CDCES Exercise and Physical Activity Management 2

Question 1

A patient with type 1 diabetes reports that blood glucose rises significantly during early-morning high-intensity exercise. What physiological phenomenon most likely explains this?

Accepted Answer

A surge in counter-regulatory hormones (epinephrine, cortisol) that increase hepatic glucose output

Answer

The Somogyi effect

Answer

Decreased peripheral glucose uptake due to cold morning temperatures

Answer

Rebound hyperglycemia from nocturnal hypoglycemia

Question 2

To reduce the risk of nocturnal hypoglycemia after an afternoon exercise session in a patient with type 1 diabetes, which strategy is most commonly recommended?

Accepted Answer

Consuming a bedtime snack containing carbohydrate and protein

Answer

Increasing the morning basal insulin dose

Answer

Avoiding all exercise after noon

Answer

Increasing the dinner bolus insulin by 20%

Question 3

A patient with diabetic peripheral neuropathy wants to increase physical activity. Which exercise type presents the lowest risk for foot injury and should be prioritized?

Accepted Answer

Swimming or water aerobics

Answer

Long-distance running

Answer

High-impact aerobics

Answer

Jump rope

Question 4

Which of the following exercise activities is generally contraindicated for a patient with proliferative diabetic retinopathy?

Accepted Answer

Heavy weightlifting with Valsalva maneuver

Answer

Walking at moderate pace

Answer

Swimming laps

Answer

Chair yoga

Question 5

Before a previously sedentary patient with type 2 diabetes and known cardiovascular risk factors begins a vigorous exercise program, the CDCES should recommend which pre-participation step?

Accepted Answer

A stress test or physician cardiovascular clearance

Answer

A 24-hour dietary recall

Answer

A hemoglobin A1C below 7% first

Answer

A fasting lipid panel

Question 6

A patient with type 1 diabetes uses an insulin pump. What is the recommended pump basal rate adjustment during prolonged moderate aerobic exercise?

Accepted Answer

Suspend or reduce the basal rate by 50–80% starting 60–90 minutes before exercise

Answer

Increase the basal rate by 20–30% during exercise

Answer

Disconnect the pump at the start of exercise only

Answer

No adjustment is needed if pre-meal bolus is reduced

Question 7

Which of the following statements best describes the effect of high-intensity interval training (HIIT) on blood glucose in type 1 diabetes compared to continuous moderate exercise?

Accepted Answer

HIIT may cause acute hyperglycemia during exercise but carries less hypoglycemia risk than continuous moderate exercise

Answer

HIIT consistently causes greater hypoglycemia than moderate exercise

Answer

HIIT has no measurable effect on blood glucose levels

Answer

HIIT and moderate exercise produce identical glycemic responses