Exercise Prescription Flashcards

A patient uses a continuous glucose monitor (CGM) during exercise. At what CGM glucose trend and level should they consume 15-20g of carbohydrate prophylactically?

Answer: Glucose 90 mg/dL with a rapid downward trend arrow during aerobic exercise

A glucose of 90 mg/dL with a rapid downward CGM trend during aerobic exercise indicates imminent hypoglycemia risk warranting prophylactic carbohydrate intake.

Which adaptation to resistance training is most responsible for long-term improvements in resting metabolism in patients with type 2 diabetes?

Answer: Increased skeletal muscle mass

Resistance training increases skeletal muscle mass, which is the primary metabolically active tissue that elevates resting metabolic rate and improves glucose disposal.

A patient with type 1 diabetes reports hypoglycemia consistently 8-12 hours after afternoon swimming sessions. What is the most likely cause?

Answer: Delayed (late-onset) post-exercise hypoglycemia due to glycogen repletion and enhanced insulin sensitivity

Delayed hypoglycemia 6-15 hours post-exercise occurs because muscles replenish glycogen stores and insulin sensitivity remains elevated, increasing glucose uptake during this window.

What is the Talk Test as applied to exercise intensity prescription?

Answer: Moderate intensity allows comfortable conversation but not singing; vigorous intensity limits speech to a few words

The Talk Test is a practical intensity guide: moderate exercise allows conversation but not singing, while vigorous exercise allows only brief phrases.

For a patient with diabetic peripheral neuropathy exercising regularly, what foot care practice is most critical?

Answer: Inspect feet daily for blisters, cuts, or pressure points and wear well-fitting, moisture-wicking socks and proper footwear

Daily foot inspection and appropriate footwear prevent undetected wounds that can progress to serious infections in patients with reduced foot sensation.

Which patient scenario represents the highest absolute risk for exercise-induced cardiovascular event and warrants a stress test before starting vigorous activity?

Answer: 60-year-old with type 2 diabetes, 15-year history, known CAD, and exertional chest tightness

A patient with known coronary artery disease and symptomatic exertional chest tightness has clear high cardiac risk and requires evaluation before vigorous exercise.

What is the rationale for recommending that patients with type 2 diabetes exercise within 1-3 hours after a meal?

Answer: Post-meal exercise helps blunt postprandial glucose spikes and reduces overall daily glucose variability

Exercising in the postprandial window utilizes meal-derived glucose, effectively blunting the postprandial glucose peak and improving overall glucose control.