A man with obesity of 46 years old (BMI = 33 kg/m²) recently went to the doctor for a blood test and received the information that his cholesterol was too high (258 mg/dl ). Since he has type 1 diabetes since the age of 16 and is also already taking medication for his high blood pressure, he realizes that he needs to take urgent action for his health. He enters your multidisciplinary center with the main objective of improving his general physical fitness/health and losing weight.
Personal Goal: being able to run the 10k of Leuven next year together with his son.
Set up a training program for him for the first 4 weeks.
What is the most appropriate recommendation regarding pre-participation screening?
Medical clearance including an exercise stress test is recommended before progressing to vigorous exercise
Training components
Cardio | Be careful with weight-bearing activities
Strength
Important to improve glucose tolerance
Targeting large muscle groups (multi-joint)
Importance of nutrition
Adherence’ is key
Frequency: continuity is important
Preferably train 3x/week
Start at low intensity, limited training duration
Example
Cardio (continue or fractionated)
Week 1 – 2
15 min. cycling (RPM 70, zelf gekozen weerstand, talk test)
15 min. treadmill (wandelen, vlot tempo, talk test)
Week 3 – 4
10 min. cycling (RPM 70, zelf gekozen weerstand, talk test)
15 min. treadmill (wandelen, vlot tempo, talk test)
10 min. cross (RPM 120, zelf gekozen weerstand, talk test)
Strength training
Large muscle groups, multi-joint exercises first
Cardio training:
Gradually increase duration first – then intensity
After 20 minutes of moderate intensity cycling, he suddenly feels unwell. He reports dizziness, sweating, trembling. Witnesses notes that he becomes pale and briefly loses consciousness/ or less responsive? for a few seconds. Upon regaining consciousness/ responding, he appears confused and slow to respond.
Hypoglycemia
Due to the brief loss of consciousness with rapid recovery
Most appropriate initial management
Administer 10–20 grams of oral carbohydrates such as a sandwich or custard