Type 2 Diabetes

What is the pathophysiology

body becomes resistant to insulin or doesn’t produce enough, leading to elevated blood glucose levels.

What is the first line of treatment for Type 2 diabetes

Lifestyle Changes

What other treatments occur for type 2 diabetes

Medications (metformin)
Monitoring and Management: BGL, Cholesterol and BP

What are some of the contraindications to exercise

hyperglycemia >15.0 mmol/L with ketones
hypoglycemia <4.0 mmol/L
Unstable cardiovascular disease 
Unhealed foot ulcers or advanced retinopathy

What are some considerations for exercise

Monitor blood glucose before and after exercise
Hydration  
Gradual progression
Footwear and foot care are critical

What are the clinical changes experienced

Insulin production declines, requiring medication adjustment 
Development of neuropathy, retinopathy, CVD 
Reduced mobility, strength, and balance

What is a clinician based goal pt1

Improve glycemic control 

What is the Justification for Improve glycemic control

Lowering Hb1Ac levels reduces further risk of complications

What is clinician based goal pt2

Support Behaviour Change and Self-Management

What is the justification Support Behaviour Change and Self-Management

Long-term success depends on habit formation and confidence reducing risk of developing type 1 diabetes

What is clinician based goal pt3

Enhance Insulin Sensitivity

What is the justification of enhance insulin sensitivity

Will result in improved glucose response to exercise reducing Hb1ac and need for medication

What is gestational diabetes

Hormones from the placenta cause insulin resistance during pregnancy to ensure more glucose is available for the fetus
pancreas can’t produce enough insulin to overcome this

What is the First-Line Treatment for gestational diabetes

Lifestyle Management

What is other treatment for gestational diabetes

Medication
Insulin
Some may use oral medications

What are some absolute contraindications for gestational diabetes

Uncontrolled gestational hypertension or preeclampsia
Severe anemia
Significant heart or lung disease
Persistent vaginal bleeding

What are some relative contraindications for gestational diabetes

Unstable or poorly managed blood glucose levels
Orthopaedic issues
Extreme obesity or underweight

Considerations for exercise for those with gestational diabetes

Check blood glucose Ideal pre-exercise range: 5.5–7.0 mmol/L
Prioritise low- to moderate-intensity activities
Exercise after meals: Improve insulin sensitivity

Clinical changes in gestational diabetes

Excessive Weight Gain or Rapid Weight Loss
Start of Insulin or Medication
Poor Glycemic Control: need for closer monitoring

What are the barriers to exercise for gestational diabetes

Fear of Harm to Baby
Fatigue - Emphasize accumulating activity throughout the day
Discomfort or Physical Limitations - Offer low-impact alternatives (seated exercises)

What is clinical goals pt1

Prevent Excessive Gestational Weight Gain

Justification for excessive weight gain

increase risk of t2dm

What is clinical goals pt2

Support non-pharmacological blood glucose control

Justification for support non pharmacological blood glucose control

Effective exercise can delay or avoid the need for insulin

What is clinical goals pt3

Educate and Empower Self-Management

What is the justification for educate and empower self management

Encourages independent self-care and reduces risk of developing t2dm