease with moderate activity due to the interaction of circadian rhythm hormone and insulin as well as other factors

Hypoglycemia

low blood sugar

How long after exercsie can hypoglycemia occur

risk is higher during and after excursive but can occur up to 12 hours or more post exercise

Symptoms of hypoglycemia

shakiness

hyperglycemia

high blood sugar \> 250 mg dL

Symptoms of hyperglycemia include

polyuria

When should exercise be postponed in a DM patient

when both hyperglycemia and ketones are evident

For those with diabetes

pre exercise optimal blood glucose levels are

When is conservative corrective insulin therapy recommended prior to exercise

if blood glucose levels are \>350 mg dL

polyuria

excessive production of urine

Relationship between diabetes and polyuria

dehydration resulting from polyuria secondary to hyperglycemia may contribute to a compromised thermoregulatory response

Viterous Hemorrhage

activates that dramatically elevate BP will increase risk of vitreous hemorrhage (complication of retinopathy)

Activities to avoid with Diabetic Retinopathy

Vigorous intensity arebic and resistance exercise

Who gets diabetic ulcers

people with diabetic neurpathy and poor circulation may develop ulcers without symptoms

How to avoid diabetic ulcers

feet should be kept dry and using silica gel with polyester socks

Patients with nephropathy exercise does not appear to accelerate progression of kidney disease even though protein execration acutely increased after exercise

True

What percentage of people in theUS have dyslipidemia?

30%

During consistent aerobic training how many mg dL of LDL-C are reduced

3-6 mg dL

During consistent resistance training how many mg dL of LDL - C care reduced

6-9 mg dL

ideal LDL level

ideal TC

Ideal HDL levels

\>40 mg/dL for men \>50 mg/dL for women

ideal triglycerides levels

Statin drugs

hyperlipidemia drugs that reduce cholesterol by blocking the enzyme necessary for cholesterol production in the liver; HMG-CoA reductase inhibitor drugs

What type of people benefit from statins

individuals with established CVD

What is cholesterols main function?

to maintain the integrity and fluidity of cells membrane and to serve as a precursors for the synthesis of substances that are vital for the organism including steroid horses

Statins may induce muscle weakness and soreness and rhadbomyolyis

True

Exercise Testing for Dyslipidemia

exercise testing is not required for asymptotic people looking to being light to moderate training program

Frequency of Aerobic fitness for patients with dyslipidemia

\>5 days a week

Time of Aerobic fitness for patients with dyslipidemia

30-60 a day to promote or maintain weight loss
50-60 min or more of daily exercise is recommended

Intensity of Aerobic fitness for patients with dyslipidemia

40-75% of HRR

Population with hypertension

1 billion people world wide

Most individuals getting treated with medication require more than one medication

true

Hypertension is the most common and preventable symptom of CVD

True

Lifestyle factors to reduce hypertension

reduce sodium

Exercise testing for hypertensive patients

patients with uncontrolled BP with resting SBB \> 150 mm Hg and or DBP of \>90 mm Hg should consult with doctor before starting exercise program

Individuals with BP of \_________ mm Hg must NOT enable in any exercise including testing prior to medical evaluation and adequate BP management

\>160/\>90mm Hg

Is hypertension an indication for exercise testing

No it is not but it can help evaluate BP response to exercise

Individuals with HTN may have exaggerated BP response to exercise even if resting BP is controlled

True

Beta Blockers

adversely affect thermoregulatory function

Beta blockers also increase

predisposition to hypoglycemia

Cardio-specific

B1 antagonists

Non specific

Target B2 and B3 receptors

Individuals on beta blockers are more likely to

have attenuated HR response to exercise and reduced maximal exercise capacity

What special population should emphasize the importance of PRE and HR peak

Individuals on beta blockers

Individuals on dueirtic therapy may experience what

hypokalemia and other electrolyte imbalances

Calcium channel blockers

reduce the influx of calcium in cardiomyocytes during depolarization

Frequency of aerobic fitness with individuals with hypertension

\>5-7 days a week

Intensity for aerobic fitness for individual with hypertension

moderate 40-59% of HRR or 12-14 on RPE

Time for aerobic fintness for individual with hypertension

\>30 minutes a day of continuous or accumulated exercise

Relative indication to stop fitness test for hypertensive patient

BP of \>250/115 mmHg

What intensity is the benefit to risk ratio of aerobic fitness for individuals with hypertension

moderate intensity

What maneuver can result in high BP responses in hypertensive patients

Valsalva Maneuver

Post exercise considerations for hypertensive individuals

gradual termination of exercise due to anti-hypertensive medications can lead to sudden reduction in BP post exercise

Cool down period for hypertensive patients should be extended

true

Overweight BMI is defined as

25-29.9 kg*m^2

Obesity BMI is defined as

30 kg*m^2

What percent of Us adults are classified as overweight or obese

70%

What percentage of youth are overweight or obese?

32%

Physical activity for overweight and obese individuals promoting minimal weight lose for 12-18 months

Physical activity for overweight and obese individuals promoting modest weight loss of 2-4 kg (4-6 lbs) 12-18 months

\>150 minutes per week

Physical activity for overweight and obese individuals promoting modest weight loss of 5-7.5 kg (11-16.5 lbs) 12-18 months

\>225-420 minutes per week

To promite long term weight loss maintenance individuals should progress to at least

250 minutes per week of moderate to vigorous

To archived the weekly maitenance activity goal of \>250 minutes a week physical active should be performed

5-7 days a week

Physical activity can be accumulated in multiple daily bouts of at least how many minutes

10 minutes

Reduction of 1-2 lbs a week is how many calories

500-1000 kcal

Resistance training alone shows result in clinically significant weight loss

false

Patients with excess fat mass also tend to exhibit greater fat free mass

true