Module 3: Cardiovascular Exercise & Diabetes
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Questions and Answers

What are the direct benefits of chronic exercise training for diabetics?

Chronic exercise training directly improves insulin action and blood glucose control.

How does chronic exercise impact the risks associated with type 2 diabetes?

It reduces risk factors such as obesity, hypertension, and high blood cholesterol.

Explain how glucose transport into skeletal muscle can occur.

Glucose transport can be stimulated by insulin or exercise.

What role does exercise play in relation to lipid-induced insulin resistance?

<p>Exercise can bypass mechanisms underlying lipid-induced insulin resistance.</p> Signup and view all the answers

Describe the effects of both acute and chronic exercise on glucose levels in diabetics.

<p>Both types of exercise reduce glucose levels for an extended timeframe in diabetics.</p> Signup and view all the answers

What is a key physiological mechanism triggered by insulin during glucose transport?

<p>Insulin stimulates the movement of GLUT-4 to the skeletal muscle membrane.</p> Signup and view all the answers

Discuss why exercise testing may be indicated for individuals with diabetes.

<p>ECG stress testing may be necessary for sedentary individuals or those seeking vigorous activities.</p> Signup and view all the answers

What are the goals of exercise training in individuals with diabetes?

<p>The goals include prevention of diabetes-related complications and cardiovascular disease risk factor reduction.</p> Signup and view all the answers

What role does insulin play in the uptake of glucose by skeletal muscle?

<p>Insulin stimulates the movement of GLUT-4 to the skeletal muscle membrane, enhancing glucose transport.</p> Signup and view all the answers

How does adipose tissue insulin resistance affect skeletal muscle function?

<p>Insulin resistance in adipose tissue leads to increased fatty acid release, which accumulates in skeletal muscle and impairs insulin signaling.</p> Signup and view all the answers

What are the consequences of a high lipid environment on insulin signaling?

<p>A high lipid environment leads to the accumulation of reactive lipids which impair insulin signaling, causing insulin resistance.</p> Signup and view all the answers

List three acute complications of hyperglycemia related to diabetes.

<p>Diabetic ketoacidosis, hyperglycemic hyperosmolar nonketotic syndrome, and general diabetes out of control.</p> Signup and view all the answers

What are some common symptoms of hypoglycemia?

<p>Shakiness, weakness, sweating, anxiety, and hunger are common symptoms of hypoglycemia.</p> Signup and view all the answers

Define peripheral neuropathy and name one symptom.

<p>Peripheral neuropathy is a condition resulting from damage to the peripheral nerves; one symptom is numbness in the extremities.</p> Signup and view all the answers

What is diabetic retinopathy, and how is it caused?

<p>Diabetic retinopathy is damage to the retina caused by chronically elevated blood sugar levels leading to microvascular complications.</p> Signup and view all the answers

What is the A1C target for most individuals with diabetes?

<p>The A1C target for most individuals should be 7% or less.</p> Signup and view all the answers

What is diabetes characterized by?

<p>Hyperglycemia due to defects in insulin secretion and/or utilization.</p> Signup and view all the answers

What is the main physiological process involved in regulating blood glucose in type 2 diabetics?

<p>Insulin resistance in peripheral tissues and defective insulin secretion.</p> Signup and view all the answers

Considering the presence of complications in diabetic patients, what mode of exercise testing should be prioritized?

<p>Particular attention should be paid to the mode of exercise testing based on the presence of complications ('opaties').</p> Signup and view all the answers

What is the recommended exercise frequency for maximizing cardiovascular benefits in diabetes management?

<p>An exercise frequency greater than 3 days per week is suggested.</p> Signup and view all the answers

What is the primary treatment goal for managing diabetes?

<p>To achieve and maintain normal blood glucose levels.</p> Signup and view all the answers

What complications may arise during exercise in individuals with diabetes?

<p>Hypoglycemia and hyperglycemia, injuries or cardiovascular events.</p> Signup and view all the answers

Which two types of exercise are recommended for individuals with Type 2 Diabetes Mellitus (T2DM)?

<p>Both aerobic and resistance exercise are recommended.</p> Signup and view all the answers

Describe one effective exercise strategy for managing type 2 diabetes.

<p>Incorporating regular aerobic and resistance training into the weekly routine.</p> Signup and view all the answers

What must be considered regarding food intake for individuals on hypoglycemic medication during exercise?

<p>Individuals on hypoglycemic medication should consume additional carbohydrates, specifically 15g for each hour of exercise.</p> Signup and view all the answers

How does exercise influence glucose transport into skeletal muscles?

<p>Exercise stimulates the translocation of GLUT-4 vesicles to the muscle membrane.</p> Signup and view all the answers

What happens when glucose utilization exceeds glucose production during moderate exercise in diabetics?

<p>This condition leads to hypoglycemia.</p> Signup and view all the answers

Why do insulin and counterregulatory hormone concentrations behave abnormally in diabetic individuals during exercise?

<p>They do not respond to exercise in a normal manner, leading to an imbalance in glucose metabolism.</p> Signup and view all the answers

What are the two main types of diabetes?

<p>Type 1 diabetes and Type 2 diabetes.</p> Signup and view all the answers

What is gestational diabetes?

<p>Glucose intolerance that occurs during pregnancy.</p> Signup and view all the answers

What is the primary issue faced by diabetics who engage in exercise?

<p>The most common problem is the imbalance between glucose utilization and glucose production.</p> Signup and view all the answers

What fasting blood glucose levels indicate normoglycemia during exercise?

<p>Normoglycemia is indicated when glucose utilization equals glucose production.</p> Signup and view all the answers

What does the A1C blood test measure?

<p>The A1C blood test measures the average blood sugar level over the past 120 days.</p> Signup and view all the answers

What is the target blood pressure for diabetes patients?

<p>The target blood pressure for diabetes patients is less than 130/80 mmHg.</p> Signup and view all the answers

What is the LDL cholesterol target for individuals with diabetes?

<p>The LDL cholesterol target is less than 2.0 mmol/L.</p> Signup and view all the answers

Name two classes of common medications for diabetes management.

<p>Oral anti-hyperglycemics like Metformin and insulin are two common classes.</p> Signup and view all the answers

How much moderate-to-vigorous intensity exercise should diabetics aim for weekly?

<p>Diabetics should aim for 150 minutes or more of moderate-to-vigorous intensity exercise weekly.</p> Signup and view all the answers

What is the effect of exercise on insulin levels in the body?

<p>Insulin levels decrease with exercise to promote glucose utilization by muscles.</p> Signup and view all the answers

What is a possible consequence if insulin did not decrease during exercise?

<p>If insulin did not decrease, it could lead to hypoglycemia due to excessive glucose uptake by cells.</p> Signup and view all the answers

What are some components of diabetes self-management?

<p>Components include setting personal goals, stress management, and regular health screenings.</p> Signup and view all the answers

How does acute exercise influence plasma glucose levels in diabetics?

<p>Acute exercise reduces plasma glucose levels for an extended timeframe in diabetics.</p> Signup and view all the answers

What role does GLUT-4 translocation play during exercise in individuals with diabetes?

<p>GLUT-4 translocation involves the stimulated movement of GLUT-4 to the plasma membrane, facilitating glucose uptake even in diabetes.</p> Signup and view all the answers

What impact does acute exercise have on lipid-induced insulin resistance?

<p>Acute exercise prevents lipid-induced insulin resistance by reducing the formation of reactive lipids and promoting proper lipid storage.</p> Signup and view all the answers

Explain the relationship between acute exercise and insulin sensitivity based on exercise intensity.

<p>Acute exercise enhances insulin sensitivity, with greater improvements observed at higher exercise intensities.</p> Signup and view all the answers

What changes occur in the abundance of mGPAT and DGAT1 after acute exercise?

<p>After acute exercise, the concentrations of mGPAT and DGAT1 increase significantly, approximately by 35%.</p> Signup and view all the answers

How does acute exercise enhance glucose transport mechanisms in athletes compared to sedentary individuals?

<p>Acute exercise enhances both insulin and exercise-stimulated glucose transport mechanisms more effectively in athletes than sedentary individuals.</p> Signup and view all the answers

What physiological changes occur in individuals with Type II Diabetes related to hyperglycemia during exercise?

<p>In Type II Diabetics, hyperglycemia can be present up to 13 out of 24 hours, affecting their exercise performance.</p> Signup and view all the answers

Discuss the significance of reactive lipids in the context of acute exercise and insulin resistance.

<p>Reactive lipids contribute to insulin resistance, but acute exercise helps mitigate this formation, improving metabolic function.</p> Signup and view all the answers

Study Notes

Module 3: Cardiovascular Exercise Principles - Week 3

  • Module focuses on exercise prescription for common chronic conditions, specifically diabetes.
  • Learning objectives include defining diabetes, identifying physiological processes involved in blood glucose regulation and contributing factors to high blood glucose levels in type 2 diabetes, identifying treatment goals and justifying exercise's role, describing complications of exercise in diabetics, and designing effective exercise strategies for type 2 diabetes management.

Diabetes

  • Chronic metabolic disease characterized by hyperglycemia.
  • Results from defects in insulin secretion and/or inability to utilize insulin.
  • Types:
    • Type 1: Autoimmune disease causing beta cell destruction in pancreas, stopping insulin production.
    • Type 2: Metabolic disease from insulin resistance in peripheral tissues and defective insulin secretion.
    • Gestational Diabetes: Glucose intolerance during pregnancy due to contra-insulin effects.

Blood Glucose Control

  • Blood glucose control is impaired in type 2 diabetes.
  • 24-hour blood glucose control was studied by Van Dijk et al. (2015).

Glucose Transport in Skeletal Muscle

  • Overview of glucose transport within skeletal muscle.
  • Key factors like glucose, blood, insulin, exercise, cytosol, GLUT-4, and vesicles are involved.
  • Glucose transport can be stimulated by insulin or exercise.

Prevalence and Diagnosis

  • Prevalence of diagnosed diabetes among individuals aged one year and older, by age group and sex in Canada (2014/15) is presented.
  • Worldwide prevalence data for diabetes in adults (20–79 years) across Europe, North America and Oceania (2010) is presented.

Diagnostic Criteria

  • Diagnostic criteria for diabetes are not provided in the given text.

Type 2 Diabetes: Progressive Development

  • Discusses type 2 diabetes care, highlighting insulin-sensitizing agents and implications for cardiovascular disease prevention (1998).

Insulin-Stimulated Glucose Transport

  • Elevated glucose circulates, stimulating pancreas to release insulin.
  • Insulin binds to receptors on target tissues (e.g., skeletal muscle).
  • 50-80% of insulin-stimulated glucose uptake occurs in skeletal muscle.
  • 40% of body mass is affected by the process.
  • Key proteins involved include IRS, AKT, AS160 and GLUT-4.

Pathophysiology of Insulin Resistance

  • Adipose tissue (AT) becomes insulin resistant before skeletal muscle.
  • Healthy AT vs. Adipocyte hypertrophy.
  • Lipolysis and related factors.
  • Effects of excess lipids on insulin signaling, including reactive lipids like diacylglycerols (DAGs) and ceramides.

Diabetic Complications

  • Acute complications: Hyperglycemia (manifestations), Hypoglycemia (potential causes), Diabetic ketoacidosis, Hyperglycemic hyperosmolar nonketotic syndrome.
  • Chronic complications: Peripheral neuropathies (somatic, autonomic), Nephropathies, Retinopathies, Macro/microvascular complications, Diabetic foot ulcers, and Infections.

Prevalence of hyperglycemia

  • Hyperglycemia was present in 13 out of 24 hours in "well-controlled" diabetics.

Exercise Regulation of Glucose

  • Acute exercise reduces plasma glucose for an extended timeframe.
  • Exercise enhances glucose transport independently of insulin.
  • Mechanisms like adenosine diphosphate (ADP), accumulation of calcium (Ca2+), and reactive oxygen species (ROS) are involved in exercise-stimulated glucose transport.

Exercise Prescription in Diabetes

  • Goals of exercise training in diabetes include glucose control, prevention of diabetes-related complications, and CVD risk factor reduction.

Exercise Testing in Diabetes

  • Recommendations include ECG stress testing for individuals with diabetes who have been sedentary and/or desire vigorous intensity activities.
  • Annual CVD risk factor assessments are crucial for detecting silent ischemia, which is commonly undetected in diabetic patients.

Exercise Prescription Recommendations

  • Combined endurance and resistance exercise is recommended to develop and maintain cardiorespiratory fitness, body composition, and muscular strength/endurance.
  • Food intake adjustments are necessary for individuals on hypoglycemic medications.

Glucose Regulation During Exercise

  • Glucose utilization and production are balanced under normal conditions, maintaining glucose homeostasis for individuals without diabetes. However, for individuals with diabetes, there can be imbalances leading to hypo/hyperglycemia.
  • During exercise there should be close monitoring of blood glucose levels and carbohydrate intake to prevent hypoglycemia. This applies particularly for individuals who are on insulin or blood sugar lowering drugs

Summary and Key Points

  • Key points regarding exercise-stimulated glucose transport and exercise prescription in diabetic patients are discussed.
  • Individuals should consider their medication schedule, diabetic complications, exercise goals/benefits, individual training needs, and contraindications during exercise.

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Description

This quiz delves into exercise prescription for managing diabetes, focusing on the physiological processes of blood glucose regulation. You'll explore the different types of diabetes, treatment goals, and the role of exercise in managing this chronic condition. Assess your understanding of how exercise strategies can be tailored for effective diabetes management.

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