4.7.0.0 Hy­po­glycemia

In in­di­vid­u­als tak­ing in­sulin and/‍or in­sulin sec­re­t­a­gogues, phys­i­cal ac­tiv­i­ty may cause hy­po­glycemia if the med­i­ca­tion dose or car­bo­hy­drate con­sump­tion is not al­tered. In­di­vid­u­als on these ther­a­pies may need to in­gest some added car­bo­hy­drate if pre-‍ex­er­cise glu­cose lev­els are <90 mg/dL (5.0 mmol/‍L), de­pend­ing on whether they are able to lower in­sulin doses dur­ing the work­out (such as with an in­sulin pump or re­duced pre-‍ex­er­cise in­sulin dosage), the time of day ex­er­cise is done, and the in­ten­si­ty and du­ra­tion of the ac­tiv­i­ty (138,142). In some pa­tients, hy­po­glycemia after ex­er­cise may occur and last for sev­er­al hours due to in­creased in­sulin sen­si­tiv­i­ty. Hy­po­glycemia is less com­mon in pa­tients with di­a­betes who are not treat­ed with in­sulin or in­sulin sec­re­t­a­gogues, and no rou­tine pre­ven­tive mea­sures for hy­po­glycemia are usu­al­ly ad­vised in these cases. In­tense ac­tiv­i­ties may ac­tu­al­ly raise blood glu­cose lev­els in­stead of low­er­ing them, espe­cially if pre-‍ex­er­cise glu­cose lev­els are el­e­vat­ed (157).