Module 3: Cardiovascular - Diabetes Management

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the target A1C level for effectively managing diabetes?

Less than 9.0%

Less than 8.0%

Less than 6.5%

Less than 7.0% (correct)

Which of the following medications is considered an oral anti-hyperglycemic agent?

Insulin N

Metformin (correct)

Rosiglitazone

Humalog

What is the recommended blood pressure target for individuals managing diabetes?

Less than 120/70 mmHg

Less than 150/100 mmHg

Less than 130/80 mmHg (correct)

Less than 140/90 mmHg

How many minutes of moderate-to-vigorous activity is recommended weekly for diabetes management?

150 minutes Signup and view all the answers

What effect does exercise have on insulin levels during physical activity?

Insulin levels decrease to facilitate glucose transport Signup and view all the answers

Which of the following is NOT a common goal in diabetes management?

Weight gain Signup and view all the answers

What characterizes diabetes as a chronic metabolic disease?

Elevated blood glucose levels due to insulin resistance Signup and view all the answers

What type of training might be sufficient for a young, physically fit individual in diabetes management?

75 minutes of vigorous-intensity or interval training Signup and view all the answers

Which physiological process is primarily involved in glucose transport in skeletal muscle?

GLUT-4 vesicle action during exercise Signup and view all the answers

What is a common complication that can arise during exercise for individuals with diabetes?

Hypoglycemia due to increased insulin sensitivity Signup and view all the answers

Which of the following lifestyle changes is essential for diabetes self-management?

Regular exercise Signup and view all the answers

What is the primary treatment goal for managing diabetes?

Achieving blood glucose control Signup and view all the answers

Which type of diabetes is primarily caused by insulin resistance?

Type 2 Diabetes Signup and view all the answers

What are insulin-sensitizing agents used for in the management of diabetes?

To enhance insulin sensitivity and lower blood glucose Signup and view all the answers

What effect does exercise have on blood glucose levels for someone with type 2 diabetes?

It typically results in reduced insulin requirements Signup and view all the answers

Which statement is TRUE regarding gestational diabetes?

It develops during pregnancy due to counter-regulatory effects of hormones. Signup and view all the answers

What substance accumulates during muscle contraction as a result of exercise?

Reactive oxygen species Signup and view all the answers

Which enzyme is suggested to be involved in increased IMTG synthesis following exercise?

DGAT1 Signup and view all the answers

How does exercise affect insulin sensitivity in individuals with high IMTG concentrations?

It improves insulin sensitivity Signup and view all the answers

What mechanism may exercise use to improve insulin sensitivity in obesity?

Enhancing partitioning of fatty acids toward IMTG synthesis Signup and view all the answers

Which of the following is NOT a part of the signaling cascade stimulated by exercise?

Inhibition of adenosine diphosphate (ADP) Signup and view all the answers

Which of the following is a key factor that stimulates glucose transport during exercise?

Accumulation of reactive oxygen species (ROS) Signup and view all the answers

What is the primary action of insulin on skeletal muscle tissue?

Stimulates GLUT-4 translocation Signup and view all the answers

What is the effect of a single session of exercise on IMTG synthesis?

It increases IMTG synthesis Signup and view all the answers

What is a consequence of adipose tissue becoming insulin resistant?

Increased accumulation of lipids in skeletal muscle Signup and view all the answers

Which factor is primarily responsible for GLUT-4's movement to the plasma membrane during exercise?

Muscle contraction Signup and view all the answers

Which of the following reactive lipids is produced due to excess lipids in skeletal muscle?

Diacylglycerols (DAGs) Signup and view all the answers

What are common symptoms of hyperglycemia in acute complications?

Headache and fatigue Signup and view all the answers

What condition might result from too much insulin administration?

Hypoglycemia Signup and view all the answers

What is a characteristic symptom of diabetic retinopathy?

Changes in vision Signup and view all the answers

What should most people aim for regarding their A1C percentage?

7% or less Signup and view all the answers

Which of the following is a chronic complication of diabetes?

Peripheral neuropathies Signup and view all the answers

What is a direct benefit of chronic exercise training for diabetics?

Improvement in blood glucose control Signup and view all the answers

Which factor does NOT contribute to the progression of type 2 diabetes according to the content?

Maintaining a healthy diet Signup and view all the answers

How does exercise affect glucose transport in individuals with insulin resistance?

By bypassing insulin resistance Signup and view all the answers

What role does GLUT-4 play in glucose transport to skeletal muscle?

It increases glucose transport when stimulated by insulin Signup and view all the answers

What is one of the goals of exercise training in diabetes?

Reduce cardiovascular disease risk factors Signup and view all the answers

What effect does a high lipid environment have on insulin in diabetics?

It reduces insulin sensitivity Signup and view all the answers

What can acute and chronic exercise do for diabetics regarding glucose levels?

Reduce glucose levels for an extended timeframe Signup and view all the answers

Which of the following statements is true about exercise testing in individuals with diabetes?

ECG stress testing may be beneficial for those wanting vigorous activities. Signup and view all the answers

What effect does acute exercise have on GLUT-4 in diabetics?

It stimulates the movement of GLUT-4 to the plasma membrane. Signup and view all the answers

What is a key mechanism by which acute exercise reduces lipid-induced insulin resistance?

By enhancing proper lipid storage. Signup and view all the answers

How long was the overnight lipid infusion conducted before assessing the effects of exercise?

18 hours Signup and view all the answers

What is the relationship between acute exercise and glucose levels in diabetics?

Acute exercise reduces plasma glucose for an extended timeframe. Signup and view all the answers

What effect did acute exercise have on the abundance of mGPAT and DGAT1 after exercise?

Increase by approximately 35% Signup and view all the answers

What does the summary suggest about the effect of acute exercise on insulin sensitivity?

Acute exercise enhances both insulin and exercise-stimulated glucose transport. Signup and view all the answers

Which of the following is a major finding regarding glycemic instability in type II diabetics?

Hyperglycemia is present in 13 out of 24 hours in controlled diabetics. Signup and view all the answers

What does the increase in ceramide concentration after exercise indicate?

Worsening insulin resistance. Signup and view all the answers

Study Notes

Module 3: Cardiovascular - Exercise Principles

Week 3
Instructor: Dr. Tanya Holloway, PhD, ACSM-RCEP

Exercise Prescription for Common Chronic Conditions - Diabetes

Learning Objectives:
- Define diabetes
- Identify physiological processes for blood glucose regulation and factors contributing to high blood glucose in type 2 diabetes.
- Identify treatment goals for diabetes and the role of exercise in management.
- Describe complications that arise with exercise in diabetics.
- Design effective exercise strategies for type 2 diabetes management.

Diabetes

Chronic metabolic disease characterized by high blood sugar due to defects in insulin secretion or utilization.
- Type 1: Autoimmune disease destroying pancreatic beta cells, stopping insulin production.
- Type 2: Metabolic disorder caused by insulin resistance in peripheral tissues and impaired insulin secretion.
- Gestational diabetes: Glucose intolerance developing during pregnancy.

Blood Glucose Control in Type 2 Diabetes

Blood glucose control is impaired in type 2 diabetes.
24-hour blood glucose control data from Van Dijk et al. (2015)

Overview of Glucose Transport in Skeletal Muscle

Glucose in blood
Insulin
Exercise
Cytosol
GLUT-4 vesicle

Insulin Stimulated Glucose Transport

Elevated blood glucose stimulates pancreas to release insulin (for type-2 diabetics)
Insulin binds to receptors on target tissues, including skeletal muscle.
50-80% of insulin-stimulated glucose uptake occurs in skeletal muscle.
40% of body mass is related to skeletal muscle glucose uptake.

Insulin- Stimulated Glucose Transport (Specific details)

Glucose in blood
Insulin
IRS proteins
Cytosol
AKT
AS160
GLUT-4 vesicles

Pathophysiology of Insulin Resistance

Adipose tissue becomes insulin resistant before skeletal muscle.
- Healthy AT (adipose tissue)
- Adipocyte hypertrophy
- Inflammation
- ROS (reactive oxygen species) emission
- Lipolysis
- High Caloric surplus (FFA-Alb)
- Increased release of fatty acids from fat tissue.
Accumulation of fatty acids in skeletal muscle.
Reactive lipids (DAG, Ceramides) impair insulin signaling.

The Effect of Excess Lipids on Insulin Signaling

Adipose tissue insulin resistance = increased circulating lipids.
Lipid transporters accumulate on skeletal muscle membrane.
Increased transport of lipids into muscle.
Excess lipids lead to reactive lipid production (DAGs, ceramides).
Reactive lipids impair insulin signaling.

Diabetic Complications

Acute complications
- Hyperglycemia
- Hypoglycemia: potential causes include diabetes being out of control, diabetic ketoacidosis, hyperglycemic hyperosmolar nonketotic syndrome
- Symptoms include headache, weakness, fatigue
Chronic complications
- Peripheral neuropathies (somatic and autonomic), nephropathies, retinopathies, macro/microvascular complications, diabetic foot ulcers, infections.

Acute Effects of Exercise on Glucose Transport in Diabetics

Acute exercise reduces plasma glucose for an extended time frame in diabetics

Acute Exercise Induces GLUT-4 Translocation

Exercise stimulated movement of GLUT-4 to the plasma membrane remains intact in diabetics.

Acute Exercise Prevents Lipid Induced Insulin Resistance (18hrs overnight lipid infusion study)

Exercise Prescription in Diabetes

Goals
- Glucose control
- Prevention of diabetes-related complications
- Reduce CVD risk factors

Diabetes Mellitus: Exercise Testing

ECG stress testing may be indicated.
Annual cardiovascular risk factor assessments are advised
Testing should be based on symptoms and complications.

Chronic Effects of Exercise on Glucose Transport in Diabetics

Chronic exercise training leads to several benefits like improving insulin action and blood glucose control, enhancing cardiovascular and metabolic fitness, reducing type 2 diabetes risk factors such as obesity, high blood pressure and high cholesterol levels.

Exercise in Diabetes: Summary & Key points

Exercise plays a vital role in managing diabetes by facilitating glucose transport into skeletal muscle cells, regardless of insulin resistance.
Acute and chronic exercise leads to improved insulin sensitivity and reduces reactive lipid production.
Regular exercise is essential for managing diabetes and reducing associated risk factors like obesity, high blood pressure and high cholesterol.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz focuses on exercise prescriptions specifically designed for managing type 2 diabetes. You will explore the physiological processes affecting blood glucose regulation, treatment goals, and the impact of exercise on diabetic patients. Understand the strategies to effectively manage diabetes through exercise and recognize the potential complications that may arise.