Beetus 6

Question 1

PT mgmt

Exercise and diabetes effectiveness

Answer 1

structured resistance training associated with slight reduction in HbA1c

Question 2

PT mgmt:

effectiveness of exercise on DM is highly dependent upon:

Answer 2

Duration of intervention

Question 3

What is the recommended amount of exercise for a DM pt?

Answer 3

• Need over 150 mins/week of structured exercise (decrease in HbA1c levels)
• Exercise less than 150 mins/wk linked to a much lower reduction

.89% vs .36%

Question 4

What is the goal for PT mgmt of a pt with DM?

Answer 4

• at least 150 mins/week (mod » vigorous aerobic exercise)
• spread out during at least 3 days during the week
• no more than 2 consecutive days between bouts of aerobic activity

Question 5

What are concerns with exercise and DM?

Answer 5

• pre-exercise eval
• metabolic control before exercise
• blood glucose monitoring before and after exercise

Question 6

What should happen before undertaking exercise more intense than brisk walking? (Sedentary DM II pts)

Answer 6

Should have a complete eval

Question 7

ECG stress testing: pre-exercise eval

For asymptomatic individuals at low risk for CAD

Answer 7

• not recommended

- may be indicated for higher risk individuals

Question 8

Exercise and DM: concerns

Blood glucose monitoring before and after exercise

Answer 8

• allow insulin to peak
• transient hyperglycemia can follow intense physical activity
• learn the pt’s specific glycemic response to different conditions
• ID when changes in insulin or food intake are necessary
• carb-based foods/drinks should be available and used PRN during or after exercise to avoid hypoglycemia

Question 9

Insulin peak rule of thumb

Answer 9

• Takes one hour

- varies by type of insulin used

Question 10

Heating modalities and DM

Answer 10

Increase absorption speed of insulin from subcutaneous sites

Question 11

Cold modalities and DM

Answer 11

Decrease speed of absorption of insulin from subcutaneous sites

Question 12

Electrical modalities and DM

Answer 12

• use with caution

- advise against using on trunk

Question 13

How might exercise affect insulin/oral anti-diabetic drugs?

Answer 13

may enhance effectiveness

Question 14

Because exercise can enhance effectiveness of insulin and oral anti-diabetic drugs, what is important to be aware of

Answer 14

signs of hypoglycemia

Question 15

What are some options to have on hand to deal with an acute episode of hypoglycemia?

Answer 15

• juice
• 2 packets of sugar
• cake frosting
• glucose tablets

Question 16

Hypo and hyperglycemia:

Pt compliance and med administration

Answer 16

• pt may forget to take meds

- in hospital, check whether pt has been given insulin and whether/when they have had a meal

Question 17

What is Charcot joint caused by?

Answer 17

Partly due to lack of proprioception

Question 18

Where is Charcot joint common?

Answer 18

• foot
• shoulder
• hand

Question 19

S/s of Charcot joint

Answer 19

• severe swelling
• warmth
• redness
• pain

Question 20

Charcot foot results in:

Answer 20

Radiographic changes over time