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

High-intensity exercise triggers a large release of counter-regulatory hormones, particularly epinephrine, which stimulates hepatic glucose output and can cause transient hyperglycemia.

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

A bedtime snack containing both carbohydrate and protein can help stabilize blood glucose overnight by providing a sustained glucose source during the period of enhanced muscle glycogen resynthesis.

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

Swimming and water aerobics are non-weight-bearing, eliminating pressure on insensate feet, which significantly reduces the risk of undetected injury in patients with peripheral neuropathy.

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

Heavy weightlifting involving the Valsalva maneuver sharply increases intraocular and blood pressure, raising the risk of vitreous hemorrhage or retinal detachment in proliferative retinopathy.

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

Patients with diabetes and cardiovascular risk factors should receive medical cardiovascular clearance, often including a stress test, before beginning a vigorous exercise program to identify silent ischemia.

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

CDCES Exercise and Physical Activity Management 2