Exercise Prescription Flashcards

A patient with well-controlled type 2 diabetes and no complications asks about exercise during illness. What is the best advice?

Answer: Reduce intensity and monitor glucose closely; stop if glucose is very high or low or symptoms worsen

Illness raises glucose through stress hormones; light to moderate activity may be continued cautiously with close glucose monitoring, but high or very low glucose or worsening symptoms are reasons to stop.

Which measure most directly assesses cardiorespiratory fitness and is used to guide aerobic exercise intensity in diabetes management?

Answer: VO2 max (maximal oxygen uptake)

VO2 max is the gold standard measure of cardiorespiratory fitness and is used to set aerobic exercise intensity as a percentage of maximal capacity.

What insulin adjustment strategy is generally recommended for a patient with type 1 diabetes planning a 60-minute afternoon aerobic workout?

Answer: Reduce rapid-acting insulin at the meal before exercise by 25-75% depending on individual response

Reducing the premeal rapid-acting insulin dose by 25-75% before planned aerobic exercise helps prevent exercise-induced hypoglycemia in type 1 diabetes.

A sedentary 65-year-old with type 2 diabetes and mild osteoarthritis should be encouraged to begin physical activity with which approach?

Answer: Begin with low-intensity, short-duration activity and gradually progress

A gradual, progressive approach starting with low-intensity, shorter sessions minimizes injury risk and improves adherence in older sedentary adults with comorbidities.

What is the mechanism by which regular aerobic exercise improves glycemic control in type 2 diabetes independent of weight loss?

Answer: It improves insulin sensitivity in skeletal muscle by increasing mitochondrial density and GLUT-4 expression

Regular aerobic exercise enhances insulin sensitivity by increasing mitochondrial biogenesis and upregulating GLUT-4 expression in skeletal muscle.

Which of the following is a contraindication to unsupervised exercise that requires medical clearance first?

Answer: Unstable angina or recent cardiac event

Unstable angina or a recent cardiac event requires medical evaluation and clearance before initiating or resuming an exercise program.

When counseling a patient about exercise and nephropathy, which statement is most accurate?

Answer: Moderate exercise does not worsen diabetic nephropathy and may be beneficial for cardiovascular risk

Moderate-intensity exercise does not worsen diabetic nephropathy and provides cardiovascular and metabolic benefits; extreme high-intensity exercise may transiently increase proteinuria.