CBDCE Exercise and Physical Activity 2 — Questions and Answers
Question 1: Which of the following is a contraindication to exercise in a person with diabetes?
- Stable background retinopathy
- Uncontrolled proliferative retinopathy (Correct answer)
- Well-controlled hypertension
- Stable mild peripheral neuropathy
Correct answer: Uncontrolled proliferative retinopathy
Uncontrolled proliferative retinopathy is a contraindication because vigorous exercise can raise intraocular pressure and risk vitreous hemorrhage or retinal detachment.
Question 2: A diabetes educator is counseling a patient on exercise and insulin adjustment. Which general strategy is appropriate for preventing exercise-induced hypoglycemia with planned aerobic exercise?
- Double the insulin dose before exercise
- Reduce the insulin dose acting during exercise and/or increase carbohydrate intake (Correct answer)
- Administer insulin immediately post-exercise
- Avoid all insulin on exercise days
Correct answer: Reduce the insulin dose acting during exercise and/or increase carbohydrate intake
Reducing the dose of insulin active during exercise and/or consuming additional carbohydrates are evidence-based strategies to prevent exercise-induced hypoglycemia.
Question 3: What is the recommended maximum number of consecutive days without exercise for adults with type 2 diabetes, per ADA guidelines?
- 1 day
- 2 days (Correct answer)
- 3 days
- 5 days
Correct answer: 2 days
The ADA recommends no more than 2 consecutive days without exercise to maintain improvements in insulin sensitivity.
Question 4: High-intensity interval training (HIIT) in type 2 diabetes is associated with which acute glycemic response during early recovery?
- Immediate sustained hypoglycemia
- Transient hyperglycemia followed by later hypoglycemia (Correct answer)
- No change in blood glucose
- Permanent normoglycemia
Correct answer: Transient hyperglycemia followed by later hypoglycemia
HIIT triggers catecholamine release causing transient hyperglycemia during/immediately after exercise, followed by a risk of hypoglycemia hours later.
Question 5: For a sedentary patient with type 2 diabetes and obesity, which initial exercise approach is most appropriate when designing a program?
- Begin with 60-minute vigorous sessions five days per week
- Start with short bouts of low-to-moderate activity and gradually increase (Correct answer)
- Recommend competitive sports immediately for motivation
- Restrict all exercise until A1C is below 7%
Correct answer: Start with short bouts of low-to-moderate activity and gradually increase
Gradual progression from short, manageable bouts prevents injury and burnout while building exercise tolerance and adherence in deconditioned patients.
Question 6: Which laboratory value should be obtained before a person with diabetes begins a vigorous exercise program to evaluate cardiovascular risk?
- Serum creatinine only
- Exercise stress test if indicated by risk assessment (Correct answer)
- Thyroid-stimulating hormone
- Complete metabolic panel only
Correct answer: Exercise stress test if indicated by risk assessment
An exercise stress test is recommended when clinical risk assessment suggests significant cardiovascular disease, as vigorous exercise can unmask silent cardiac ischemia.
Question 7: Breaking up prolonged sitting with brief activity bouts every 20–30 minutes in people with type 2 diabetes is recommended because it:
- Replaces the need for structured exercise sessions
- Attenuates postprandial glucose spikes and reduces insulin resistance (Correct answer)
- Lowers fasting glucose more than aerobic exercise
- Is only beneficial for patients on insulin
Correct answer: Attenuates postprandial glucose spikes and reduces insulin resistance
Regular interruptions of sedentary behavior with short activity bouts blunt postprandial hyperglycemia and reduce the metabolic harm of prolonged sitting.
CBDCE Exercise and Physical Activity 2
Which of the following is a contraindication to exercise in a person with diabetes?