Lec 8 Diabetes and Exercise - Aerobic

Vocabulary-based flashcards covering aerobic exercise recommendations, physiological responses, clinical considerations, and management strategies for individuals with diabetes.

Aerobic Exercise

Repeated and continuous movement of large muscle groups that rely primarily on aerobic energy systems.

General Physical Activity Frequency Recommendation

150 min per week of moderate-to-vigorous intensity aerobic exercise over at least 3 days with no more than 2 consecutive days without activity.

Resistance Exercise Recommendation

$2 - 3$ sessions per week performed on non-consecutive days.

Flexibility and Balance Training Recommendation

$2 - 3$ sessions per week for older adults.

Pre-exercise BGL of <5.0 mmol/L (Strategy)

Consume $15 - 30\,g$ of carbohydrate (CHO) prior to exercise depending on intensity and duration.

Pre-exercise BGL of 5.1 - 8.3 mmol/L (Strategy)

Consume $10 - 60\,g$ of carbohydrate (CHO) at the onset of exercise depending on intensity, duration, and insulin.

Pre-exercise BGL of >14 mmol/L (Strategy)

Check for ketones; low to moderate exercise is okay if ketones are absent, but intense exercise should be avoided.

Insulin Reduction for Exercise

A reduction of $25\% - 75\%$ in insulin dose during and after aerobic exercise, useful for planned activities.

Post-exercise Hypoglycaemia Risk Duration

The risk of hypoglycaemia persists for up to ~$30\,h$ post-exercise due to factors like replenished muscle glycogen and increased insulin sensitivity.

High-intensity Exercise Blood Glucose Response

Associated with hyperglycaemia and a lower risk of hypoglycaemia due to a surge in adrenaline and noradrenaline.

Type 2 Diabetes (T2D) Prevention Recommendation

150 min per week of aerobic physical activity plus dietary changes resulting in weight loss of $5\% - 7\%$.

Peripheral Neuropathy Clinical Precautions

Keep feet dry, use appropriate footwear, check feet daily, and consider non-weight-bearing activities.

Autonomic Neuropathy Clinical Precautions

Avoid rapid postural changes to prevent hypotension, use RPE instead of HR, hydrate well, and avoid exercise in the heat.

Retinopathy Clinical Precautions

Avoid vigorous activities that dramatically elevate blood pressure and activities dangerous due to limited vision like outdoor evening cycling.

Beta Blockers ($\beta$ blockers) (Clinical Consideration)

Blunt adrenergic responses (reducing defences against hypoglycaemia) and cause inappropriate HR, BP, and thermoregulatory responses.

ACE Inhibitors (Clinical Consideration)

Increase insulin sensitivity, which results in an increased risk of hypoglycaemia.

Statins (Clinical Consideration)

Cholesterol-lowering medications that may cause muscle weakness, inflammation, and poor blood glucose control.

Sedentary Behaviour Interruption (T2D)

Prolonged sitting should be interrupted with light activity every $30\,min$ for blood glucose benefits.

Behavior Change Techniques (5 Keys)

Focus on past successes, barrier identification/problem solving, use of follow-up prompts, identifying where/when to perform behavior, and reviewing behavioural goals.

GLUT 4

A glucose transporter whose availability after exercise is a factor in the persistent risk of post-exercise hypoglycaemia.