The Vicious Cycle of extreme Exercise & Hypoglycemia in T1 Diabetes
The America Diabetes Association 76th session started this weekend in the States and we are reporting on the most interesting results.
Yesterday, Stephen Davis MBBS, University of Maryland, presented latest research examining the cause and management of exercise-induced hypoglycemia in Type 1 Diabetes. Having hypoglycemia following exercise is common but most people do not know that the response to subsequent hypoglycaemia’s can be blunted for up to 2 days. In other words, you may not be as aware as you would normally be of the initial hypo symptoms because of having a post exercise hypo a day or so ago. Experiencing hypoglycemia during exercise involves a reduction in messaging from your brain to your entire body (reduced neuroendocrine response) along with an increase in insulin sensitivity. In simple terms, this puts you at a greater risk of further hypo’s. This appears to be more of a threat in men than women, taking intense activity. Short intensive bursts such as sprint, increase blood sugars and longer sessions of moderate exercise, decrease blood sugars. The message is to vary exercise.
Does the intensity of exercise affect hypo’s? It does not seem to but a burst of high intensity exercise, even just 10 seconds of sprints, following 20 minutes of moderate exercise can protect glucose levels for up to two hours.
Bill Tamborlane, MD, Yale, discussed hypoglycemia in children and adults with T1 diabetes and concluded that the highest risk is at night, 6 hours after a meal, while asleep. That risk for night-time hypoglycemia is increased after exercise in the afternoon in both children and young. Almost half of children experienced a nighttime dip after afternoon exercise. Continuous Glucose Monitoring is very beneficial for people taking regular intense exercise to detect trends and plan action appropriately.