Diabetes : Type 1 & Type 2 Part: 1. Diabetes Mellitus: Etymology The word diabetes comes from a Greek derivative meaning “to pass through a siphon”. The.

DiabetesDiabetes::Type 1 & Type 2Type 1 & Type 2

Part: 1Part: 1

Diabetes Mellitus: Diabetes Mellitus: EtymologyEtymology

The word diabetes comes from a The word diabetes comes from a Greek derivative meaning “to pass Greek derivative meaning “to pass through a siphon”. through a siphon”.

The word mellitus comes from a Latin The word mellitus comes from a Latin derivative meaning “sweetened with derivative meaning “sweetened with honey”. honey”.

Combining the words diabetes and Combining the words diabetes and mellitus literally means “sugar mellitus literally means “sugar passing through the body” passing through the body”

Definition of DiabetesDefinition of Diabetes Diabetes mellitus is a group of metabolic diseases Diabetes mellitus is a group of metabolic diseases

characterized by high blood sugar (glucose) levels, characterized by high blood sugar (glucose) levels, which result from defects in insulin secretion, or which result from defects in insulin secretion, or action, or both. Elevated levels of blood glucose action, or both. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. Normally, blood urine, hence the term sweet urine. Normally, blood sugar levels are tightly controlled by insulin, a sugar levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is elevates (for example, after eating food), insulin is released from the pancreas to normalize the released from the pancreas to normalize the glucose level. In patients with diabetes, the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes absence or insufficient production of insulin causes hyperglycemia. Although diabetes is a chronic hyperglycemia. Although diabetes is a chronic medical condition, it can be controlled.medical condition, it can be controlled.

ImportantImportant DefinitionsDefinitions

Chronic Disease: a disease of long durationChronic Disease: a disease of long duration Metabolic Disease: any disorder that involves an alteration in Metabolic Disease: any disorder that involves an alteration in

the normal metabolism of carbohydrates, lipids, proteins, the normal metabolism of carbohydrates, lipids, proteins, water, and nucleic acids. water, and nucleic acids.

Blood Sugar (Glucose): sugar in the form of glucose in the Blood Sugar (Glucose): sugar in the form of glucose in the blood.blood.

Insulin: a polypeptide hormone secreted by the pancreas and Insulin: a polypeptide hormone secreted by the pancreas and assists in the regulation of the metabolism of carbohydrates, assists in the regulation of the metabolism of carbohydrates, fats and the conversion of glucose and glycogen, which lower fats and the conversion of glucose and glycogen, which lower blood glucose levels. blood glucose levels.

Hyperglycemia: the presence of abnormally high Hyperglycemia: the presence of abnormally high concentration of glucose in the blood.concentration of glucose in the blood.

Pancreas: an irregularly shaped gland which lies behind the Pancreas: an irregularly shaped gland which lies behind the stomach that secretes pancreatic juices into the duodenum stomach that secretes pancreatic juices into the duodenum and insulin into the bloodstream. and insulin into the bloodstream.

PathologyPathology The increase of blood glucose in persons with diabetes causes a The increase of blood glucose in persons with diabetes causes a

loss of sugar through the urine. Normally the kidney reabsorbs loss of sugar through the urine. Normally the kidney reabsorbs all glucose that filters from the blood into the kidney tubules. all glucose that filters from the blood into the kidney tubules. However, individual with diabetes, the kidney cannot reabsorb However, individual with diabetes, the kidney cannot reabsorb the excessive amount of glucose. When blood glucose levels rise the excessive amount of glucose. When blood glucose levels rise about 160 mg/dl, the excess spills over into the urine, which is about 160 mg/dl, the excess spills over into the urine, which is called glycosuria. The excess of glucose in the urine causes called glycosuria. The excess of glucose in the urine causes another major problem that is high osmotic pressure that holds another major problem that is high osmotic pressure that holds water in the kidney tubules preventing much of it from being water in the kidney tubules preventing much of it from being reabsorbed. The person with diabetes excretes not only large reabsorbed. The person with diabetes excretes not only large amount glucose but also large amount of fluid. This obviously amount glucose but also large amount of fluid. This obviously causes the body to dehydrate, which is partially compensated by causes the body to dehydrate, which is partially compensated by person drinking large amount of water due to excessive thirst person drinking large amount of water due to excessive thirst (polydipsia). If the person does not keep up with excessive fluid (polydipsia). If the person does not keep up with excessive fluid loss malfunction of certain cells in the brain can occur leading loss malfunction of certain cells in the brain can occur leading the weird behavior, coma and death. Diabetic patients have to the weird behavior, coma and death. Diabetic patients have to concerns the supply of energy to the tissues. Despite the large concerns the supply of energy to the tissues. Despite the large quantities of glucose present in the blood, the cells cannot obtain quantities of glucose present in the blood, the cells cannot obtain the normal amount of glucose to supply energy. Therefore, they the normal amount of glucose to supply energy. Therefore, they resort to fats and proteins for nourishment. As a result decreased resort to fats and proteins for nourishment. As a result decreased protein synthesis and an increase use of protein as an energy protein synthesis and an increase use of protein as an energy source by glucose-starved cells, tissues waste away. Therefore, source by glucose-starved cells, tissues waste away. Therefore, patient loses huge amount of weight and loses ability to grow or patient loses huge amount of weight and loses ability to grow or repair damaged tissues.repair damaged tissues.

Pathology ContinuedPathology Continued

Type 1 DiabetesType 1 Diabetes Type 1(Insulin dependent or formerly known as juvenile Type 1(Insulin dependent or formerly known as juvenile

onset):onset): In type 1 diabetes, the pancreas undergoes an In type 1 diabetes, the pancreas undergoes an autoimmune attack by the body itself, and is rendered incapable autoimmune attack by the body itself, and is rendered incapable of making insulin. Abnormal antibodies have been found in the of making insulin. Abnormal antibodies have been found in the majority of patients with type 1 diabetes. Antibodies are proteins majority of patients with type 1 diabetes. Antibodies are proteins in the blood that are part of the body's immune system. The in the blood that are part of the body's immune system. The patient with type 1 diabetes must rely on insulin medication for patient with type 1 diabetes must rely on insulin medication for survival. In autoimmune diseases, such as type 1 diabetes, the survival. In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to inflammatory cells that are directed against and cause damage to patients' own body tissues. In persons with type 1 diabetes, the patients' own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are 1 diabetes is, in part, genetically inherited, though the details are not fully understood. Exposure to certain viral infections (mumps not fully understood. Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. These antibodies can be pancreas cells where insulin is made. These antibodies can be measured in the majority of patients, and may help determine measured in the majority of patients, and may help determine which individuals are at risk for developing type 1 diabetes. which individuals are at risk for developing type 1 diabetes.

Type 2 DiabetesType 2 Diabetes Type 2 diabetes (non insulin dependent or formerly Type 2 diabetes (non insulin dependent or formerly

known as adult onset)known as adult onset): the most common form. People : the most common form. People can develop it at any age, even during childhood. This can develop it at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a form of diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use condition in which muscle, liver, and fat cells do not use insulin properly. At first, the pancreas keeps up with the insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in however, it loses the ability to secrete enough insulin in response to meals. While it is said that type 2 diabetes response to meals. While it is said that type 2 diabetes occurs mostly in individuals over 30 years old and the occurs mostly in individuals over 30 years old and the incidence increases with age, we are seeing an alarming incidence increases with age, we are seeing an alarming number patients with type 2 diabetes who are barely in number patients with type 2 diabetes who are barely in their teen years. In fact, for the first time in the history of their teen years. In fact, for the first time in the history of humans, type 2 diabetes is now more common than type humans, type 2 diabetes is now more common than type 1 diabetes in childhood. Most of these cases are a direct 1 diabetes in childhood. Most of these cases are a direct result of poor eating habits, higher body weight, and lack result of poor eating habits, higher body weight, and lack of exercise.of exercise.

Comparison of Type 1 & Type 2 Comparison of Type 1 & Type 2 DiabetesDiabetes

CharacteristicsCharacteristics Type 1Type 1 Type 2Type 2

Usual Age At OnsetUsual Age At Onset Under 20 Under 20 yearsyears

Over 40 yearsOver 40 years

Development Of Development Of SymptomsSymptoms

RapidRapid SlowSlow

Percent Of Diabetic Percent Of Diabetic PopulationPopulation

~10%~10% ~90%~90%

Association With Association With ObesityObesity

RareRare CommonCommon

Beta Cells Of IsletsBeta Cells Of Islets DestroyedDestroyed Usually not Usually not destroyeddestroyed

Insulin SecretionInsulin Secretion DecreasedDecreased Normal or IncreasedNormal or Increased

Associated With Associated With Particular HLA AntigensParticular HLA Antigens

YesYes NoNo

Usual TreatmentUsual Treatment InsulinInsulin Diet, Oral Diet, Oral stimulators of stimulators of

insulin secretion insulin secretion

Signs & Symptoms of DiabetesSigns & Symptoms of Diabetes High amounts of glucose in the urine can cause increased High amounts of glucose in the urine can cause increased

urine output and lead to dehydration. Dehydration causes urine output and lead to dehydration. Dehydration causes increased thirst and water consumption. increased thirst and water consumption.

The inability of insulin to perform normally has effects on The inability of insulin to perform normally has effects on protein, fat and carbohydrate metabolism. Insulin is an protein, fat and carbohydrate metabolism. Insulin is an anabolic hormone, that is, one that encourages storage of anabolic hormone, that is, one that encourages storage of fat and protein. A relative or absolute insulin deficiency fat and protein. A relative or absolute insulin deficiency eventually leads to weight loss despite an increase in eventually leads to weight loss despite an increase in appetite. appetite.

Some untreated diabetes patients also complain of fatigue, Some untreated diabetes patients also complain of fatigue, nausea and vomiting. nausea and vomiting.

Patients with diabetes are prone to developing infections of Patients with diabetes are prone to developing infections of the bladder, skin, and vaginal areas. the bladder, skin, and vaginal areas.

Fluctuations in blood glucose levels can lead to blurred Fluctuations in blood glucose levels can lead to blurred vision. vision.

Extremely elevated glucose levels can lead to lethargy and Extremely elevated glucose levels can lead to lethargy and coma. coma.

Complications Related to DiabetesComplications Related to Diabetes

Acute ComplicationsAcute Complications

Without insulin, patients with type 1 diabetes develop severely Without insulin, patients with type 1 diabetes develop severely elevated blood sugar levels. This leads to increased urine glucose, elevated blood sugar levels. This leads to increased urine glucose, which in turn leads to excessive loss of fluid and electrolytes in the which in turn leads to excessive loss of fluid and electrolytes in the urine. Lack of insulin also causes the inability to store fat and urine. Lack of insulin also causes the inability to store fat and protein along with breakdown of existing fat and protein stores. protein along with breakdown of existing fat and protein stores. This deregulation, results in the process of ketosis and the release This deregulation, results in the process of ketosis and the release of ketones into the blood. Ketones turn the blood acidic, a of ketones into the blood. Ketones turn the blood acidic, a condition called diabetic ketoacidosis (DKA). Symptoms of diabetic condition called diabetic ketoacidosis (DKA). Symptoms of diabetic ketoacidosis include nausea, vomiting, and abdominal pain. ketoacidosis include nausea, vomiting, and abdominal pain. Without prompt medical treatment, patients with diabetic Without prompt medical treatment, patients with diabetic ketoacidosis can rapidly go into shock, coma, and even death. ketoacidosis can rapidly go into shock, coma, and even death.

In patients with type 2 diabetes, stress, infection, and medications In patients with type 2 diabetes, stress, infection, and medications (such as corticosteroids) can also lead to severely elevated blood (such as corticosteroids) can also lead to severely elevated blood sugar levels. Accompanied by dehydration, severe blood sugar sugar levels. Accompanied by dehydration, severe blood sugar elevation in patients with type 2 diabetes can lead to an increase elevation in patients with type 2 diabetes can lead to an increase in blood osmolality (hyperosmolar state). This condition can lead to in blood osmolality (hyperosmolar state). This condition can lead to coma (hyperosmolar coma). A hyperosmolar coma usually occurs coma (hyperosmolar coma). A hyperosmolar coma usually occurs in elderly patients with type 2 diabetes.in elderly patients with type 2 diabetes.

Complications Related to Diabetes Complications Related to Diabetes ContinuedContinued

Chronic ComplicationsChronic Complications The major eye complication of diabetes is called diabetic retinopathy.The major eye complication of diabetes is called diabetic retinopathy. Diabetes accelerates hardening of the arteries (atherosclerosis) of the Diabetes accelerates hardening of the arteries (atherosclerosis) of the

larger blood vessels, leading to coronary heart disease (angina or larger blood vessels, leading to coronary heart disease (angina or heart attack), strokes, and pain in the lower extremities because of heart attack), strokes, and pain in the lower extremities because of lack of blood supply. For more information, please read the following lack of blood supply. For more information, please read the following articles: stroke, angina and heart attack.articles: stroke, angina and heart attack.

Kidney damage from diabetes is called diabetic nephropathy.Kidney damage from diabetes is called diabetic nephropathy. Nerve damage in diabetes is called diabetic neuropathy and is caused Nerve damage in diabetes is called diabetic neuropathy and is caused

by disease of small blood vessels. In essence, the blood flow to the by disease of small blood vessels. In essence, the blood flow to the nerves is limited, leaving the nerves without blood flow, and they get nerves is limited, leaving the nerves without blood flow, and they get damaged or die as a result (a term known as ischemia).damaged or die as a result (a term known as ischemia).

Because of poor blood circulation, diabetic foot injuries may not heal. Because of poor blood circulation, diabetic foot injuries may not heal. Sometimes, minor foot injuries can lead to serious infection, ulcers, Sometimes, minor foot injuries can lead to serious infection, ulcers, and even gangrene, necessitating surgical amputation of toes, feet, and even gangrene, necessitating surgical amputation of toes, feet, and other infected parts.and other infected parts.

Diabetic neuropathy can also affect nerves to the stomach and Diabetic neuropathy can also affect nerves to the stomach and intestines, causing nausea, weight loss, diarrhea, and other intestines, causing nausea, weight loss, diarrhea, and other symptoms of gastro paresis (delayed emptying of food contents from symptoms of gastro paresis (delayed emptying of food contents from the stomach into the intestines, due to ineffective contraction of the the stomach into the intestines, due to ineffective contraction of the stomach muscles).stomach muscles).

Diagnosis of DiabetesDiagnosis of Diabetes

The following tests are used for diagnosis:The following tests are used for diagnosis:

A A fasting plasma glucose testfasting plasma glucose test measures blood glucose measures blood glucose after patient have gone at least 8 hours without eating. This after patient have gone at least 8 hours without eating. This test is used to detect diabetes.test is used to detect diabetes.

An An oral glucose tolerance testoral glucose tolerance test measures blood glucose measures blood glucose after patient have gone at least 8 hours without eating and after patient have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage. This 2 hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes.test can be used to diagnose diabetes.

In a In a random plasma glucose testrandom plasma glucose test, doctor checks blood , doctor checks blood glucose without regard to when patient ate last meal. This glucose without regard to when patient ate last meal. This test, along with an assessment of symptoms, is used to test, along with an assessment of symptoms, is used to diagnose diabetes.diagnose diabetes.

Positive test results should be confirmed by repeating the Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance fasting plasma glucose test or the oral glucose tolerance test on a different day.test on a different day.

Fasting Plasma Glucose TestFasting Plasma Glucose Test

Plasma Glucose Plasma Glucose Result (mg/dL)Result (mg/dL)

DiagnosisDiagnosis

99 & Below99 & Below NormalNormal

100 to 125100 to 125 Pre-diabetes Pre-diabetes (impaired fasting (impaired fasting

glucoseglucose

126 & Above126 & Above Diabetes *Diabetes ** Results confirmed by repeating the test on another * Results confirmed by repeating the test on another dayday

Treatment of DiabetesTreatment of DiabetesThere is no cure for diabetes. The immediate goals are to stabilize your There is no cure for diabetes. The immediate goals are to stabilize your blood sugar and eliminate the symptoms of high blood sugar. The long-term blood sugar and eliminate the symptoms of high blood sugar. The long-term goals of treatment are to prolong life, relieve symptoms, and prevent long-goals of treatment are to prolong life, relieve symptoms, and prevent long-term complications such as heart disease and kidney failure.term complications such as heart disease and kidney failure.

LEARN THESE SKILLSLEARN THESE SKILLSBasic diabetes management skills will help prevent the need for emergency Basic diabetes management skills will help prevent the need for emergency

care. These skills include:care. These skills include: How to recognize and treat low blood sugar (hypoglycemia) and high blood How to recognize and treat low blood sugar (hypoglycemia) and high blood

sugar (hyperglycemia) sugar (hyperglycemia) What to eat and when What to eat and when How to take insulin or oral medication How to take insulin or oral medication How to test and record blood glucose How to test and record blood glucose How to test urine for ketones (type 1 diabetes only) How to test urine for ketones (type 1 diabetes only) How to adjust insulin and/or food intake when changing exercise and eating How to adjust insulin and/or food intake when changing exercise and eating

habits habits How to handle sick days How to handle sick days Where to buy diabetes supplies and how to store them Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. long-term health problems and the best ways to prevent these problems. People with diabetes need to review and update their knowledge, because People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being new research and improved ways to treat diabetes are constantly being developed.developed.

Diabetes & Physical ActivityDiabetes & Physical ActivityPart: 2Part: 2

Diabetes & ExerciseDiabetes & Exercise

Exercise is considered to be one of the Exercise is considered to be one of the cornerstones of diabetes carecornerstones of diabetes care

The effects of diabetes on a session of The effects of diabetes on a session of exercise is dependent upon several factors, exercise is dependent upon several factors, including:including: use and type of medications to lower blood glucoseuse and type of medications to lower blood glucose timing of medication administrationtiming of medication administration timing, amount, and type of previous food intaketiming, amount, and type of previous food intake blood glucose level before exercise blood glucose level before exercise presence and severity of diabetic complicationspresence and severity of diabetic complications use of other medicationsuse of other medications intensity, duration, and type of exerciseintensity, duration, and type of exercise

Benefits for Diabetics from ExerciseBenefits for Diabetics from Exercise

Possible improvement in blood glucose control in Possible improvement in blood glucose control in those individuals with type IIthose individuals with type II

Improved insulin sensitivity resulting in a lower Improved insulin sensitivity resulting in a lower medication requirement medication requirement

Reduction in body fat, which can help to increase Reduction in body fat, which can help to increase insulin sensitivityinsulin sensitivity

Cardiovascular benefits; a decreased risk for Cardiovascular benefits; a decreased risk for cardiovascular diseasecardiovascular disease

Stress reduction: stress can interrupt diabetes Stress reduction: stress can interrupt diabetes control by increasing counter regulatory hormones, control by increasing counter regulatory hormones, ketones, free fatty acids and urine outputketones, free fatty acids and urine output

Prevention of type II diabetesPrevention of type II diabetes

Prescribing Exercise to Individuals Prescribing Exercise to Individuals with Diabeteswith Diabetes

Careful monitoring of blood glucose levels and Careful monitoring of blood glucose levels and attention to food intake and medication attention to food intake and medication administration are necessary in order for administration are necessary in order for individuals with diabetes to participate in physical individuals with diabetes to participate in physical activityactivity

Exercise must be individualized according to Exercise must be individualized according to medication schedule, presence and severity of medication schedule, presence and severity of complications, and expected benefits and goals of complications, and expected benefits and goals of the programthe program

Generally speaking, 1 hour of exercise requires Generally speaking, 1 hour of exercise requires an additional 15 grams of carbohydrate either an additional 15 grams of carbohydrate either before of after exercisebefore of after exercise

If exercise is vigorous or lasts longer than 1 hour, If exercise is vigorous or lasts longer than 1 hour, and additional 15 to 30 grams of carbohydrate and additional 15 to 30 grams of carbohydrate per hour may be necessaryper hour may be necessary

Exercise Precautions with Exercise Precautions with Individuals Who Have DiabetesIndividuals Who Have Diabetes

Must have a readily available source Must have a readily available source of fast acting carbohydrates (ie. box of fast acting carbohydrates (ie. box of raisins, can of Pepsi Cola, fruit of raisins, can of Pepsi Cola, fruit juice, cookies)juice, cookies)

Participants’ must consume Participants’ must consume adequate amounts of fluid before, adequate amounts of fluid before, during, and after exerciseduring, and after exercise

Participants must always carry Participants must always carry medical identificationmedical identification

Exercise Prescription: AdolescentsExercise Prescription: AdolescentsPart: 3Part: 3

AdolescenceAdolescence Defined as the second stage of life, ages 10 to 22, when young Defined as the second stage of life, ages 10 to 22, when young

people experience significant biological, physiological, and social people experience significant biological, physiological, and social changes necessary to prepare for adulthood (Holmes 1995). changes necessary to prepare for adulthood (Holmes 1995).

Divided into early adolescents (10 to 14) and late adolescents (15 Divided into early adolescents (10 to 14) and late adolescents (15 to 22) to 22)

Many adolescents will experience a growth spurt of 2.5 to 3 years Many adolescents will experience a growth spurt of 2.5 to 3 years during which they will attain about 20% of their adult height during which they will attain about 20% of their adult height (Payne and Isaacs 1995). (Payne and Isaacs 1995).

Final growth often occurs by the age of 18 for females and by Final growth often occurs by the age of 18 for females and by around 20 to 21 for malesaround 20 to 21 for males

Some studies suggest that some adolescents experience a period Some studies suggest that some adolescents experience a period of clumsiness and awkwardness when in a phase of rapid growth of clumsiness and awkwardness when in a phase of rapid growth

If this period of clumsiness is evident, teachers should reassure If this period of clumsiness is evident, teachers should reassure students that the awkward stage is only temporary and very students that the awkward stage is only temporary and very naturalnatural

During the rapid growth many adolescents often feel self-During the rapid growth many adolescents often feel self-conscious about their bodies and abilitiesconscious about their bodies and abilities

Physical Activity and AdolescentsPhysical Activity and Adolescents

Children in North America are fatter than they Children in North America are fatter than they were in previous decades (U.S. Department of were in previous decades (U.S. Department of Health and Human Services 2000; Flegal, Dietz, Health and Human Services 2000; Flegal, Dietz, Srinivasan, and Berenson 1988). Srinivasan, and Berenson 1988).

This circumstance is a major cause of concern for This circumstance is a major cause of concern for parents, health practitioners, politicians, and parents, health practitioners, politicians, and physical education teachers. The main reason for physical education teachers. The main reason for this concern is the fact that obesity is related to this concern is the fact that obesity is related to the two main categories of killers in the U.S. - the two main categories of killers in the U.S. - heart disease and cancer (Centers for Disease heart disease and cancer (Centers for Disease Control and Prevention 2002). Control and Prevention 2002).

Physical activity is a way of combating obesity, Physical activity is a way of combating obesity, and lack of it is one of the reasons we have this and lack of it is one of the reasons we have this problem today (Centers for Disease Control and problem today (Centers for Disease Control and Prevention 2002). Prevention 2002).

Exercise for Adolescents Exercise for Adolescents (Ages 14 to 16 Years Old)(Ages 14 to 16 Years Old)

Exercise should provide both aerobic and anaerobic Exercise should provide both aerobic and anaerobic componentscomponents

Adolescence is a period of dynamic change for most Adolescence is a period of dynamic change for most individuals which includes physical, emotional and individuals which includes physical, emotional and social adjustmentssocial adjustments

Students physical capabilities may vary greatly due Students physical capabilities may vary greatly due to the amount of individual change that is taking to the amount of individual change that is taking placeplace

It is important to get everyone involved in activities It is important to get everyone involved in activities which they are comfortable participating in which they are comfortable participating in

Boys and girls should be separated into they’re own Boys and girls should be separated into they’re own groups to provide the most comfortable atmosphere groups to provide the most comfortable atmosphere for all participantsfor all participants

Attention span of adolescents is shorter than that of Attention span of adolescents is shorter than that of adults, therefore instructions should be to the point adults, therefore instructions should be to the point and provided during each rest periodand provided during each rest period

Type of Exercise for AdolescentsType of Exercise for Adolescents

Short term moderate to high intensity Short term moderate to high intensity physical activity are age appropriate for physical activity are age appropriate for adolescents ages 14 to 16adolescents ages 14 to 16

High intensity activities should be followed High intensity activities should be followed up by a short rest period to allow students up by a short rest period to allow students to recuperateto recuperate

Games that involve running, kicking, ball Games that involve running, kicking, ball control, and throwing are optimal for this control, and throwing are optimal for this age groupage group

Activities could include soccer, dodge ball, Activities could include soccer, dodge ball, floor hockey, hand ball etc. floor hockey, hand ball etc.