BC ADM Exercise and Activity 5 — Questions and Answers
Question 1: What is the MOST likely explanation when a person with type 1 diabetes experiences hyperglycemia immediately after a 5-km race?
- Inadequate insulin absorption from the pump site due to increased blood flow
- Excessive catecholamine secretion during maximal effort suppressing insulin and stimulating glucagon (Correct answer)
- Delayed gastric emptying reducing glucose absorption during the race
- Over-correction of pre-race hypoglycemia with too many carbohydrates
Correct answer: Excessive catecholamine secretion during maximal effort suppressing insulin and stimulating glucagon
Maximal-intensity exercise triggers a large catecholamine surge that inhibits insulin secretion and stimulates glucagon, causing acute post-race hyperglycemia.
Question 2: Which of the following BEST describes insulin-like growth factor (IGF-1) mediated benefit of resistance exercise in diabetes?
- IGF-1 increases hepatic glucose output to fuel muscle repair
- IGF-1 promotes muscle hypertrophy and enhances glucose transporter expression (Correct answer)
- IGF-1 decreases GLUT-4 density in skeletal muscle
- IGF-1 primarily acts on adipose tissue to increase lipolysis during exercise
Correct answer: IGF-1 promotes muscle hypertrophy and enhances glucose transporter expression
Exercise-induced IGF-1 promotes muscle protein synthesis and upregulates GLUT-4 expression, enhancing long-term glucose uptake capacity.
Question 3: A patient with type 1 diabetes and a history of severe hypoglycemia unawareness asks about safe exercise. What is the MOST important management strategy?
- Restrict all exercise to supervised gym settings only
- Raise glucose targets before exercise, use CGM with alerts, and exercise with a partner informed of emergency procedures (Correct answer)
- Avoid exercise entirely until hypoglycemia awareness is fully restored
- Switch all insulin to ultra-long-acting formulations before resuming exercise
Correct answer: Raise glucose targets before exercise, use CGM with alerts, and exercise with a partner informed of emergency procedures
Raising pre-exercise glucose targets, using CGM with low-glucose alerts, and exercising with an informed companion are key safety measures for those with impaired hypoglycemia awareness.
Question 4: Which statement about water-based exercise (swimming, water aerobics) for people with diabetes is MOST accurate?
- Water exercise is contraindicated for those with diabetic foot ulcers due to infection risk (Correct answer)
- CGM sensors are fully waterproof and accurate in all water temperatures
- Water exercise provides no cardiovascular benefit compared to land-based exercise
- Swimming is contraindicated in type 1 diabetes due to difficulty monitoring glucose
Correct answer: Water exercise is contraindicated for those with diabetic foot ulcers due to infection risk
Open wounds including diabetic foot ulcers pose significant infection risk in pool or open water environments, making water exercise contraindicated until ulcers are healed.
Question 5: A person with type 2 diabetes reports that their fasting glucose is consistently higher on days after they exercise in the evening. What is the MOST likely explanation?
- Evening exercise suppresses overnight glucagon secretion
- The dawn phenomenon is more pronounced after evening exercise due to growth hormone release during sleep (Correct answer)
- Exercise increases overnight hepatic glucose output through catecholamine activation persisting into sleep
- Evening meals consumed after exercise are contributing to elevated fasting glucose
Correct answer: The dawn phenomenon is more pronounced after evening exercise due to growth hormone release during sleep
Evening exercise can stimulate growth hormone release, which interacts with the dawn phenomenon to cause higher fasting glucose the following morning.
Question 6: What percentage of maximum heart rate is generally used to define the lower boundary of vigorous-intensity aerobic exercise?
- 55%
- 64%
- 77% (Correct answer)
- 90%
Correct answer: 77%
Vigorous-intensity aerobic exercise is generally defined as ≥77% of maximum heart rate, corresponding to a significant increase in breathing and an inability to speak in full sentences.
Question 7: A diabetes educator is counseling a patient about exercise-associated hypoglycemia that occurs 12–16 hours after prolonged endurance exercise. Which mechanism is PRIMARILY responsible?
- Rebound hyperinsulinemia from post-exercise pancreatic beta-cell overstimulation
- Muscle glycogen resynthesis competing with the brain for circulating glucose during the recovery period
- Persistent GLUT-4 upregulation in muscle increasing non-insulin-mediated glucose uptake during glycogen repletion (Correct answer)
- Reduced renal glucose reabsorption causing glycosuria in the recovery period
Correct answer: Persistent GLUT-4 upregulation in muscle increasing non-insulin-mediated glucose uptake during glycogen repletion
Prolonged exercise depletes muscle glycogen; during recovery, GLUT-4 remains upregulated to facilitate glycogen resynthesis, continuing to draw glucose from the bloodstream for many hours.
BC ADM Exercise and Activity 5
What is the MOST likely explanation when a person with type 1 diabetes experiences hyperglycemia immediately after a 5-km race?