Exercise in patients with diabetes using insulin or secretagogues increases hypoglycemia risk, which can be managed by monitoring blood glucose, adjusting insulin, and consuming carbohydrates.
How can exercise-related hypoglycemia be managed in patients with Type 1 and Type 2 diabetes mellitus?
Patients with diabetes on insulin or secretagogues face increased hypoglycemia risk during exercise, which can be mitigated by glucose monitoring, insulin adjustment, and carbohydrate supplementation.
Current recommendations are that people with Type 1 and Type 2 diabetes mellitus exercise regularly. However, in cases in which insulin or insulin secretagogues are used to manage diabetes, patients have an increased risk of developing hypoglycemia, which is amplified during and after exercise. Repeated episodes of hypoglycemia blunt autonomic nervous system, neuroendocrine and metabolic defenses (counter-regulatory responses) against subsequent episodes of falling blood glucose levels during exercise. Likewise, antecedent exercise blunts counter-regulatory responses to subsequent hypoglycemia. This can lead to a vicious cycle, by which each episode of either exercise or hypoglycemia further blunts counter-regulatory responses. Although contemporary insulin therapies cannot fully mimic physiologic changes in insulin secretion, people with diabetes have several management options to avoid hypoglycemia during and after exercise, including regularly monitoring blood glucose, reducing basal and/or bolus insulin, and consuming supplemental carbohydrates.
Younk et al. (Fri,) conducted a review in Type 1 and Type 2 diabetes mellitus. Exercise was evaluated. Exercise in patients with diabetes using insulin or secretagogues increases hypoglycemia risk, which can be managed by monitoring blood glucose, adjusting insulin, and consuming carbohydrates.