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Exercise-induced hypoglycemia: Things to know

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The medical name for low blood sugar during or after exercise is exercise-induced hypoglycemia (EIH). The condition can cause itself in a variety of ways, including weakness, shakiness, and extreme exhaustion.

The body’s major source of energy is glucose. The body requires more energy during activity and hence uses more glucose. EIH is caused by an increase in the desire for glucose. Other factors could also be at play.

The symptoms, causes, treatment, and prevention of EIH are all covered in this article. It also covers if EIH is an indication of diabetes and when EIH should be treated.

When to ask assistance

If blood glucose levels go too low, hypoglycemia can be fatal. If you have one or more of the following symptoms, you should get medical help right away:

  • loss of consciousness
  • confusion
  • symptoms that persist despite resting or consuming more food
  • seizure

If people commonly develop EIH or hypoglycemia at other times, they should see a doctor. If the person has diabetes, this could indicate that they are taking too much insulin or that their diabetes medicine dosage is inaccurate.

What is EIH?

Exercise-induced hypoglycemia

Hypoglycemia is a condition in which the blood glucose level is insufficient to supply the body’s energy requirements. Hypoglycemia is defined as a blood glucose level of less than 70 milligrams per deciliter (mg/dl) according to doctors. Most people, however, do not experience hypoglycemia symptoms until their blood glucose levels fall below 55 mg/dl.

Carbohydrates are broken down into glucose by the body. The glucose then enters the bloodstream, prompting the pancreas to produce insulin in response. Insulin aids glucose entry into the body’s cells, allowing it to be used as fuel.

Because active muscles require more fuel, exercise raises glucose demand. Exercise may also make a person more insulin sensitive, which means the insulin works more efficiently and lowers blood glucose levels faster. These factors, when combined, can cause in EIH.

If a person has the following characteristics, they are more prone to develop EIH:

  • have insulin sensitivity or take insulin
  • already have low blood glucose, such as from hunger or from diabetes medication
  • do an intense workout that demands more energy

Symptoms of EIH

Glucose fuels the majority of major bodily activities. As a result, EIH symptoms can vary. The following are some probable signs and symptoms:

  • weakness
  • confusion
  • anxiety
  • fainting
  • shaking
  • dizziness

Hypoglycemia that lasts for a long time or is severe might be fatal. It could result in the following:

Causes

Exercise increases the body’s energy demands, causing it to respond by burning more glucose. People with low glucose levels or those whose bodies metabolize glucose quickly can develop hypoglycemia.

EIH can be caused by a number of reasons, including:

  • exercising immediately after a meal
  • being sick
  • drinking too much alcohol without food
  • using insulin or other diabetes medications
  • not eating enough, or fasting
  • not consuming enough carbohydrates

Exercise causes a significant increase in insulin, which eliminates glucose from the blood, in certain people. Even if a person is well-nourished and does not take blood glucose-lowering drugs, this rise might cause hypoglycemia.

If a person has persistent EIH, a doctor may prescribe medicine to help them recover. Most people, however, can solve the problem by making proper lifestyle modifications.

Is EIH a sign of diabetes?

EIH is not always a symptom of diabetes. Exercise by itself can significantly lower blood glucose levels. People with diabetes, on the other hand, have increased risk factors for hypoglycemia.

Hyperglycemia, or high blood glucose, is a complication of untreated diabetes. If people who take diabetes drugs take more than they need, they are more likely to develop hypoglycemia. It’s also possible that you’re not getting enough nourishment to match your exercise level.

Also, if people with diabetes take diabetic medicine while fasting or commencing a restrictive diet, they may develop hypoglycemia.

Treatment for EIH

Mild EIH normally does not necessitate therapy. In many cases, the condition arises as a result of a person not eating enough food before exercising. Individuals should consume a carbohydrate-rich meal 1–2 hours before a workout to avoid EIH.

Chronic EIH might occasionally indicate a problem with insulin manufacturing. A doctor may administer diazoxide to treat low blood sugar in people who have chronic EIH.

A doctor may consider removing a portion of the pancreas to reduce insulin production in rare circumstances.

Prevention in people with diabetes

People who take diabetic drugs to control their blood glucose levels should check their blood glucose levels before exercising, according to the American Diabetes Association (ADA). If their blood glucose level is below 100 mg/dl, they should consume 15–20 grams (g) of carbs to raise it.

Among the possibilities are:

  • 4 glucose tablets
  • 1 glucose gel tube
  • 1 tablespoon of honey or sugar
  • 4 ounces (oz) of soda or juice

The American Diabetes Association recommends that a person recheck their blood glucose after 15 minutes. If the blood sugar level stays below 100 mg/dl, they should eat another 15 g carbohydrate portion. They should do this every 15 minutes until their blood glucose level reaches at least 100 mg/dl.

Anaerobic exercise, such as high intensity interval training (HIIT), may reduce the incidence of hypoglycemia in people with diabetes, according to a 2019 review. Short bursts of intensive activity are followed by a rest and then another brief burst of intense activity in HIIT.

Prevention in people without diabetes

People without diabetes can usually avoid EIH by doing the following:

  • avoiding drinking alcohol before a workout
  • eating regular meals throughout the day
  • gradually building up to new exercise routines to give the body time to adapt

Stop and take a break if you start to feel unsteady or dizzy throughout your workout. They should drink 4 oz (113 g) of juice or eat a slice of toast before continuing their workout.

Conclusion

Hypoglycemia occurs when blood glucose levels fall too low to meet a person’s body’s energy needs. Hypoglycemia that happens during or after exercise is known as EIH. The condition can affect both people and non-diabetics.

Diabetes patients are more likely to develop EIH, especially if they use insulin or other blood glucose-controlling drugs. In such circumstances, a person should consult a doctor to see whether their drug amounts can be adjusted.

EIH is most commonly caused by not eating enough before exercising or not giving the body enough time to acclimatize to a new exercise schedule in people who do not have diabetes. If a person continues to have regular EIH despite following the necessary precautions, they should seek medical advice to establish the underlying cause.

Sources:

  • https://www.diabetes.org/healthy-living/fitness/getting-started-safely/blood-glucose-and-exercise
  • https://www.frontiersin.org/articles/10.3389/fendo.2019.00326/full
  • https://drc.bmj.com/content/6/1/e000578.abstract
  • https://www.medicalnewstoday.com/articles/exercise-induced-hypoglycemia-what-to-know
  • https://www.cdc.gov/diabetes/basics/insulin-resistance.html
  • https://www.ncbi.nlm.nih.gov/books/NBK534841/
  • https://www.hormone.org/diseases-and-conditions/diabetes/non-diabetic-hypoglycemia
  • https://www.frontiersin.org/articles/10.3389/fendo.2020.00578/full