Diabetes Exercise and Activity 3 — Questions and Answers
Question 1: A person with diabetes uses a continuous glucose monitor (CGM). What CGM trend arrow should make them cautious about starting intense exercise?
- Arrow pointing straight across (stable)
- Arrow pointing steeply downward (Correct answer)
- Arrow pointing slightly upward
- No arrow displayed
Correct answer: Arrow pointing steeply downward
A steeply falling CGM arrow indicates rapidly dropping glucose, suggesting that starting intense exercise could accelerate the drop and cause hypoglycemia.
Question 2: Which exercise modification is recommended for people with diabetic peripheral neuropathy affecting the feet?
- Increase running mileage to strengthen foot muscles
- Emphasize non-weight-bearing activities like swimming or cycling (Correct answer)
- Avoid all exercise until neuropathy resolves
- Wear thinner-soled shoes for better feedback
Correct answer: Emphasize non-weight-bearing activities like swimming or cycling
Non-weight-bearing exercise like swimming or cycling reduces risk of foot injury and ulcers in people with peripheral neuropathy who may not feel pain signals from the feet.
Question 3: A Type 2 diabetic patient on metformin alone starts a new walking program. How does this primarily help their diabetes management?
- Metformin works better when combined with exercise
- Exercise improves insulin sensitivity in muscle cells (Correct answer)
- Walking raises insulin secretion from the pancreas
- Exercise reduces metformin side effects
Correct answer: Exercise improves insulin sensitivity in muscle cells
Physical activity increases GLUT4 transporter activity in skeletal muscle, enhancing insulin sensitivity so muscles take up glucose more efficiently from the bloodstream.
Question 4: What is the primary concern with exercising outdoors in hot weather for people with diabetes?
- Heat directly raises blood glucose levels permanently
- Dehydration can worsen hyperglycemia and impair temperature regulation (Correct answer)
- Sweat invalidates CGM readings entirely
- Hot weather prevents insulin from working at all
Correct answer: Dehydration can worsen hyperglycemia and impair temperature regulation
Dehydration concentrates blood glucose and impairs the body's cooling mechanisms; people with diabetes are especially vulnerable to heat-related illness during exercise.
Question 5: Someone with proliferative diabetic retinopathy wants to exercise. Which activity should they AVOID?
- Swimming laps
- Heavy weightlifting and Valsalva maneuver activities (Correct answer)
- Gentle yoga stretching
- Leisurely walking
Correct answer: Heavy weightlifting and Valsalva maneuver activities
Activities involving straining or the Valsalva maneuver sharply increase intraocular pressure and can cause vitreous hemorrhage in people with proliferative retinopathy.
Question 6: What happens to insulin absorption rate when insulin is injected into a limb that will be actively exercised shortly after?
- Absorption rate slows significantly
- Absorption rate increases, potentially causing hypoglycemia (Correct answer)
- Absorption rate is completely unaffected by exercise
- Insulin becomes inactive when injected near active muscles
Correct answer: Absorption rate increases, potentially causing hypoglycemia
Increased blood flow to exercising limbs accelerates subcutaneous insulin absorption, which can lead to higher-than-expected insulin levels and hypoglycemia.
Question 7: What is the recommended minimum frequency for resistance training in people with diabetes according to ADA guidelines?
- Once per month
- 2-3 times per week on non-consecutive days (Correct answer)
- Every day for maximum benefit
- Only when aerobic exercise is not possible
Correct answer: 2-3 times per week on non-consecutive days
The ADA recommends resistance training at least 2-3 times per week on non-consecutive days to allow muscle recovery while building strength and improving glucose metabolism.
Diabetes Exercise and Activity 3
A person with diabetes uses a continuous glucose monitor (CGM).
What CGM trend arrow should make them cautious about starting intense exercise?