Myth: Diabetes comes from eating too much sugar

Prediabetic: 100-125 mg/dl

Fasting blood glucose over 125 - diabetic

Random test over 200 - diabetic

Hemoglobin A1C 5.7-6.4 pre 6.5 or above diabetic

If A1C is 7 - under control (still high risk)

Retinopathy - detached retina from pressure in head when holding breath -> blindness

Nepropathy - neurons in kidneys

Macrovascular : MI and stroke

Neuropathy - nerve damage ( can't feel feet)

 -can lead to sores-- adjust workout, increase balance etc to avoid gangrene

Silent Ischemia from blood vessel block

Insulin deficiency - not enough to regulate glucose

Autoimmune - pancrease are under attack (including glucagon and beta cells.)  Hypoglycemic - no glucagon being transported

Usually occurs betfore 30years

Symptoms : Frequent urination, always thirsty/hungry, weightloss, fatigue

Warning Signs: Dry mouth, urination, dry flushed skin, always tired/short of breath ketones (using fat for energy in absence of carbs), confusion, pain.  Young kids get this

Mostly obesity

Relative insulin deficiency - producing reduced amounts of insulin

Can be controlled with oral meds or insul

Genetics, environment (sedentary, poor diet)

Insulin abnormalities, increased glucose production, increase fat breakdown, hormonal secretions in intestines

Symptoms: Infections, blurred vision, slow to heal cuts and bruises, hands/feet tingling or numb, skin/gum/bladder infection

Gestational diabetes(Pregnant) - glucose intolerance during pregnancy.  From family history or a previously obese baby

Gluose can drop quickly, check before, during and after

May need to eat something before exercise

Be aware of how food has been metabolized and what they ate

Do they have retinopathy, neuropathy, comorbidities

Protein slows absorption of carbs

Complications: Balance, sores, other meds, pressure buildup in the head ( continue to remind them to breathe)

Exercise Training With Diabetes

Those who train with diabetes - glucose goes up and sensitivity to receptors stays up

Body fat decreases, healthy 

Can control diabetes without insulin/meds

Nutrition care plan

habitual exercise

weight loss (Most diabetics esp. type II are overweight)

Meds: take insulin 15 minutes before you eat, based on when you are taking it, what you are doing etc 

Exercise Prescription: What meds do they take and when?

What are their comorbidities, complications
What are their goals/benefits

FITT: Same as apparently healthy except cardio!

F: 3-7 days a week

I: No control 40-60, good control 40-85

T: 150 min a week

T: enjoyable

Contraindications: If glucose is too high (ketones) or too low

Infection, illness, retinal hemmorrhage

Exercise Testing for diabetes depends on age, duration of diabetes, and if there are complications 

Blisters, infections, gangrene can unknowingly happen

Get as much medical history as possible

Make sure they have an adequate source of CHO

No exercising late at night esp. without eating - can drop low in sleep and die

infection

dehydration

retinal detachment

heart beat control

thermoregulation

peripheral neuropathy

other comorbidities

ACSM

Hypoglycemia UNDER 70

Shaky, weak, sweaty, nervous, anxious, hunger, headache, fingers and mouth tingling, visual disturbances, mental dullness, confusion, amnesia---> Coma

Always consume before exercise if under 70

Monitor before, during, after bc glucose can quickly drop

When and what type of insulin was taken, where did they inject

exercise partner

keep hydrated

watch for complications

Precautions for CVD (BP) and over weight - FEET