Exercised-induced hypoglycemia: What you need to know

During a recent fat bike ride, my continuous glucose alarm went off due to low levels: why can this happen and what to do about it.

During high-intensity exercise, it is common for blood glucose levels to decrease due to the increased demand for energy by the working muscles. Here are a few reasons why you might experience a sharp drop in blood glucose levels during intense exercise:

1. Increased Glucose Utilization: High-intensity exercise requires a significant amount of energy, which is primarily supplied by glucose. As you exert yourself, your muscles consume glucose at a faster rate to meet the energy demands. This can lead to a rapid decrease in blood glucose levels.

2. Accelerated Insulin Sensitivity: During exercise, your body becomes more sensitive to insulin, meaning it becomes more efficient at using insulin to facilitate glucose uptake into cells. As a result, insulin can act more effectively to clear glucose from the bloodstream and deliver it to the muscles, leading to a decrease in blood glucose levels.

3. Glycogen Depletion: The body stores glucose in the form of glycogen in the liver and muscles. High-intensity exercise can rapidly deplete these glycogen stores, particularly in the muscles. As glycogen is broken down to release glucose, it can cause a decrease in blood glucose levels.

4. Hormonal Response: Intense exercise triggers the release of various hormones, including adrenaline and cortisol, which can have a blood glucose-lowering effect. These hormones promote the breakdown of glycogen and the release of glucose from the liver, further contributing to a decrease in blood glucose levels.

It's important to note that while a temporary decrease in blood glucose levels during intense exercise is normal, it's crucial to maintain adequate fueling before and during exercise to prevent severe drops that could lead to hypoglycemia. If you consistently experience significant drops in blood glucose levels during exercise or have concerns about your blood sugar regulation, it is advisable to consult a healthcare professional for a thorough evaluation and personalized guidance. They can assess your specific situation and provide appropriate recommendations based on your individual needs.

If you experience a sudden drop in blood glucose levels during exercise, it is important to take appropriate steps to address the situation. Here are some recommended actions to consider:

1. Check Your Blood Glucose Level: If you have a glucose meter available, test your blood glucose level to confirm if it is indeed low. Symptoms alone may not be sufficient to determine your blood sugar level accurately.

2. Treat Hypoglycemia: If your blood glucose level is confirmed to be low (typically below 70 mg/dL or 3.9 mmol/L), it is important to consume fast-acting carbohydrates to raise your blood sugar. Examples of suitable options include glucose tablets or gels, fruit juice, regular soda, or a small serving of a high-sugar snack. Follow the recommended dosage provided by your healthcare professional or the product's instructions.

3. Rest and Monitor: Take a break from your exercise and allow your blood sugar to stabilize. Monitor your symptoms and blood glucose levels during this time to ensure they are returning to a safe range.

4. Re-evaluate Your Exercise Routine: Reflect on the factors that may have contributed to the sudden drop in blood glucose levels. Consider adjusting your exercise routine, such as modifying the intensity or duration, or incorporating more balanced pre-exercise and during-exercise nutrition to better support your blood sugar regulation.

5. Consult a Healthcare Professional: If you frequently experience significant drops in blood glucose levels during exercise or have concerns about your blood sugar regulation, it is advisable to consult a healthcare professional. They can evaluate your specific situation, perform necessary tests, and provide personalized guidance based on your individual needs.

Remember, it is important to be prepared for hypoglycemia during exercise, especially if you have a history of low blood sugar or diabetes. Carry a source of fast-acting carbohydrates with you, inform your exercise partners about your condition, and consider wearing medical identification jewelry to alert others in case of an emergency.