BC ADM Exercise and Activity 2 — Questions and Answers
Question 1: A person with type 1 diabetes plans a 90-minute afternoon bike ride. Their pre-exercise glucose is 140 mg/dL. What is the MOST appropriate carbohydrate strategy?
- No carbohydrates needed since glucose is already elevated
- Consume 15–30 g carbohydrates before and 15 g every 30–45 minutes during exercise (Correct answer)
- Take extra insulin before exercise to prevent hyperglycemia
- Eat a high-protein meal only and avoid carbohydrates until after exercise
Correct answer: Consume 15–30 g carbohydrates before and 15 g every 30–45 minutes during exercise
For prolonged aerobic exercise, consuming 15–30 g carbohydrates before and 15 g every 30–45 minutes helps prevent exercise-induced hypoglycemia.
Question 2: Which phenomenon explains why blood glucose may remain elevated for several hours after high-intensity anaerobic exercise in people with diabetes?
- Decreased hepatic gluconeogenesis
- Catecholamine-mediated glycogenolysis and gluconeogenesis (Correct answer)
- Reduced cortisol secretion during recovery
- Increased peripheral glucose uptake by exercising muscle
Correct answer: Catecholamine-mediated glycogenolysis and gluconeogenesis
High-intensity anaerobic exercise triggers catecholamine release, which stimulates hepatic glycogenolysis and gluconeogenesis, causing post-exercise hyperglycemia.
Question 3: A patient with type 2 diabetes on metformin and a GLP-1 receptor agonist begins a walking program. Which statement about hypoglycemia risk is MOST accurate?
- Metformin and GLP-1 agonists rarely cause hypoglycemia, so exercise poses minimal added risk (Correct answer)
- GLP-1 agonists significantly increase hypoglycemia risk during exercise
- Metformin alone causes significant hypoglycemia with exercise
- Walking always requires supplemental carbohydrates regardless of medication class
Correct answer: Metformin and GLP-1 agonists rarely cause hypoglycemia, so exercise poses minimal added risk
Metformin and GLP-1 receptor agonists have low intrinsic hypoglycemia risk, so exercise does not substantially increase hypoglycemia risk in patients on these agents alone.
Question 4: What is the recommended minimum duration of interruption to prolonged sitting for individuals with type 2 diabetes to improve postprandial glucose levels?
- 30 seconds every 60 minutes
- 3 minutes of light activity every 30 minutes (Correct answer)
- 10 minutes of moderate activity every 2 hours
- 5 minutes of vigorous activity every 90 minutes
Correct answer: 3 minutes of light activity every 30 minutes
Breaking prolonged sitting with 3 minutes of light-intensity activity every 30 minutes significantly reduces postprandial glucose in people with type 2 diabetes.
Question 5: A patient with proliferative diabetic retinopathy asks about safe exercise options. Which activity should be AVOIDED?
- Swimming laps at a moderate pace
- Heavy weightlifting with Valsalva maneuver (Correct answer)
- Walking on a treadmill at 3 mph
- Stationary cycling at low resistance
Correct answer: Heavy weightlifting with Valsalva maneuver
Heavy resistance exercise with the Valsalva maneuver causes acute increases in intraocular pressure, risking vitreous hemorrhage in proliferative retinopathy.
Question 6: Which continuous glucose monitoring (CGM) trend arrow MOST warrants stopping exercise and treating hypoglycemia proactively?
- Glucose 140 mg/dL with a horizontal arrow
- Glucose 180 mg/dL with a single up arrow
- Glucose 100 mg/dL with a double down arrow (Correct answer)
- Glucose 90 mg/dL with a single up arrow
Correct answer: Glucose 100 mg/dL with a double down arrow
A CGM reading of 100 mg/dL with a double down arrow indicates rapidly falling glucose, posing imminent hypoglycemia risk during exercise.
Question 7: For a person with type 1 diabetes using an insulin pump, what adjustment is recommended when starting a 60-minute moderate-intensity aerobic session?
- Increase basal rate by 20% during exercise
- Suspend or reduce basal rate by 50–80% 60–90 minutes before exercise (Correct answer)
- Deliver a correction bolus before exercise to prevent hyperglycemia
- Disconnect the pump and give no insulin during exercise
Correct answer: Suspend or reduce basal rate by 50–80% 60–90 minutes before exercise
Reducing or suspending the basal rate 60–90 minutes before aerobic exercise allows time for circulating insulin levels to decrease, reducing hypoglycemia risk.
BC ADM Exercise and Activity 2
A person with type 1 diabetes plans a 90-minute afternoon bike ride.
Their pre-exercise glucose is 140 mg/dL.
What is the MOST appropriate carbohydrate strategy?