Diabetes Exercise and Activity 2 — Questions and Answers
Question 1: A person with Type 1 diabetes wants to go for a 45-minute run. Their blood glucose is 90 mg/dL before starting. What should they do?
- Start running immediately without any changes
- Eat 15-30g of carbohydrates before starting (Correct answer)
- Skip the run until glucose is above 200 mg/dL
- Inject extra insulin before starting
Correct answer: Eat 15-30g of carbohydrates before starting
A pre-exercise blood glucose of 90 mg/dL is borderline low, so consuming 15-30g of carbohydrates before prolonged aerobic exercise helps prevent hypoglycemia.
Question 2: Which type of exercise tends to cause a delayed drop in blood glucose, often occurring 6-12 hours after the activity?
- Short sprints
- Prolonged aerobic exercise (Correct answer)
- Light stretching
- Isometric exercises
Correct answer: Prolonged aerobic exercise
Prolonged aerobic exercise depletes glycogen stores, which the body then replenishes over the next 6-12 hours, drawing glucose from the blood and potentially causing delayed hypoglycemia.
Question 3: What is the recommended approach for adjusting basal insulin when a person with Type 1 diabetes plans a full day of physical activity?
- Double the basal insulin dose
- Reduce basal insulin by 20-50% on the day of activity (Correct answer)
- Take no basal insulin on activity days
- Switch to a fast-acting insulin only
Correct answer: Reduce basal insulin by 20-50% on the day of activity
Reducing basal insulin by 20-50% on high-activity days helps prevent exercise-induced hypoglycemia while maintaining some background insulin coverage.
Question 4: A diabetic patient checks their blood glucose and gets a reading of 310 mg/dL. They also have ketones in their urine. What should they do about exercise?
- Exercise lightly to bring glucose down
- Postpone exercise, correct ketones with insulin and fluids (Correct answer)
- Do resistance training only
- Exercise for 10 minutes then recheck
Correct answer: Postpone exercise, correct ketones with insulin and fluids
Exercise with elevated ketones is dangerous because it can worsen ketoacidosis; the priority is to hydrate, correct glucose with insulin, and wait until ketones clear.
Question 5: Which post-exercise snack is MOST appropriate for preventing overnight hypoglycemia after an intense evening workout for a Type 1 diabetic?
- A sugary sports drink
- A protein-rich snack with some complex carbohydrates (Correct answer)
- A large high-fat meal
- Nothing — blood glucose was normal after the workout
Correct answer: A protein-rich snack with some complex carbohydrates
A protein-and-complex-carb snack before bed after evening exercise helps maintain blood glucose through the night as muscles replenish glycogen.
Question 6: What effect does resistance (strength) training typically have on blood glucose during the exercise session itself?
- Always causes a rapid drop in blood glucose
- Can cause a temporary rise in blood glucose due to stress hormones (Correct answer)
- Has no effect on blood glucose whatsoever
- Causes the same response as aerobic exercise
Correct answer: Can cause a temporary rise in blood glucose due to stress hormones
Resistance exercise stimulates release of catecholamines and cortisol, which can temporarily raise blood glucose during the session, unlike the glucose-lowering effect typical of aerobic exercise.
Question 7: How often should people with diabetes generally perform aerobic exercise according to major diabetes guidelines?
- Once a week for 60 minutes
- At least 150 minutes per week spread over at least 3 days (Correct answer)
- Every day for 30 minutes regardless of intensity
- Only when blood glucose is above 200 mg/dL
Correct answer: At least 150 minutes per week spread over at least 3 days
ADA guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity spread over at least 3 days with no more than 2 consecutive days off.
Diabetes Exercise and Activity 2
A person with Type 1 diabetes wants to go for a 45-minute run.
Their blood glucose is 90 mg/dL before starting.
What should they do?