1. Kim Harper, Meggan McLeod, Katherine Farrell, and Carly Lepp
Diabetes
Group 2 Lab 1
Kim Harper, Meggan McLeod, Katherine Farrell, and Carly Lepp
Part 1

2. Definition of Diabetes
“a chronic metabolic disease characterized by an absolute or relative deficiency of insulin resulting in hyperglycemia (blood glucose over 180 mg/dl).” (ACSM)
There are two types of Diabetes. Type 1 and Type 2

3. Comparison Chart of two types Of Diabetes
Type I diabetes
Type II diabetes
Definition
Also known as insulin dependent diabetes mellitus (IDDM). Insulin must be supplied by injection as there is an absolute deficiency due to a reduction of insulin secreting cells of the pancreas.
Also known as non-insulin dependent diabetes mellitus (NDDM). People with type II diabetes may have elevated, reduced, or normal insulin levels but still present with hyperglycemia.
Development of symptoms
Rapid
Slow
Medications
Insulin/ hypoglycemic agents (lys-pro, lente, ultra lente and tolazamide, glipizide or metformin) antihypertensives, lipid-lowering gents
Oral stimulators of insulin secretions (sulfonylureas, meglitinides, biguanides, and alpha-glucosidase inhibiters)

4. Comparison Chart Continued
Causes
Thought to be because of an autoimmune response directed at the pancreatic cells
An insulin secretion deficiency in the pancreas combined with an insulin resistance in peripheral tissues. Family history of diabetes, old age, obesity and lack of exercise are also predisposing factors.
Usual Age of Onset
Under 20 yrs
Over 40 yrs
Populations Affected
~10% of diabetic population
~90% of diabetic population
Treatment
Insulin injections
Diet; regular exercise; oral stimulators of insulin secretion; insulin injections.
Association with obesity
Rare
Common
Signs and Symptoms
General signs and symptoms
Increased frequency of urination
Increased thirst and appetite
General weakness
Without medication
Dry mouth
Abdominal pain
Nausea and vomiting
Sweet breath
Weak rapid pulse

5. Contraindications to exercise with Diabetes
blood glucose >240 mg/dl and ketones in urine for type I diabetes and >300mg/dl without ketones for type II. May have loss of protective sensation in feet or foot ulcers and thus should avoid outdoor activities.may have acute illness, infection, or fever.

6. Complications with Diabetes
Severe kidney disease, 2x as likely as the general population to die of coronary heart disease, leading cause of blindness in adults (diabetic retinopathy), major cause of renal disease, peripheral vascular disease occurs 5x more often, up to 50% of non-traumatic amputations are the result of diabetic neuropathies. Diabetes is also the leading cause of death by disease.

7. Types of Drugs for Type II Diabetes
Sulfonylureas- Stimulate beta cells of the pancreas to release more insulin. Has been used since the 1950’s. It is taken 1- 2 times daily before meals. An example is chlorpropamide (brand name diabinese).
Meglitinides- Stimulate beta cells of the pancreas to release more insulin. Shouldn’t be mixed with alcohol. Taken 3 times daily at meals. An example is Nateglinide (brand name starlix).

8. More Types of Drugs of Drugs for Type II Diabetes
Biguanides- Lower blood glucose levels by decreasing the amount of glucose produced by the liver, also by making the muscle tissue more sensitive to insulin so glucose can be absorbed. Taken twice daily. An example is metformin (brand name- Glucphage).
Alpha-Glucosidase inhibitors- Lower blood glucose levels by blocking the break down of starches. Taken with meals.
*** Only Type II Diabetes can use pills.

9. Exercise with Diabetes
people with diabetes can follow the standard exercise guidelines for frequency, and duration but should maintain heart rates around 40-70% max H.R. (~ bpm) lower for older adults and higher for younger people especially if taking a heart rate altering medication. Also food intake and insulin dosage should be altered prior to exercise and exercise should be done at roughly the same time everyday, preferably in the a.m. to avoid fluctuations in insulin levels. Some suggested aerobic activities are swimming, cycling, and brisk walking. If the diabetes affects the blood pressure anerobic exercises such as weight lifting should be avoided as they increase blood pressure.

10. Benefits of Exercise with Diabetes
increased insulin sensitivity, increased glucose tolerance, helps combat obesity, can help reverse the resistance to insulin that occurs as a result of diabetes, reduction of risk factors for coronary heart disease (ie. lowers cholesterol). May help to lower blood pressure, enhance quality of life.

11. Exercise Program Guidelines
always have physician’s approval to exercise, know specific signs and symptoms of an insulin reaction, always have a warm-up and a cool down period, keep an eye on blood glucose levels

12. Adolescents Aged 14-16
Lab 3
Part 2

13. Physical Developments
Adolescents within this age group are transitioning from being a child to an adult and are in the midst of a growth period
Muscle tissue begins to grow rapidly, more dramatically in boys than in girls
Weight gain occurs and body shape changes – males shoulders widen and become more muscular, girls become “curvier” and experience an increase in overall body fat
Males are at their peak height velocity (PHV), whereas females have already gone through their PHV growth spurt
Development of secondary sex characteristics

14. How do Physical Changes Affect Adolescents
Teens may be clumsier because of growth spurts.
Teenage girls may become overly sensitive about their weight. This concern arises because of the rapid weight gain associated with puberty. Sixty percent of adolescent girls report that they are trying to lose weight. A small percentage of adolescent girls (1-3%) become so obsessed with their weight that they develop severe eating disorders such as anorexia nervosa or bulimia. Anorexia nervosa refers to starvation; bulimia refers to binge eating and vomiting.

15. Psychosocial Constraints Self Esteem
Influenced by verbal and non verbal communication
Adolescents compare themselves to their peers
Adolescent females tend to have lower self esteem due to physical changes that occur at puberty – weight gain, change in height, appearance

16. Psychosocial Constraints Motivation
Improve skills and attain goals
Make new friends
Be part of a team
Competition
Fun
Increase fitness
Drop-out begins to occur at this age

17. Psychosocial Constraints Attention Constraints
Very social and vocal
Interact with peers and make new friends
May ignore adult instruction and have shorter attention span if topic of discussion isn’t of interest

18. LTAD – Training to Train Stage
Males 12-16, Females 11-15
This developmental stage is the major fitness developmental stage
This stage focuses on improving aerobic fitness and strength
Adolescents within this age group are very competitive and are beginning to specialize in certain sports
Adolescents are introduced to free weights for strength training
This stage integrates mental, cognitive, and emotional development
Important to promote the benefits of physical activity and encourage students of this age group to persist in physical activities and exert effort to improve

19. References
Getchell, N., Haywood, K.M. (2005). Life Span Motor Development (4th Ed.). Champaign, Il. Edwards Brothers
Albright. (1997). Diabetes. ACSM's exercise management for persons with chronic diseases and disabilities (pp )
Long-Term Athlete Development Plan.
National Strength and Conditioning Association. (2004). Diabetes. In R. Earle, & T. Baechle (Eds.), (pp )NSCA certification Commission.
Rimmer, J. (1994). Diabetes. Fitness and rehabilitation programs for special populations (pp )