What is diabetes mellitus characterized by?

insufficient insulin production or inability to use it properly

How many people in the US are affected by diabetes mellitus?

~37.3 million people in US

What percentage of diabetes cases are Type 1?

5-10%

What percentage of diabetes cases are Type 2?

90-95%

What causes Type 1 diabetes?

Autoimmune disease: beta cells destroyed

What occurs in Type 1 diabetes?

Insufficient insulin production from pancreas

What treatment is required for Type 1 diabetes?

Insulin injections required

What occurs in Type 2 diabetes?

Insulin resistance / insufficient insulin

What conditions are associated with Type 2 diabetes?

obesity (mainly abdominal), hypertension, dyslipidemia, & sedentary lifestyle

How does exercise affect glucose control?

Muscle contraction has an insulin-like effect

What are the benefits of regular physical activity for diabetes?

improves glucose tolerance, increases insulin sensitivity and decreases HbA1C

What is hyperglycemia also referred to as?

diabetic coma

What occurs during hyperglycemia?

High glucose levels

What does hyperglycemia cause the kidneys to do?

excrete glucose and water

What symptoms result from hyperglycemia?

dehydration, headache, weakness, fatigue

What can occur during hyperglycemia?

Ketoacidosis can occur

What forms when the body relies on fat metabolism and cannot use CHO?

ketones

What can ketoacidosis result in?

coma and death

What are optimal glucose levels before exercise?

90-250mg/dl

When should exercise be postponed due to elevated ketones?

if >250 mg/dl with elevated ketones

When should exercise be postponed without elevated ketones?

if >350 mg/dl without elevated ketones

What is hypoglycemia also referred to as?

insulin shock

What blood glucose level defines hypoglycemia?

Blood glucose <70 mg/dl

Is hypoglycemia a contraindication to exercise?

Contraindication to exercise

What can cause hypoglycemia?

too much insulin, too little CHO intake, Poor planned exercise

What are symptoms of hypoglycemia?

Shakiness, weakness, nervousness, dizziness, headache, confusion

How can risk of hypoglycemia be reduced?

changing insulin timing, reducing insulin doses, and/or increasing carbohydrate intake

What time of day may be best for exercise in diabetes?

Early morning exercise may be best

What is a major goal of exercise prescription for diabetes mellitus?

Maximize caloric expenditure

What should individuals with diabetes regularly monitor?

glucose

What should be considered regarding insulin and exercise?

Injection site, Insulin dosage before/after exercise, CHO intake

What should be ingested if pre or post-exercise glucose is <100 mg/dl?

20-30 g of CHO

What should be considered regarding exercise prescription in diabetes?

Time of day, Partner

How do resistance exercises compare metabolically to aerobic exercise in diabetes?

Resistance exercise confers similar metabolic benefits to aerobic exercise

When should high-intensity and resistance exercise be avoided in diabetes?

if retinopathy is present

How can neuropathy affect exercise responses?

Neuropathy can alter the CV response to exercise

What can peripheral neuropathy lead to?

fluid-filled blisters or diabetic foot ulcers

What type of aerobic exercise should eventually be emphasized in diabetes?

vigorous-intensity aerobic exercise

What type of training may provide better overall blood glucose control?

HIIT

For T2DM, how many consecutive days without aerobic exercise should be avoided?

no more than two consecutive days

During combined training, what exercise order may lower the risk of hypoglycemia in T1DM?

completing resistance training prior to aerobic training

What is metabolic syndrome diagnosed by?

the presence of a group of cardiovascular disease risk factors

Approximately what percentage of the US population meets the criteria for metabolic syndrome?

~35%

Who is metabolic syndrome more common in?

older and overweight/obese individuals

What are the goals of treating metabolic syndrome?

Decrease risk for CV disease and diabetes

What underlying risk factors are key to treat in metabolic syndrome?

Obesity, Hypertension, Dyslipidemia

What interventions may be necessary for metabolic syndrome?

lifestyle and pharmacological interventions

What dietary recommendations are suggested for metabolic syndrome?

Decreased calories and sodium, increased fiber, low-fat

What is a good starting exercise recommendation for metabolic syndrome?

150 min/week of moderate intensity

What weekly exercise duration is recommended for body weight reduction in metabolic syndrome?

250-300 min/week

How can daily and weekly physical activity be accumulated in metabolic syndrome?

multiple shorter bouts (>10 minutes in duration)

What amount of PA may be necessary to promote or maintain weight loss in some individuals?

60−90 min ∙ d−1 of PA

What type of combined training can improve risk factors in metabolic syndrome?

Resistance training along with aerobic

What is dyslipidemia?

Abnormal amount of lipids in the blood

What lipid abnormalities are included in dyslipidemia?

Elevated total cholesterol (TC), low-density lipoproteins (LDL), or triglycerides (TG) or low high-density lipoproteins (HDL)

What is cholesterol?

a fat (lipid) which is produced by the liver and is crucial for normal body functioning

What do lipoproteins do?

Carry cholesterol and other lipids through circulation

What do chylomicrons transport?

fats from intestines to tissues

What does VLDL transport?

fats from liver to adipose tissue

What does LDL transport?

cholesterol from the liver to cells of the body

What does HDL transport?

cholesterol from the body's tissues to the liver

What is LDL commonly known as?

bad cholesterol

What does LDL promote?

atherosclerotic plaque build up

What is HDL commonly known as?

good cholesterol

What does HDL promote?

removal of cholesterol from plaques

What medications are commonly used to treat dyslipidemia?

Statins (HMG-CoA reductase inhibitors)

What dietary changes may improve lipid profile?

Reduction in saturated fat, Monounsaturated fats seem best (increase HDL/decrease cholesterol), Omega-3 fatty acids may reduce triglycerides, Increased dietary fiber

What side effects may statins cause?

muscle damage (weakness and soreness)

How long may it take to see improvements in lipid profile?

weeks to months

What percentage of hypertension cases are chronic primary hypertension?

95%

What lifestyle factors contribute to primary hypertension?

high-fat and high-salt diets and physical inactivity

What are principal causes of secondary hypertension?

chronic kidney disease, excessive hormone secretion, and sleep apnea

What lifestyle modifications are recommended for hypertension?

habitual PA, smoking cessation, weight management, reduced sodium intake, moderation of alcohol consumption

What dietary pattern is recommended for hypertension?

Dietary Approaches to Stop Hypertension (DASH) diet