BC ADM Exercise and Activity 4 — Questions and Answers
Question 1: A patient with autonomic neuropathy begins an exercise program. Which cardiovascular response abnormality should the educator anticipate?
- Exaggerated heart rate response to exercise
- Fixed resting tachycardia with blunted heart rate increase during exercise (Correct answer)
- Bradycardia at rest that normalizes with activity
- Normal heart rate variability throughout exercise
Correct answer: Fixed resting tachycardia with blunted heart rate increase during exercise
Cardiac autonomic neuropathy causes resting tachycardia and an impaired chronotropic response, meaning heart rate does not increase normally with exercise intensity.
Question 2: What is the recommended approach to blood glucose monitoring for a person with type 1 diabetes beginning a new exercise routine?
- Check only before exercise until a stable pattern is established
- Monitor before, during (if >30 min), and after exercise, and check at bedtime (Correct answer)
- No additional monitoring beyond the usual schedule is required
- Only check glucose if symptoms of hypoglycemia develop during exercise
Correct answer: Monitor before, during (if >30 min), and after exercise, and check at bedtime
During initiation of a new exercise routine, frequent monitoring before, during prolonged sessions, after, and at bedtime helps identify glucose patterns and guide adjustments.
Question 3: Which statement BEST describes the effect of resistance training on body composition in people with type 2 diabetes?
- Resistance training primarily reduces visceral fat without affecting lean mass
- Resistance training increases lean muscle mass, which improves insulin sensitivity and resting metabolic rate (Correct answer)
- Resistance training has no significant effect on glycemic control compared to aerobic exercise
- Resistance training is contraindicated in obesity due to joint stress
Correct answer: Resistance training increases lean muscle mass, which improves insulin sensitivity and resting metabolic rate
Resistance training builds lean muscle mass, which increases glucose disposal capacity and resting metabolic rate, contributing to improved insulin sensitivity.
Question 4: A competitive athlete with type 1 diabetes needs to maintain performance during a high-intensity interval training (HIIT) session. Which pre-exercise glucose target is MOST appropriate?
- 70–100 mg/dL to optimize fuel utilization
- 126–180 mg/dL with no downward CGM trend (Correct answer)
- 200–250 mg/dL to ensure adequate fuel stores
- Below 70 mg/dL to stimulate maximal fat oxidation
Correct answer: 126–180 mg/dL with no downward CGM trend
A pre-HIIT glucose of 126–180 mg/dL with no falling trend provides a safe buffer against hypoglycemia while avoiding significant hyperglycemia during intense activity.
Question 5: According to the 2023 ADA Standards of Care, how many days per week of aerobic exercise are recommended for adults with type 2 diabetes?
- At least 2 days per week
- At least 3 days per week with no more than 2 consecutive days without exercise (Correct answer)
- 5–7 days per week of at least 60 minutes
- Every day without rest days
Correct answer: At least 3 days per week with no more than 2 consecutive days without exercise
ADA recommends at least 150 minutes of moderate-intensity aerobic activity spread over at least 3 days per week, with no more than 2 consecutive days without activity.
Question 6: A patient on a sulfonylurea plans to exercise vigorously for 45 minutes. Their pre-exercise glucose is 90 mg/dL. What is the MOST appropriate recommendation?
- Proceed with exercise; 90 mg/dL is a safe starting point
- Consume 15–20 g of rapid-acting carbohydrates before starting exercise (Correct answer)
- Take half the usual sulfonylurea dose before exercise
- Cancel the exercise session until glucose exceeds 126 mg/dL
Correct answer: Consume 15–20 g of rapid-acting carbohydrates before starting exercise
Sulfonylureas increase hypoglycemia risk during exercise; with a pre-exercise glucose of 90 mg/dL, consuming 15–20 g carbohydrates before vigorous activity is prudent.
Question 7: Which glucose level measured by CGM during exercise should prompt the individual to stop activity and treat, per expert consensus guidelines?
- Below 140 mg/dL
- Below 100 mg/dL (Correct answer)
- Below 70 mg/dL
- Below 54 mg/dL
Correct answer: Below 100 mg/dL
Expert consensus recommends consuming carbohydrates and potentially pausing exercise when CGM reads below 100 mg/dL during activity to prevent frank hypoglycemia.
BC ADM Exercise and Activity 4
A patient with autonomic neuropathy begins an exercise program.
Which cardiovascular response abnormality should the educator anticipate?