A 54 yo diabetic man has joined the hospital diabetes care program. In this program, he will receive diabetes education and exercise instruction. He was diagnosed diabetic eight months ago. He has been put on Glucovance BID and told to diet and exercise. He recently began to walk for 30 minutes, four days a week at a light intensity.  Hospitalizations include kidney stones at age 28 years old. Usual childhood diseases. No family history of heart disease, however, his grandmother was diagnosed with diabetes at age 58 year old. He is a past smoker, having smoked 1 pack/week for 35 years and recently has tapered off.

His laboratory data:
Height  69.2”                                                 
Weight   240.3 pounds
Resting HR 75 bpm                                         
Resting Blood Pressure  119/80
Cholesterol   210                                             
Vital Capacity 3.5 L
HDL   42 mg/dl                                               
FEV1   2.3 L/sec
Triglycerides  438 mg/dl                                   
Percent Fat   28.4%
Glucose  125  mmol/L                                     
Waist Circumference    103.1 cm
HbA1C     8%                                                 
Hip Circumference   125.0 cm

About Your Assignment

Instructions: 
Answer the following questions on the case study above. Submit your answers in this assignment portal.
1.  Is physical activity/exercise appropriate for this patient at this time? Explain (.25 pts)

2. What is/are the appropriate exercise/physical activity facility/location for this patient? Explain (.5 pts)

3. What exercise prescription/physical activity advice should be? Explain (.25 points each)
a. Mode
b. Frequency
c. Intensity
d. Duration

4. What precautions would you give him about the time of day for physical activity/exercise? (.25 pts)

5. What precautions would you give him about the timing of medications and physical activity/exercise? (.25 pts)

6. If his pre-exercise blood sugar is 115 mg/dl, what medication/diet precautions would you give him about exercising that day? (.25 pts)

7. If his pre-activity blood sugar is 240 mg/dl, what medication/diet precautions would you give him about exercising that day? (.25 pts)
a. What is his risk for an activity related hypoglycemia? (.25 pts)
8. If he presented with retinopathy, how would you adjust his exercise/physical activity prescription? (.25 pts)
a. What additional precautions would you consider for a diabetic with retinopathy? (.25 pts)
9. If he presented with neuropathy, how would you adjust his exercise/physical activity prescription? (.25 pts)