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What is the primary cause of Type 1 diabetes?
What is the primary cause of Type 1 diabetes?
Type 2 diabetes is characterized by an inability to utilize insulin due to autoimmune destruction.
Type 2 diabetes is characterized by an inability to utilize insulin due to autoimmune destruction.
False
Name one potential complication that can arise with exercise in diabetics.
Name one potential complication that can arise with exercise in diabetics.
Hypoglycemia
Gestational diabetes is a type of diabetes that occurs during __________.
Gestational diabetes is a type of diabetes that occurs during __________.
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What is one of the treatment goals for diabetes management?
What is one of the treatment goals for diabetes management?
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Match the types of diabetes to their descriptions:
Match the types of diabetes to their descriptions:
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Glucose transport into skeletal muscle can only occur when insulin is present.
Glucose transport into skeletal muscle can only occur when insulin is present.
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What is the role of exercise in the management of diabetes?
What is the role of exercise in the management of diabetes?
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What percentage of insulin-stimulated glucose uptake occurs in skeletal muscle?
What percentage of insulin-stimulated glucose uptake occurs in skeletal muscle?
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Insulin resistance in adipose tissue (AT) occurs after skeletal muscle becomes insulin resistant.
Insulin resistance in adipose tissue (AT) occurs after skeletal muscle becomes insulin resistant.
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What is the primary consequence of the accumulation of reactive lipids in skeletal muscle?
What is the primary consequence of the accumulation of reactive lipids in skeletal muscle?
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The key transporter that insulin stimulates the movement of to the skeletal muscle membrane is __________.
The key transporter that insulin stimulates the movement of to the skeletal muscle membrane is __________.
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Match the following complications with their definitions:
Match the following complications with their definitions:
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What is a common symptom of hyperglycemia?
What is a common symptom of hyperglycemia?
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Diabetic ketoacidosis is characterized by hyperglycemia, ketosis, and metabolic alkalosis.
Diabetic ketoacidosis is characterized by hyperglycemia, ketosis, and metabolic alkalosis.
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What A1C percentage is generally considered a target for most people with diabetes?
What A1C percentage is generally considered a target for most people with diabetes?
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What does the A1C blood test measure?
What does the A1C blood test measure?
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The target LDL cholesterol for managing diabetes should be less than 2.5 mmol/L.
The target LDL cholesterol for managing diabetes should be less than 2.5 mmol/L.
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Name one oral anti-hyperglycemic medication used to manage diabetes.
Name one oral anti-hyperglycemic medication used to manage diabetes.
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Regular _________ is crucial for diabetes management.
Regular _________ is crucial for diabetes management.
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Match the management strategies with their descriptions:
Match the management strategies with their descriptions:
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Which of the following should be controlled to less than 130/80 mmHg for diabetes management?
Which of the following should be controlled to less than 130/80 mmHg for diabetes management?
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High Intensity Interval Training (HIIT) is recommended for individuals who are not physically fit.
High Intensity Interval Training (HIIT) is recommended for individuals who are not physically fit.
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What is one of the primary treatment goals for diabetes?
What is one of the primary treatment goals for diabetes?
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What is one key effect of exercise on glucose transport?
What is one key effect of exercise on glucose transport?
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Individuals who exercise regularly are typically less insulin sensitive despite high IMTG levels.
Individuals who exercise regularly are typically less insulin sensitive despite high IMTG levels.
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Name one substance that accumulates as a result of muscle contraction during exercise.
Name one substance that accumulates as a result of muscle contraction during exercise.
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A single session of exercise can markedly improve _____ sensitivity.
A single session of exercise can markedly improve _____ sensitivity.
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What signaling cascade is stimulated during exercise to aid glucose uptake?
What signaling cascade is stimulated during exercise to aid glucose uptake?
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Match the following components to their role in glucose transport during exercise:
Match the following components to their role in glucose transport during exercise:
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The expression of lipogenic enzymes such as DGAT1 increases after acute exercise.
The expression of lipogenic enzymes such as DGAT1 increases after acute exercise.
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What is the term for the observed phenomenon where athletes have high IMTG levels yet remain insulin sensitive?
What is the term for the observed phenomenon where athletes have high IMTG levels yet remain insulin sensitive?
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What effect does acute exercise have on plasma glucose levels in diabetics?
What effect does acute exercise have on plasma glucose levels in diabetics?
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The translocation of GLUT-4 to the plasma membrane is impaired in diabetics after exercise.
The translocation of GLUT-4 to the plasma membrane is impaired in diabetics after exercise.
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What is one key benefit of acute exercise regarding lipid-induced insulin resistance?
What is one key benefit of acute exercise regarding lipid-induced insulin resistance?
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Acute exercise enhances both insulin and exercise stimulated __________ transport.
Acute exercise enhances both insulin and exercise stimulated __________ transport.
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Match the following terms with their descriptions:
Match the following terms with their descriptions:
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What was the effect of an 18-hour lipid infusion on insulin sensitivity?
What was the effect of an 18-hour lipid infusion on insulin sensitivity?
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Acute exercise increases the abundance of mGPAT and DGAT1 after exercise.
Acute exercise increases the abundance of mGPAT and DGAT1 after exercise.
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What is the relationship between acute exercise and muscular triglyceride storage?
What is the relationship between acute exercise and muscular triglyceride storage?
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What is one direct benefit of chronic exercise training in diabetics?
What is one direct benefit of chronic exercise training in diabetics?
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Exercise can trigger glucose transport independently of insulin resistance.
Exercise can trigger glucose transport independently of insulin resistance.
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What is the role of GLUT-4 in glucose transport?
What is the role of GLUT-4 in glucose transport?
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Chronic exercise training can help reduce the risk factors for type 2 diabetes, such as __________ and obesity.
Chronic exercise training can help reduce the risk factors for type 2 diabetes, such as __________ and obesity.
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Match the following benefits of exercise in diabetics with their corresponding category:
Match the following benefits of exercise in diabetics with their corresponding category:
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Which of the following best describes the impact of high lipid environments on insulin?
Which of the following best describes the impact of high lipid environments on insulin?
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Annual CVD risk factor assessments are not necessary for individuals with diabetes mellitus.
Annual CVD risk factor assessments are not necessary for individuals with diabetes mellitus.
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What can acute and chronic exercise reduce in diabetics?
What can acute and chronic exercise reduce in diabetics?
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Study Notes
Module 3: Cardiovascular Exercise Principles, Week 3
- Module focuses on exercise prescription for common chronic conditions, specifically diabetes.
- Learning goals include defining diabetes, identifying physiological processes in regulating blood glucose, the treatment goal for diabetes, complications of exercise, and effective exercise strategies for type 2 diabetes management.
Diabetes
- A chronic metabolic disease characterized by hyperglycemia due to insulin secretion defects or insulin utilization issues.
- Types include:
- Type 1: autoimmune disease in children and adults, causing pancreas beta cell destruction and halting insulin production.
- Type 2: metabolic disease caused by insulin resistance in peripheral tissue and defective insulin secretion.
Learning Objectives
- Define diabetes.
- Identify physiological processes involved in blood glucose regulation and factors contributing to high blood glucose in type 2 diabetics.
- Clarify the treatment goal of diabetes and justify exercise's role in acute and chronic management.
- Detail complications arising from exercise in diabetics.
- Design effective exercise strategies for type 2 diabetes management.
Blood Glucose Control
- Blood glucose control is impaired in type 2 diabetics.
- 24-hour blood glucose control is discussed in Van Dijk et al. (Diabetes Journal 2015; 28:24-30).
Glucose Transport in Skeletal Muscle
- Glucose, blood, insulin, exercise, cytosol, GLUT-4, vesicle are key components in the process of transportation within skeletal muscle.
- Highlighting the insulin-stimulated or exercise-stimulated movement of glucose into skeletal muscle for glucose transport enhancement.
- Notably, insulin binding to its receptor on target tissues, particularly skeletal muscle, plays a significant role in facilitating glucose uptake, accounting for 50-80% of insulin-stimulated glucose uptake, impacting 40% of body mass.
Pathophysiology of Insulin Resistance
- Adipose tissue (AT) becomes insulin-resistant before skeletal muscle.
- Key contributors to insulin resistance in AT include adipocyte hypertrophy, inflammation, reactive oxygen species (ROS) emission, and lipolysis.
- Elevated fatty acid release from adipose tissue and accumulation in skeletal muscle are linked to this phenomenon.
- Excessive lipid accumulation negatively impacts insulin signaling.
- Accumulation of reactive lipids, such as diacylglycerols (DAGs) and ceramides, is implicated in disrupting insulin signaling.
Diabetic Complications
- Acute complications include hyperglycemia (manifestations) and hypoglycemia (potential causes) encompassing diabetic ketoacidosis and hyperosmolar nonketotic syndrome.
- Chronic complications include peripheral neuropathies (somatic and autonomic), nephropathies, retinopathies, macro/microvascular complications, diabetic foot ulcers and infections.
Exercise Prescription for Diabetes
- Treatment goals include diet (when and what to eat), medication, and regular exercise.
- Patients with diabetes should aim for an A1C of 7% or less. Maintain blood pressure at levels below 130/80 mmHg and LDL cholesterol below 2.0 mmol/L.
- 150+ minutes of moderate-to-vigorous intensity aerobic activity per week, spread across at least three non-consecutive exercise days, are usually recommended. Shorter, more intense sessions might be sufficient for younger and more physically fit individuals.
Chronic Exercise Training Benefits
- Chronic aerobic exercise improves insulin action and blood glucose control.
- Chronic aerobic exercise promotes improved cardiovascular and metabolic fitness.
- Improvements in cardiovascular fitness, reduction of risk factors (obesity, hypertension, and high blood cholesterol), and progression of diabetes are other key benefits of exercise.
Glucose Control During and After Exercise
- Glucose control during and after exercise is essential and highlights that insulin and counter-regulatory hormones do not respond uniformly in diabetics compared to non-diabetics.
- Diabetic individuals may experience acute exercise-induced hypoglycemia lasting up to 48 hours post-exercise.
- Monitoring blood glucose levels is crucial to prevent hyperglycemia and hypoglycemia.
Contraindications for Exercise in Diabetes
- Exercise is contraindicated when blood glucose is excessively high (>14 mmol/L) in the presence of ketones, or low (<4 mmol/L) without an adequate carbohydrate intake to avoid hypoglycemia before activity.
- In diabetics with retinopathy or hypertension, high-intensity activities, including activities involving Valsalva maneuvers, should be avoided and light weight with low contraction velocity for resistance training is instead recommended.
- Special precautions are needed for those with peripheral neuropathy due to the risk of ulcers and fracture. Special shoes or padding are recommended.
General Exercise Prescription for Diabetes
- Prescriptions must be personalized based on medication schedules, the severity of diabetes complications, and the expected exercise benefits.
- Diabetic individuals should include endurance and resistance exercises to develop and maintain cardiorespiratory fitness, body composition, and muscular strength and endurance.
- Food intake must be considered for individuals on medication that can affect blood glucose levels or those who are engaging in vigorous training lasting over an hour.
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Description
This quiz covers cardiovascular exercise principles related to diabetes management. Students will learn to define diabetes, understand physiological processes that regulate blood glucose, and develop effective exercise strategies for type 2 diabetes. Master the complications of exercise and the treatment goals to manage this chronic condition.
