1. Diabetes Characterized by an absolute (type 1) or relative (type 2) insulin deficiency that results in hyperglycemia A major health problem and leading cause of death in the United States More than 17 million with diabetes, only 11.1 million are diagnosed

2. Diabetes Type 1 –Lack of insulin –Develops early in life –10% diabetic population Type 2 –Resistance to insulin –Develops later in life –90% diabetic population

3. Diabetes

4. Exercise and the Diabetic Control of blood glucose is important Adequate insulin is required Ketosis –Metabolic acidosis from accumulation of ketone bodies –May result from a lack of insulin

5. Effect of Prolonged Exercise in Diabetics Fig 17.1

6. Exercise and Type 1 Diabetes Pre-exercise blood glucose level –80 to 250 mgdl -1 Timing with insulin –Should not exercise at time of peak insulin action Glucose monitoring –During/after exercise Carbohydrate intake –During recovery

7. Effect of Plasma Insulin Levels in Type 1 Diabetics During Exercise Fig 17.2

8. Exercise and Type 2 Diabetes Blood glucose monitoring –In those taking oral hyperglycemic agents Exercise prescription –4-7 times per week Promotes weight loss and sustained increase in insulin sensitivity –Minimum of 1000 kcal/wk From all physical activity

9. American Diabetes Association Goals for Nutrition Therapy Attain & maintain optimum metabolci outcomes: –Blood glucose levels in normal range –A lipid & lipoprotein profile that reduces the risk of macrovascular disease –Blood pressure level that reduces risk of vascular disease Improve health through food choice & activity Address individual nutritional needs