A 70 year old man (Mr. TJ) was diagnosed with type 2 diabetes mellitus 7 years ago. He has the following history. He was active till the age of 45 but since then he has led a sedentary life.

CASE STUDY 1: CHAPTER 8 DIABETES

A 70 year old man (Mr. TJ) was diagnosed with type 2 diabetes mellitus 7 years ago. He has the following history. He was active till the age of 45 but since then he has led a sedentary life. After being diagnosed with DM 7 years ago, he started participating in mild physical activity (walking in the nearby park for 20 minutes 3-4 days/week). Since he experiences acute periodic episodes of diabetes out of control, his endocrinologist and physician wants him to start a planned exercise program to improve his overall health.

There is more information and questions in the attachment below

Requirements: 1 page

NAME _________________

CASE STUDY 1: CHAPTER 8 DIABETES

A 70 year old man (Mr. TJ) was diagnosed with type 2 diabetes mellitus 7 years ago. He has the following history. He was active till the age of 45 but since then he has led a sedentary life. After being diagnosed with DM 7 years ago, he started participating in mild physical activity (walking in the nearby park for 20 minutes 3-4 days/week). Since he experiences acute periodic episodes of diabetes out of control, his endocrinologist and physician wants him to start a planned exercise program to improve his overall health.

Physical examination:

Height: 5’10”

Weight: 225 lb

HR: 65 beats/min

BP: 140/82 mmHg

Body fat: 28.2% (skinfold) 

Medications:

Glucophage – 2 times/day

Captopril (for blood pressure control and protection of kidneys)

Lipitor (for control of hyperlipidemia)

Complications history:

Chronic six-vessel coronary arterial bypass graft surgery 1 year ago

Moderate peripheral neuropathy

Stage 3 diabetic nephropathy

Lab testing:

Fasting glucose: 150 mg/dl

HbA1c: 8.8%

TG: 198 mg/dl

TC: 185 mg/dl

HDL: 30 mg/dl 

LDL: 120 mg/dl

Microproteinuria

GXT:

Maximum BP: 185/85 mmHg

Maximum HR: 147 beats/min

VO2 max: 25.5 ml/kg/min

Random blood glucose before test: 180 mg/dl 

Based on Mr. TJ’s given history and your knowledge about exercise prescription in patients with chronic diseases, answer the following questions. Be specific to the given case, answer in meaningful sentences and base your answers on references from the text and the Position Stand.

List the cardiovascular risk factors for Mr. TJ (5 pts).

2.     What are your goals? Goals should be specific to risk factors (10 pts).

3.     Develop an appropriate exercise prescription for Mr. TJ (Include mode, Intensity, frequency and duration). Lay it out for one week then add two more weeks of progressive overload (10 pts).

4.     Is Mr. TJ likely to have problems with hypoglycemia during or following exercise? Why or why not (10 pts)?

5.     What are potential risks of exercise for Mr. TJ? What special consideration/precautions should be taken for Mr. TJ while prescribing an exercise program (10 pts)?

6.     Any special advice you would give to Mr. TJ (keeping his medical history and present condition in mind) (5 pts)?