Diabetes Exercise and Activity 4 — Questions and Answers
Question 1: During a group fitness class, a person with Type 1 diabetes begins to feel shaky and confused. Their glucometer reads 58 mg/dL. What is the immediate first step?
- Continue exercising until the class ends
- Stop exercise and consume 15g of fast-acting carbohydrates immediately (Correct answer)
- Inject glucagon right away
- Drink a large glass of water
Correct answer: Stop exercise and consume 15g of fast-acting carbohydrates immediately
The '15-15 rule' for mild-to-moderate hypoglycemia calls for stopping activity and consuming 15g of fast-acting carbohydrates, then rechecking glucose in 15 minutes.
Question 2: Which statement about exercise and HbA1c is most accurate?
- Exercise has no measurable effect on HbA1c levels
- Regular exercise can lower HbA1c by approximately 0.5-1.0% in Type 2 diabetes (Correct answer)
- Exercise only improves HbA1c if combined with insulin therapy
- Exercise raises HbA1c by increasing glucose production
Correct answer: Regular exercise can lower HbA1c by approximately 0.5-1.0% in Type 2 diabetes
Meta-analyses show that regular structured exercise reduces HbA1c by approximately 0.5-1.0% in Type 2 diabetes through improved insulin sensitivity and increased glucose utilization.
Question 3: A diabetic patient is planning to start high-intensity interval training (HIIT). What should they be aware of regarding blood glucose response?
- HIIT always lowers blood glucose more than moderate exercise
- HIIT can initially raise blood glucose due to catecholamine release before it drops (Correct answer)
- HIIT has no effect on blood glucose
- HIIT should never be attempted with diabetes
Correct answer: HIIT can initially raise blood glucose due to catecholamine release before it drops
The intense anaerobic bursts in HIIT trigger adrenaline and cortisol release, which can spike blood glucose during the session, followed by a drop during recovery.
Question 4: What is the recommended blood glucose target range before starting moderate aerobic exercise for a person with Type 1 diabetes?
- 40-70 mg/dL
- 90-250 mg/dL (Correct answer)
- 300-350 mg/dL
- Above 400 mg/dL
Correct answer: 90-250 mg/dL
A pre-exercise blood glucose of 90-250 mg/dL is generally considered safe to begin moderate aerobic exercise for most people with Type 1 diabetes.
Question 5: How does prolonged sitting (sedentary behavior) affect blood glucose control, even in people who meet weekly exercise guidelines?
- Meeting exercise guidelines fully offsets the harm of prolonged sitting
- Prolonged sitting independently worsens insulin resistance and glucose levels (Correct answer)
- Sitting has no metabolic effect if calorie intake is controlled
- Only standing desks can correct sitting-related glucose problems
Correct answer: Prolonged sitting independently worsens insulin resistance and glucose levels
Research shows prolonged uninterrupted sitting independently raises post-meal glucose and insulin resistance, even in people who exercise regularly — breaking sitting time every 30 minutes helps.
Question 6: What precaution should a person with autonomic neuropathy take during exercise?
- Avoid all forms of exercise permanently
- Monitor heart rate carefully since they may not feel angina or have an abnormal heart rate response (Correct answer)
- Exercise only at maximum intensity to strengthen the nervous system
- Drink caffeinated beverages before exercise to boost heart rate
Correct answer: Monitor heart rate carefully since they may not feel angina or have an abnormal heart rate response
Autonomic neuropathy can blunt pain sensation (silent ischemia), impair heart rate response, and cause orthostatic hypotension, requiring careful cardiac monitoring during exercise.
Question 7: Which benefit of exercise is MOST directly related to improving Type 2 diabetes management?
- Increased appetite stimulation
- Enhanced skeletal muscle glucose uptake through GLUT4 translocation (Correct answer)
- Reduced kidney filtration rate
- Increased glucagon secretion
Correct answer: Enhanced skeletal muscle glucose uptake through GLUT4 translocation
Exercise causes GLUT4 glucose transporters to move to the muscle cell surface, enabling insulin-independent glucose uptake and directly lowering blood glucose during and after activity.
Diabetes Exercise and Activity 4
During a group fitness class, a person with Type 1 diabetes begins to feel shaky and confused.
Their glucometer reads 58 mg/dL.
What is the immediate first step?