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Potential Complications of Diabetes
Heart disease/strokes Kidney disease/dialysis Eye disease/blindness Neuropathy/amputation TERM 2
STUDY: Effects of Exercise &
DM
DEFINITION 2 Training Diabetics on a 6 week program can decrease back to the non-Diabetic conditions TERM 3
Diabetes' Effects on Subcutaneous Fat
DEFINITION 3 causes an increase TERM 4
What Decreases Insulin Action
DEFINITION 4 Physical inactivity Genetics Poor diet Excess body fat Visceral (intra-abdominal) fat Aging (loss of muscle mass) Inflammation TERM 5
What Effect Does Activity Have on Insulin
DEFINITION 5 helps deter the incidence of insulin loss
Effects of Activity on Insulin
A single bout of exercise has long been known to increase insulin sensitivity, at least temporarily Acute exercise results in greater glucose storage in muscle (as glycogen) post-ex Exercise-induced improvements in IS can be partially negated by overfeeding TERM 7
Which is More Important: Intensity or
Duration
DEFINITION 7 Duration TERM 8
"Pick up the Pace"
Training
DEFINITION 8 speed by 10% for 30 minutes per day, 3 days per week Cardiovascular fitness more with 90 faster min/wk Any type of intervals may be beneficial TERM 9
Is Diet or Exercise More Important fo
Decreasing Visceral Fat
DEFINITION 9 Exercise is the more important component (aerobic and resistance) TERM 10
Low Level Inflammation Markers
DEFINITION 10 Fat/macrophages release cytokines, such as IL-6, TNF-alpha, resistin, etc. *Exercise helps prevent diabetic complications (decreases inflammation)
Mechanisms for Glucose Uptake During
Exercise
(1) Insulin Rest Exercise (2) Contractions Exercise Separate, but additive mechanisms TERM 17
Training Effects on BG
DEFINITION 17 Training BG use and fat use Thus, less muscle glycogen used after 2-3 weeks of training Need to absolute exercise intensity for same effect TERM 18
How Does Exercising Post-Meal Effects
Insulin?
DEFINITION 18 it causes it to decrease TERM 19
Characteristics of Aerobic Activities
DEFINITION 19 Aim for 150 min/wk moderate to vigorous Min. of every other day Walking at any speed (w/ good socks/shoes) TERM 20
Characteristics of Resistance Activities
DEFINITION 20 Recommended at least 2 days per wk Any intensity (15 reps moderate, 10 reps high) 2-3 sets per ex Work large muscle groups & core
Characteristics of Flexibility
Training
Stretches best done at least 2-3 days per week or after any exercise session Include all major muscle groups Hold stretches for 10-30 seconds TERM 22
Hypoglycemia Prevention Steps
DEFINITION 22
- Assess risk of low BG during & after Higher with new/unaccustomed ex Higher when insulin levels elevated 2. Lower exogenous insulin doses 3. Increase carbohydrate/food intake 4. Watch for delayed-onset hypoglycemia (for up to 48 hours after activity) TERM 23
Cautions with Hyperglycemia
DEFINITION 23 Avoid exercising if fasting glucose levels are > 250 mg/dl with ketosis present Use caution if glucose levels are > 300 mg/dl, and no ketosis is present (most with type 2 diabetes) *can also stimulate dehydration which isn't active until 1% of total body fluids have already been lost TERM 24
THR Should be Below ____ with Angina on
Exertion.
DEFINITION 24 10 beats TERM 25
Graded Exercise Testing is Recommended
if:
DEFINITION 25 Age > 40 years Age > 30 & type 1 or type 2 > 10 years or additional risk factor(s): CVD, complications Peripheral vascular disease present Presence of autonomic neuropathy
Evaporation Accounts for ____ heal lost during
exercise and ____ during rest.
Evaporation accounts for 80% of heat lost during exercise, but only for about 5-20% at rest. Insensible water loss removes about 10% of heat (lung, mucosa..). TERM 32
What is the Main Means of Heat Loss During
Exercise and Rest?
DEFINITION 32 During exercise, evaporation is the main means of heat loss; during rest, radiation is. TERM 33
Internal Temperature and Exercise
DEFINITION 33 Can exceed 40 C (104 F) during exercise Small increases can make muscles' energy systems more efficient (Q10 effect - increases metabolism and enzyme activities) May be 42 C (107.6 F) in active muscles Above 40 C can affect the nervous system and reduce the ability to unload excess heat TERM 34
Regulators of Heat
Exchange
DEFINITION 34 Hypothalamus (thermostat) Effectors Sweat glands Smooth muscle around arterioles (dilate/constrict) Skeletal muscles (shivering) Endocrine glands (Thyroxine/catecholamines) TERM 35
Response of Hypothalamus to Hyperthermia
DEFINITION 35 Increase in blood temperature Peripheral thermoreceptors in the skin relay info back to the hypothalamus Stimulates the hypothalamus Central thermoreceptors in the hypothalamus transmit info about the internal temperature Arterioles vasodilate (muscle activity increases which increases metabolic heat) Sweat glands stimulated for evaporation Decrease in body temperature
Rates of Heat
Exchange
Heat produced by average body at rest is 1.25 to 1.5 kcal per minute. Heat produced during exercise can exceed 15 kcal per minute (1.55 L/hour). This heat must be dissipated by the bodys thermoregulatory systems. TERM 37
Cardiovascular Drift
DEFINITION 37 the HR increases to compensate for lower SV TERM 38
A 5% Loss in Dehydration Causes:
DEFINITION 38 a 30% loss in performance TERM 39
Does the Thirst Mechanism Match the
Hydration State?
DEFINITION 39 no TERM 40
Hyponatremia
DEFINITION 40 Hyponatremia is an electrolyte disturbance (a disturbance of the salts in the blood) in which the sodium (Natrium in Latin) concentration in the plasma is lower than normal, can cause confusion, disorientation, and seizures
The Renin-Angiotensin
Mechanism
Decrease in plasma volume and blood flow - stimulates adlestorone secretio from the adrenal crotex which changes (with the use of renin) angiotensin I into II and starts the reabsorption of fluid along with sodium TERM 47
Wet Bulb Globe Temperature
DEFINITION 47 The Wet Bulb Globe Temperature (WBGT) is a composite temperature used to estimate the effect of temperature, humidity, wind speed (wind chill) and solar radiation on humans Simultaneously accounts for conduction, radiation, evaporation, & convection - dry bulb measures air temperature - wet bulb measures temperature as water evaporates from it TERM 48
Warning Signs of Heat Stroke
DEFINITION 48 Heat Cramp - might have cramping in your legs - sigh of heat stress You then go into thirst, sweating, & fatigue Next stage is heat exhaustion where the skin becomes pale/cool with overall weakness - heat exhaustion You then develop head aches, skin becomes dry and you stop sweating because the body is trying to retain the water because your plasma volume has dropped so low Heat stroke - cardiac arrest TERM 49
Treatment of Heat Cramps, Heat Exhaustion,
& Heat Stroke
DEFINITION 49 Heat crampsmove to cooler location and administer fluids or saline solution Heat exhaustionmove to cooler environment, elevate feet; give saline if conscious or intravenous saline if unconscious Heat strokerapidly cool body in cold water, ice bath or with wet towels; seek medical attention TERM 50
2 Techniques to Prevent Hyperthermia
DEFINITION 50
- avoid exercising in humid conditions above WGBT index of 28 C (82.4 F) - drink 8 oz of fluids every 15 mins
Heat Acclimatization
Ability to get rid of excess heat improves Sweat sooner, sweat glands produce a greater volume of sweat, and the sweat is more diluted (less concentrated) Reduced blood flow to skin; more available to muscle Blood volume increases Heart rate increase is less (than nonacclimatized) Stroke volume increases to aid in delivery of more blood to the muscles and skin Muscle glycogen usage decreases to delay onset of fatigue TERM 52
How Long Does it Take to Acclimate to
Heat?
DEFINITION 52 You can achieve heat acclimatization by exercising in the heat for 1 hour or more each day for 5 to 10 days. Cardiovascular adaptations occur within the first 3 to 5 days while changes in sweating mechanisms may take up to 10 days. Reduce exercise intensity to 60% to 70% the first few days before resuming more intense workouts. TERM 53
Shivering, Non-shivering Thermogenesis,
Piloerection, and Peripheral Vasoconstriction
DEFINITION 53 Shiveringrapid involuntary cycle of contraction and relaxation of muscles Nonshivering thermogenesisstimulation of metabolism, stimulation of thyroxing, NE, epinepherine that increase ATP production and increases heat production Peripheral vasoconstrictionreduces blood flow to skin Piloerectioninsulation, produces goosebumps that causes the raising of the hair follicles that act as an insulator that traps heat TERM 54
Factors that Affect Body Heat
Loss
DEFINITION 54 Wind chill Body size and composition (area to body mass ratio) Air temperature Water immersion (59F results in 3.8F/hr loss heat) TERM 55
Responses to Exercise in Cold
DEFINITION 55 Exercise-induced FFA mobilization is impaired due to vasoconstriction of subcutaneous blood vessels Muscles weaken and fatigue occurs more rapidly
Effects of Vinca Alkaolids, Daunorubicin,
Glucocorticoids, Growth Factors
Chemotherapy involves several drugs Vinca alkaloids: peripheral nerve damage Daunorubicin: cardiomyopathy Glucocorticoids: muscle weakness and wasting Growth factors: bone pain TERM 62
The Normal Menstrual Cycle
DEFINITION 62 Menarchethe first menses is ~12.8 yrs (can be delayed) Eumenorrheanormal menstrual function (10+/yr) Oligomenorrheaabnormally infrequent or scant menstruation (3- cycles/year) Amenorrheaabsence of menstruation (less than 3/yr) Primaryabsence of first menses in women 18 and older Secondaryabsence of menstruation sometime after first menses, generally three consecutive cycles TERM 63
Amenorrhea
DEFINITION 63 May occur in 2% to 12% in general population May occur in 5% to 40% of female athletes Risk increases with increased duration or intensity of training or decrease essential fat mass Athletes can become pregnant while amenorrheic TERM 64
Possible Causes of Menstrual
Dysfunction
DEFINITION 64 Prior history of menstrual dysfunction Acute stress High training volume or intensity Low body weight or body fatset points Inadequate nutrition (energy deficit) and disordered eating Hormonal alterations (decrease LH, estrogen) TERM 65
Anorexia Nervosa
DEFINITION 65 Refusal to maintain more than the minimal normal weight based on age and height Distorted body image Intense fear of fatness or gaining weight Amenorrhea
Bulimia Nervosa
Recurrent episodes of binge eating A feeling of lack of control during these binges Purging behaviorself-induced vomiting, laxative use, and/or diuretic use Twice/wk for 3 months TERM 67
Anorexia Athletica
DEFINITION 67 Not yet clinically recognized as an eating disorder Intense fear of gaining weight or fat though underweight A weight loss of at least 5% accomplished by energy deficit Use of bingeing, self-induced vomiting, laxatives, or diuretics TERM 68
The Female Athlete Triad
DEFINITION 68 Disordered eating Secondary amenorrhea Bone mineral disorders TERM 69
Typical Age of Occurrence of Menopause
DEFINITION 69 Menopause typically occurs between ages of 48 to 50, although it can occur in women as early as their 30s. The 5 years prior to menopause are often referred to as perimenopause. TERM 70
Physiologic Changes with Menopause
DEFINITION 70 Increase rate of bone mineral loss (~1%/yr) Estrogen deficiency Increase CHL, TG, & LDL; decrease HDL Increased fibrinogen levels Increased rate of muscle loss Urinary incontinence Joint pain & body stiffness Hair loss/thinning Decreased skin tone & increased wrinkling Vaginal dryness Increase abdominal fat
