A comparison between Individuals with Diabetes type 2 and Those Without the condition

Week 5 Final Assignment
Part 1

Client information
Jackson is a male adult aged 40 years. He is 5’9 feet tall and weighs 200 pounds.
Jackson was diagnosed with type 2 diabetes two years ago. At the time, he weighed 230
pounds. Jackson suffered a knee injury one afternoon after his bike’s brakes failed, making
him roll down a hill. The injury was treated at a health facility, and he was discharged. One
month later, Jackson was concerned about the wound’s condition. It was healing at a very
slow rate. It was not a serious wound and should not have taken that long to heal. He went to
the hospital. After several tests were done, he was diagnosed with type 2 diabetes. Prior to
this incident, Jackson did not have any health issues.
Compromising Condition
Diabetes type 2 is a compromising condition for Jackson. The condition is
compromising because people with type 2 diabetes are predisposed to injury. Thus, a lot of
consideration must be made before, during, and even after engaging in physical activity. The
amount of glucose in the blood of individuals with type 2 diabetes is high. This can be
attributed to two main reasons; either the body is insulin resistant and thus does not use
insulin properly, or the body does not produce enough insulin to process the glucose (Colberg
et al., 2010). Exercise helps reduce the amount of glucose in the blood. When one is
exercising, the muscles in the body can use glucose, and thus, it does not matter whether one
is insulin resistant or the body does not produce enough insulin. If an individual is insulin
resistant, engaging in physical exercise helps make the insulin more effective as the
resistance tends to go down the more one engages in physical exercise.

WEEK 5 FINAL ASSIGNMENT 3
However, before engaging in physical exercise, one must ensure that their blood sugar
is in a safe range to avoid complications. Also, one should stay hydrated by drinking water
before, during, and after exercises. A low blood glucose treatment should always be kept
within range. Thus, an individual needs to carry a carb snack of approximately 15 g in case
the blood sugar levels drop during exercise (Colberg et al., 2010). The need to constantly
keep the blood sugar levels in check makes diabetes a compromising condition during
physical activity.
A comparison between Individuals with Diabetes type 2 and Those Without the
Condition
Studies show that individuals with diabetes type 2 experience a decline in their quality
of life compared to individuals who are healthy (de Grauw et al., 1999). The functionality of
their health status tends to decrease as complications become severe. The physical fitness of
these patients is usually impaired. In the event that the individual has comorbidity, which is
very common among patients of type 2 diabetes, then the functional health status is
significantly reduced (de Grauw et al., 1999). Cardiovascular comorbidity is a common and
predominant factor in these patients. It reduces the life expectancy and impairs the functional
health status of a patient. Thus, while the functional health status of healthy individuals does
not decline, that of type 2 diabetes patients tends to decline over time (de Grauw et al., 1999).
The condition is chronic, and thus, a longer duration of diabetes means a lower functional
health status. However, studies show that type 2 diabetes does not have a direct effect on a
person’s mental health. Thus, the mental health conditions of these patients do not differ from
that of healthy individuals if all factors are kept constant.
During physical exercises, recruited skeletal muscles to need at least four times more
energy for contraction, using fatty acids, blood glucose, and glycogen from the muscles as a

WEEK 5 FINAL ASSIGNMENT 4
metabolic fuel (Nakhanakhup et al., 2006). In healthy individuals, the main source of fuel
during short-term and strenuous exercise is muscle glycogen. When the duration of physical
exercises is prolonged, the muscles derive their energy from fatty acids and blood-born
glucose. Plasma has more adrenaline, cortisol, glucagon, and growth hormone, and this
increases the production of glucose and fatty acids from the adipose tissue (Nakhanakhup et
al., 2006). Glucose from different substrates such as pyruvate is synthesized, and this helps
maintain glucose homeostasis through glucogenesis.
However, in individuals with type 2 diabetes, physical exercise helps in the
expression of GLUT4, specifically in the muscle that is being trained (Nakhanakhup et al.,
2006). Consequently, the body’s capacity to transport glucose is enhanced. This mechanism
is responsible for the increase in the body’s sensitivity and responsiveness to insulin. Other
changes include an enhanced flow of blood in the muscle, an increase in skeletal muscle
mass, and a decline in body fat. Physical training in these patients also helps in enhanced
glucose tolerance. The aim of exercise in these patients is to include chronic and cute
physiological changes in the body so as to enhance glucose tolerance and improve the body’s
sensitivity to insulin (Nakhanakhup et al., 2006). Another disparity is that before
commencing physical exercise, diabetes patients should submit to a decal examination. They
face an increased risk of silent cardiac ischemia and coronary artery disease. Also, during
screening, the patient should be checked for complications such as micro and macrovascular,
which may worsen after engaging in acute physical exercises (Nakhanakhup et al., 2006).
Chronic physiological and psychological benefits of exercise specific to individuals with
type 2 diabetes
Aerobic training is beneficial in patients with type 2 diabetes as it tends to enhance
the body’s sensitivity to the insulin it increases mitochondrial density and oxidative enzymes

WEEK 5 FINAL ASSIGNMENT 5
(Colberg et al., 2016). When individuals with diabetes type 2 engage in moderate-intensity
exercises, the utilization of blood glucose by muscles increases more than the production of
hepatic glucose, and thus the levels of blood glucose go down. Plasma insulin levels also
decline, and this reduces the risk of exercise-induced hypoglycemia in patients who are not
taking insulin or whose body’s secretion of insulin is low. The effects of aerobic exercise on
insulin and body glucose levels in the body vary depending on intensity, duration of the
exercise as well as the diet that a person consumes. The effects of one session of exercise can
last in the body for more than twenty-four hours; the effects, however, cannot last in the body
for more than seventy-two hours.
Further, when an individual is engaging in intense aerobic exercises, the body
experiences a rise in the levels of plasma catecholamine. The resulting effect is an increase in
the production of glucose. An individual may then experience hyperglycemia, and this may
last for a period of not less than one hour and not more than two hours (Colberg et al., 2010).
The effects last for about two hours because the production of glucose and the levels of
catecholamine do not go back to normalcy even after one stops engaging in the activity.
Resistance exercise also has effects on the body’s functionality. The blood glucose levels
increase by up to 125mg/dl, and the effects last for up to twenty hours (Colberg et al., 2010).
However, training is more effective if it combines aerobic and resistance training. An
increase in muscle mass as a result of the effects of resistance training could contribute to the
uptake of blood glucose without altering the fundamental capacity of the muscle to function
and respond to insulin. Additionally, an individual realizes more benefits from engaging in
physical exercise if there are chronic and acute enhancements in insulin action.

WEEK 5 FINAL ASSIGNMENT 6

Part II
Cardiovascular Health-Related Physical Fitness Test
In order for Jackson to commence the exercise program, he needs to undertake a
cardiovascular physical fitness test. The test will be crucial in defining Jackson’s present level
of cardiovascular health. There are various modes of testing, including field tests, treadmills,
and the use of a mechanically braked cycle ergometer. In Jackson’s case, we shall be adopting
field tests. The Cooper 12-Minute test will be used in assessing Jackson’s level of fitness. The
test was developed in the year 1968 by Kenneth Cooper. The test is easy to administer and is
used in the evaluation of the level of aerobic fitness. The test provides an estimate of one’s
level of VO2 Max. Jackson will be required to run or walk for a period of 12 minutes. The
test will be driven by the need to measure the maximum distance that can be covered within
the 12-minute time span. After the exercise, the VO2max can be calculated using the
following equation “VO2max (mL ∙ kg −1 ∙ min −1) = (distance in meters +504.9)/44.73” In
Jackson’s case, he was only able to run 1000 meters. His Vo2 max can thus be calculated as
(2000+504.9)/44.73. The result is 33.6 VO2max. He falls under the poor category, and as a
result, he has to ensure that he begins with low-intensity exercises and progresses to high-
intensity exercises gradually. The test will be very useful in the creation of an exercise plan.
Jackson’s Individualized Cardiovascular Fitness Program
FITT-VP principles will be used in the designing of an exercise program for Jackson.
FITT-VP is an acronym that stands for frequency intensity time, type, volume, and
progression (American College of Sports Medicine, 2018). The primary goal is to ensure that
Jackson’s fitness levels improve and, in so doing, improve his overall wellbeing. In order to
create a workable exercise plan, Jackson will be participating in exercises at least three times
every week. The aim is to ensure that Jackson remains consistent and, in so doing, adheres to

WEEK 5 FINAL ASSIGNMENT 7
the exercise plan. Jackson’s level of fitness is poor based on the results of the Cooper 12-
minute test American College of Sports Medicine, 2018). He will therefore begin with light
exercises that can be tolerated at his fitness level. He will start walking for a period of 30
minutes and progress as his level of fitness improves over time. Jackson will then start
engaging in a moderate level of exercise. He will start running for short distances and
thereafter will progress to high-intensity levels of physical exercises such as running for
longer distances. Walking has a lower MET level, and this makes it ideal for Jackson, who
has a poor fitness level. In addition, based on his fitness level, he should engage in exercises
that range between 55-90 percent of the maximum heart rate and 40-85 percent of the heart
rate reserve (Pate, Oria, & Pillsbury, 2012). We will be working with these figures to ensure
that he improves his level of fitness without putting his health in danger.
In addition to aerobic exercises, Jackson will have to engage in strength training.
Strength training will help ensure that he builds muscles as well as increases the density of
his bones. He will lift weights and cycle to ensure that his muscle mass increases and, in so
doing, keeps his weight in check. Strength training is recommended by the American
Diabetes Association as a way of ensuring that an individual keeps their blood sugar in check.
In engaging in strength training, Jackson will have an improved response to insulin as well as
lower his risk of a heart attack.
Dietary Requirements
Management of type 2 diabetes requires both exercise as well as eating healthy. A
diabetic patient must make the conscious effort of eating healthy and being selective in the
foods that one eats. The key to success for diabetic patients is pharmacotherapy, physical
exercise, and regular physical activity. Nutrition therapy is important for all individuals with
type 2 diabetes. Jackson thus needs to adhere to nutritional guidelines that are going to play a

WEEK 5 FINAL ASSIGNMENT 8
significant part in his overall wellbeing. Jackson will have to ensure that he eats non-starchy
vegetables. Among the vegetables that he should eat are carrots, broccoli, mushrooms,
tomatoes, spinach, and green beans. These vegetables should be eaten without added salt,
fats, or sugars (Hu, 2011). Every meal plan should aim to ensure that it includes a bigger
portion of non-starchy vegetables. Jackson should not consume more than 1500 to 1800
calories every day. The calorie intake is founded on the need to continue losing weight while
ensuring that the level of blood sugar is regulated.
Jackson also needs to eat fruits. The recommended fruits include Apples, pears, and
cherries. Fruits that do not have added sugars are the best because they do not elevate the
level of blood sugar, and this makes them be an important part of the dietary guidelines. It is
important for Jackson to avoid added sugars. As a result, he should avoid the consumption of
white bread, rice, and pasta. Every serving should avoid foods that have added sugars since
these foods could elevate his blood sugar level and, in so doing, put him in great danger. In
addition, it is important that he avoids processed foods (Hu, 2011). The focus should instead
be on whole foods as opposed to highly processed foods. Whole grains and whole fruits are
recommended as opposed to fruit juices and other forms of processed foods. Fast foods
should be avoided since they could take away the gains made through exercising.
Progression of the Exercise Program

Monda
y

Tuesda
y

Wednesda
y

Thursda
y

Friday Saturda
y

Sunday

Week 1 30
Minutes’
walk

Rest day 22 pounds
deadlift, 3
sets, 2 reps

Reverse
crunches
1 set, 10
reps

30
minutes
‘ walk

Rest day 30
minutes’
walk

WEEK 5 FINAL ASSIGNMENT 9

Week 2 30
minutes’
walk

Rest day 22 pounds
deadlift, 3
sets, 2 reps

Oblique
crunches
1 set, 10
reps

30
minutes
‘ walk

Rest Day 30
minutes’
walk

Week 3 30
minutes’
walk

Rest day 22 pounds
deadlift, 3
sets, 2 reps

Oblique
crunches
1 set, 10
reps

30
minutes
walk

Rest Day 30
minutes
walk

WEEK 5 FINAL ASSIGNMENT 10

References

American College of Sports Medicine. (2018). ACSM’s guidelines for exercise testing and
prescription (10th ed.). Retrieved from https://redshelf.com/
Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., …
& Braun, B. (2010). Exercise and type 2 diabetes: the American College of Sports
Medicine and the American Diabetes Association: joint position statement. Diabetes
care, 33(12), e147-e167.
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., …
& Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of
the American Diabetes Association. Diabetes care, 39(11), 2065-2079.
de Grauw, W. J., van de Lisdonk, E. H., Behr, R. R., van Gerwen, W. H., van den Hoogen, H.
J., & van Weel, C. (1999). The impact of type 2 diabetes mellitus on daily
functioning. Family practice, 16(2), 133-139.
Hu, F. B. (2011). Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes
care, 34(6), 1249-1257.
Nakhanakhup, C., Moungmee, P., Appell, H. J., & Duarte, J. A. (2006). Regular physical
exercise in patients with type II diabetes mellitus. European Review of Aging and
Physical Activity, 3(1), 10.
Pate, R., Oria, M., & Pillsbury, L. (2012). Health-related fitness measures for youth:
Cardiorespiratory endurance. In Fitness Measures and Health Outcomes in Youth.
National Academies Press (US).