EXERCISE FOR DIABETICS PATIENT
EXERCISE FOR DIABETICS PATIENT
Medical history and diagnosis
Mr X is 65 years old and was diagnosed with type 2 diabetes 6 years ago. Medication :Glucophage taken two times per day, captopril (for blood pressure control and protection of kidneys) and Lipitor for control of hyperlipidemia. Laboratory values : Last Hb 8.9%,cholesterol 201mg. dl, low density lipoproteins cholesterol 130mg. dl, high density lipoproteins cholesterol 36mg. dl, triglycerides 161mg. dl,
Physical exam :blood pressure 132/82mmHg,resting heart rate 72 beats per minute, hight 5ft 12 inc, weight 232lb with 28‰ body fat
Complications history :Acute periodic episodes of diabetes out of control but has never experienced hyperosmolar nonketotic syndrome or diabetic ketoacidosis. Chronic two vessels bypass surgery 6 years ago, moderate peripheral neuropathy, and early stage 3 diabetic nephropathy.
Exercise Test Result
No abnormal electrocardiogram changes, maximum blood pressure 179/82mmHg,maximum heart rate 150 beats per minute, vo2 Max 25.6ml.kg.min,random blood glucose before test 181mg. dl Exercise prescription
The goals of the exercise programmes, mutually agreed upon by the patient and the clinical exercise professional, are to lose weight and improve body composition, improve blood glucose levels, and reduce risk for another cardiac event. When asked about interests and hobbies, the patient indicated that he enjoyed playing with his pet, watching movies, traveling and drinking wine.
Participation in a supervised exercise programme and frequent contact with an exercise professional was given.
A warm up and cool down of static stretches and low intensity aerobic activity are prescribed.
Mode :Interest And Hobbies
While traveling, we advised him to take good care of his feet and do light activities as safely as possible.
Frequency :3 -5 days per week with a goal of increasing to daily. Intensity :This patient is taught to monitor heart rate and to use the rating of perceived exertion scale. The intensity is prescribed at 60%of maximum heart rate (150beats per minute) OR 90 beats per minute. An RPE rating of 12-13 on a 6-20 point Borg scale is advised.
Duration :An initial duration of 15-30 minutes is suggested and should be eventually increased to 60 minutes per session to facilitate weight loss.
Rate of progression :Attention is first given to frequency of exercise. Once he has reached 5 days per week or more, duration will be increased.
Other information that is necessary was given to the patient to increase his blood glucose monitoring frequency to assess the impact of exercise on his blood glucose control.
Diabetes mellitus (diabetes) is a group of metabolic diseases characterized by an inability to sufficiently produce or properly use insulin, resulting in hyperglycemia. Insulin, a hormone produced by the beta cells of the pancreas, is needed by muscle, fat, and the liver to utilize glucose. The hyperglycemia resulting from diabetes places individuals with this disease at risk for developing microvascular diseases including retinopathy and nephropathy, microvasvular diseases, and various neuropathies.
Type 2 diabetes
May range from predominant insulin resistance with relative insulin deficiency to predominant secretory defect with insulin resistance. Type 1 diabetes
Beta cells destruction, usually leading to absolute insulin deficiency Immune mediated
Idiopathic.
Other specific types
Genetic defects of beta cell function.
Genetic defects in insulin action.
Diseases of the exocrine pancreas
Endocrinopathies
Drug or chemical induced
Infections
Uncommon forms of immune -mediated diabetes
Other genetic syndromes sometimes associated with diabetes.
Gestational diabetes mellitus
Resulting from pregnancy.
N.B:
Patients with any form of diabetes May require insulin treatment at some stage of their disease. Such use of insulin does not, of itself, classify the patient.
Medical history and diagnosis
Mr X is 65 years old and was diagnosed with type 2 diabetes 6 years ago. Medication :Glucophage taken two times per day, captopril (for blood pressure control and protection of kidneys) and Lipitor for control of hyperlipidemia. Laboratory values : Last Hb 8.9%,cholesterol 201mg. dl, low density lipoproteins cholesterol 130mg. dl, high density lipoproteins cholesterol 36mg. dl, triglycerides 161mg. dl,
Physical exam :blood pressure 132/82mmHg,resting heart rate 72 beats per minute, hight 5ft 12 inc, weight 232lb with 28‰ body fat
Complications history :Acute periodic episodes of diabetes out of control but has never experienced hyperosmolar nonketotic syndrome or diabetic ketoacidosis. Chronic two vessels bypass surgery 6 years ago, moderate peripheral neuropathy, and early stage 3 diabetic nephropathy.
Exercise Test Result
No abnormal electrocardiogram changes, maximum blood pressure 179/82mmHg,maximum heart rate 150 beats per minute, vo2 Max 25.6ml.kg.min,random blood glucose before test 181mg. dl Exercise prescription
The goals of the exercise programmes, mutually agreed upon by the patient and the clinical exercise professional, are to lose weight and improve body composition, improve blood glucose levels, and reduce risk for another cardiac event. When asked about interests and hobbies, the patient indicated that he enjoyed playing with his pet, watching movies, traveling and drinking wine.
Participation in a supervised exercise programme and frequent contact with an exercise professional was given.
A warm up and cool down of static stretches and low intensity aerobic activity are prescribed.
Mode :Interest And Hobbies
While traveling, we advised him to take good care of his feet and do light activities as safely as possible.
Frequency :3 -5 days per week with a goal of increasing to daily. Intensity :This patient is taught to monitor heart rate and to use the rating of perceived exertion scale. The intensity is prescribed at 60%of maximum heart rate (150beats per minute) OR 90 beats per minute. An RPE rating of 12-13 on a 6-20 point Borg scale is advised.
Duration :An initial duration of 15-30 minutes is suggested and should be eventually increased to 60 minutes per session to facilitate weight loss.
Rate of progression :Attention is first given to frequency of exercise. Once he has reached 5 days per week or more, duration will be increased.
Other information that is necessary was given to the patient to increase his blood glucose monitoring frequency to assess the impact of exercise on his blood glucose control.
Diabetes mellitus (diabetes) is a group of metabolic diseases characterized by an inability to sufficiently produce or properly use insulin, resulting in hyperglycemia. Insulin, a hormone produced by the beta cells of the pancreas, is needed by muscle, fat, and the liver to utilize glucose. The hyperglycemia resulting from diabetes places individuals with this disease at risk for developing microvascular diseases including retinopathy and nephropathy, microvasvular diseases, and various neuropathies.
Type 2 diabetes
May range from predominant insulin resistance with relative insulin deficiency to predominant secretory defect with insulin resistance. Type 1 diabetes
Beta cells destruction, usually leading to absolute insulin deficiency Immune mediated
Idiopathic.
Other specific types
Genetic defects of beta cell function.
Genetic defects in insulin action.
Diseases of the exocrine pancreas
Endocrinopathies
Drug or chemical induced
Infections
Uncommon forms of immune -mediated diabetes
Other genetic syndromes sometimes associated with diabetes.
Gestational diabetes mellitus
Resulting from pregnancy.
N.B:
Patients with any form of diabetes May require insulin treatment at some stage of their disease. Such use of insulin does not, of itself, classify the patient.
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