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Exercise Induced Hypoglycemia: What Is It And How To Prevent It

Have you ever decreased your activity for fear of exercise induced hypoglycemia?  If so, you are not alone. Many people with diabetes decrease their activity due to the fear of hypoglycemia. This does not need to be you.  

Understanding what causes hypoglycemia and how to prevent it is important.  Ask yourself what medications you take for diabetes and when do you take them. Think about whether you exercise consistently or sporadically.  Then if you still need clarification discuss this with your doctor/endocrinologist.  

Being prepared before you exercise can help prevent low blood sugars. Without further ado, read on to understand this topic.  

Woman Running

What is Exercise Induced Hypoglycemia

Hypoglycemia is when blood sugar levels are below 70ml/dL.  A few causes for low blood sugar is taking too much insulin, not eating enough after taking insulin medication, and exercising. 

When we exercise our body demands energy right away.  That energy comes in the form of glucose or sugar.  The body will take the sugar from our blood stream and use it for energy.  If the body takes too much sugar for energy then our stores are depleted and a low blood sugar occurs. 

Insulin becomes more sensitive when a person is exercising.  Insulin helps the muscles to receive the sugar that it needs for energy more quickly when we are exercising.  It also reduces the liver’s ability to generate more glucose/sugar when the body does not have enough glucose. 

Certain types of diabetes medications cause the body to secrete insulin.  Therefore, talk to your doctor/endocrinologist to understand how your diabetes medication works if you are unsure.     

Causes of  Exercise Induced Hypoglycemia

Taking too much insulin, taking diabetes medication that increases your body’s ability to secrete insulin or taking insulin while it is working at its peak can cause exercise induced hypoglycemia.

Not eating enough carbs for your insulin needs can cause blood sugar to decrease and cause hypoglycemia 

If you take any of the medications below and experience hypoglycemia when you exercise then discuss with your doctor, if you need to use less before you exercise.  

  • Repaglinide (Prandin)
  • Nateglinide (Starlix)
  • Glyburide
  • Glipizide
  • Glimepiride (Amaryl)
  • Chlorpropamide (Diabinese)
  • Tolazamide (Tolinase)
  • Tolbutamide (Orinase)
  • Acetohexamide (Dymelor)

Symptoms of Exercise Induced hypoglycemia 

When you are exercising there are certain symptoms that you should be aware of. If you notice any of these symptoms then please stop exercising to check your blood sugar level.

  • Dizziness
  • Shakiness
  • Confusion 
  • Trouble Concentrating 
  • Blurry Vision 
  • Nausea 

Always bring a snack before you begin to exercise.  If it is under 70mg/dL then eat your snack and wait 15minutes to see if it has improved and repeat this step until the blood sugar is over 100mg/dL.      

Treatment of Exercise Induced Hypoglycemia

Always bring a snack before you begin to exercise.  While you are exercising, if your blood sugar is under 70mg/dL then eat your snack and wait 15-20 minutes to see if it has improved.  If it is still under 70mg/dL then eat another snack until your blood sugar is over 100mg/dL.  Make sure your snack has at least 15gm of carbs per serving.    

  • An apple
  • Lara bar minis
  • Raisin box
  • Squeezable Applesauce 
  • Banana

If you consistently have low blood sugars when you exercise then consult with your endocrinologist or certified diabetes educator.  They can help you understand what is causing your low blood sugars and how to correct it.  Your endocrinologist can adjust your medication as needed.  

Prevention of Exercise Induced Hypoglycemia

Understand when your insulin is working at its most active time also called peak time. Then discuss with your endocrinologist if you need to reduce your insulin, including basal insulin, or diabetes medication before any planned exercise.  For unplanned exercise when your insulin is working at its peak, eating a snack can help prevent hypoglycemia.  

For people who inject insulin, never inject insulin into your muscles before exercise as it will increase the rate of sugar absorption and increase your likelihood of having hypoglycemia.  Instead, inject insulin into the fat under the skin. 

Check your blood sugar levels right  before you exercise and right after you exercise to understand how exercise affects your blood sugar levels.  If you are exercising longer than 30 minutes then check your blood sugar levels every 30 minutes. Take action if it is starting to get lower than 100mg/dL Stop your exercise and eat a snack to prevent the low.  

Time your exercise during the day when you are least likely to have low blood sugar. This can be after certain meals, in the morning, in the evening. Everyone is different, understand how your blood sugar and exercise impacts you to determine the best time to exercise.  Consult your doctor/endocrinologist if you need help timing your exercise to prevent low blood sugars.     

Other Considerations 

Hypoglycemia can be very scary and not pleasant to deal with.  Evaluate how confident you feel dealing with low blood sugar in these situations.   

  • When you are exercising
  • When you are sleeping 
  • When you are driving
  • When you are alone 
  • Treating a low blood sugar 

If you don’t feel confident in one of these situations then discuss any concerns you have regarding low blood sugars with your doctor/endocrinologist or a certified diabetes educator. 

 Being prepared to deal with low blood sugar is important and can help you feel more confident.  Also, discuss ways that you can be prepared and how to treat low blood sugar.   

Final Thoughts 

Low blood sugar can be scary to experience especially during exercise when you may not have the best access to high carbohydrate foods.  Being prepared by having a kit to treat low blood sugar is important.  

Understanding how the medication you take can affect your blood sugar is important.  Always watch out for signs of low blood sugar when you are exercising. Make a habit of checking your blood sugar after every 30 minutes you exercise.  You can try to prevent low blood sugar by being aware. 

Next time you leave the house to exercise, grab a kit with your meter and a couple snacks.  That way you can be prepared to prevent low blood sugar while you exercise.  

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