It reduces fat oxidation during exercise mainly through the action of insulin. Fat supplementation and some special diets have limited ability to increase fat oxidation. So for intense exercises, Muscle glycogen and blood glucose are main fuels but some other supplement like fat from body stores and/or dietary supplementation, cannot adequately replace them. 24
Fluid intake before, during and after exercise:
Dehydration and heat illness occur because of reduction intake of flood during intense exercise. Loss of fluid leads through excessive urination leads to hyperglycemia which contributes in depletion of electrolytes in the body.
She has diabetic history and has low level of anticoagulants which are risk factor for clotting and leads to heart attack or stroke. Because of dehydration, blood viscosity increases and may exacerbate the risk of thrombosis.
Particularly, physical therapist should be taken care of diabetic ketoacidosis. Dehydration may be the symptoms of High blood glucose level and ketone level can rise if blood glucose level increases. If it isn’t treated immediately, could lead to diabetic coma because of high ketones and dehydration. So physical therapist should check for ketone levels if blood glucose rises more than 15mmol/l.
Therefore, it is important to take fluid if she increases exercises, at high altitude, hot weather and hot humidity and fluid intake should be sufficient to replace sweat losses. She should drink water at least 2 glasses half an hour or hour before exercise session and again 10 minute advance if she feels dehydrated.
Physical therapist asks her t...
... middle of paper ...
... right-away to raise blood glucose level. Like 4 oz. orange juice, 3 to 4 glucose tablets, 1 tablespoon of sugar or honey. 19, 40
Sign and symptoms of hyperglycemia:
Blood glucose over 240 mg/dl decreased appetite, nausea, or vomiting, fatigue, drowsiness, or no energy increased thirst and urination, sweet odor to the breath, agitation and confusion, high levels of ketones in the urine, weight loss etc.38
Exercise usually helps to lowering down glucose level and increase cells’ sensitivity to insulin and uses glycogen fore energy. If physical therapist fine symptoms of hyperglycemia during exercise than she should slow down physical activity and give her prescribed medicine or insulin for lowering down blood glucose level because if not treated, it will lead to coma and death. Orange juice or milk would be fine because it will not harm to the patient’s condition. 41
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