Exercise Prescription In a Diabetic Patient

Risk factors for cardiovascular disease include Physical inactivity +,Dyslipidemia

+Hyperglycemia +, Smoking, age +, Alcohol use, High blood pressure, Obesity+, Unhealthy

diet, familial history +.The above risk factors puts this patient at a high risk for cardiovascular

disease. Total cholesterol is high and this is a diabetic patient thus they fall into the high risk

category (Nag & Ghosh, 2014).

For the short term goals the patient should check their blood sugar regularly as soon as

they take their insulin. If blood sugar is low take appropriate steps to correct this. Patient should

set a reminder to do these on her smartphone. if blood sugar is low the patient should follow the

15/15 rule in that if blood sugar is less than 4mmol/l take 15g of carbs and wait 15 minutes to

retest. If blood sugars are below 4.0mmol/l after three tests then seek medical assistance. patient

should aim to perform moderate exercises for atleast 150 minutes per week. It should incorporate

various cardiovascular, muscle building and bone building activities. Atleast they should set 30

minutes of exercise every morning. These goals are specific as they aim to perform specific

tasks. They are measurable, attainable, relevant to glycemic control and time bound.

For the long term goals patient should see the doctor every three to five months, have a

foot exam, an eye exam and dental exam yearly. Advice given by healthcare professionals

especially on goals monitoring should be followed. these goals are specific as the patient aims to

visit the doctor at specific time, measurable as the patient can monitor how many times they visit

the healthcare professionals, attainable as setting up time to visit the hospital yearly is not too

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challenging, relevant as they aim to control diabetes and time bound as the checkups are

scheduled over specific time.

Reccomendations for 150 minutes of moderate exercises spread over a week, which

means 30 mins of exercise per day. The mode of exercising involve brisk walking. In case of

muscle strength and resistance a minimum of weekly exercises, atleast twice per week on non

consecutive days. 1-4 sets of 5-10 multijoint exercises involving major muscle groups. A slow

progression of the number of sets and load used is recommended that allows for completion of

10-15 sets, that is, moderate intensity. Flexibility exercises are recommemded to supplement the

above exercises (Colberg, 2013).

The above exercises will help the patient achieve her goal of losing 50 pounds in the next

2 months. She will be physically fit and reduce her risk for cardiovascular disease and achieve

glycemic control. After four weeks the patient will have established endurance to physical

activity although the weight may not be ideal. Various signs and symptoms should be watched

out for as they may indicate injury during exercise. Some include diabetic foot , hyperglycemia,

hypoglycemia, dehydration, musculoskeletal disorder, cardiovascular risk and medication and

exercise interactions adverse effects. Precautions to take prior to exercises include glycemic

control and hydration, good quality foot wear and an eye exam should be undertaken.

After normal progression for the next two weeks recommendation to upgrade the

exercises to vigorous exercises is made. Cardiorespiratory exercises should be vigorous in

intensity over 90 mins per week and involve jogging. Muscle strength and endurance sets should

exceed 8-10 repetitions of vigorous exercises. Flexibility exercises should be incorporated.

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 Some interventions that will assist the patient to achieve the best outcome include

education on how to carry out exercises such as warm up and cool downs, hydration and

performance of exercise under professional supervision. Regular foot observation and

monitoring of blood glucose and blood pressure before and after exercises (Kuball & American

Diabetes Association, 2018).

References

Colberg, S. R. (2013). Exercise and Diabetes : A Clinician’s Guide to Prescribing Physical

Activity. American Diabetes Association.

Kuball, E., & American Diabetes Association. (2018). Managing type 2 diabetes. John Wiley &

Sons, Inc.

Nag, T., & Ghosh, A. (2014). Cardiovascular disease risk factors in Asian Indian population:

A systematic review. Journal of Cardiovascular Disease Research, 4(4).

https://doi.org/10.1016/j.jcdr.2014.01.004