Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes

Abstract

The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.

Educational Model for Cadres and Housewives Against Changes in Family Knowledge and Behavior in Efforts to Prevent Complications of Type II DM in Bunut Wetan Village, Malang Regency

“…Thus, routine annual assessments of knowledge, skills, and behavior are required for both meeting and non-meeting diabetes patients. Annual visits to educate people about diabetes are recommended to assess all areas of selfmanagement, to review changes in behavior and coping strategies and problem-solving skills, to identify life strengths and challenges for people with diabetes, and to make adjustments in therapy (7) .…”

Novas perspetivas sobre o rácio de hidratos de carbono em indivíduos com Diabetes Tipo 2 no desporto

“…Nos indivíduos com DT2, o risco de hipoglicémia induzida por exercício é relativamente baixa porque é possível haver um melhor controlo glicémico através do uso de protocolo dietético e/ou de treino. No entanto, aqueles que estão a realizar um protocolo de insulinoterapia (14), medicamentos hipoglicémicos (27,28) ou até ter uma resistência do mecanismo de controlo hipoglicémico (10,29,30), podem estar em risco de hipoglicémia (28) e será necessário haver um reajuste ao nível de estratégias dietéticas e de treino.…”

“…As recomendações atuais para a população em geral em exercícios aeróbios de duração prolongada é de 2:1 (glicose:frutose) (46,58). Devido a situações de hipoglicémias e/ou hiperglicémias que os indivíduos com DT2 podem apresentar durante o treino aeróbio (27,28), seja devido por protocolos de insulinoterapia, medicamentos hipoglicémicos ou alterações do mecanismo de controlo interno (12,14,(28)(29)(30)61), as recomendações de HC atuais na fase peri-treino e pós-treino poderão estão desajustadas para esta população específica.…”

Management of Glycemia during Acute Aerobic and Resistance Training in Patients with Diabetes Type 1: A Croatian Pilot Study

“…Moreover, the liver produces less glucose in T1DM individuals who exercise because of higher blood insulin concentrations. Therefore, ingesting carbohydrates prior to aerobic exercise as well as reducing/withholding insulin doses might be a necessary strategy to avoid hypoglycemia [ 10 , 11 , 12 ]. On the other hand, exaggerated reduction or even skipping of insulin dosage, as well as consuming excessive amounts of carbohydrates, causes hyperglycemia before and during the exercise, possibly leading to ketosis [ 13 , 14 , 15 ].…”

“…Catecholamine levels increase in response to anaerobic changes push glucose production and release from the liver, causing blood glucose levels to rise and thus minimizing the risk of blood glucose drop during exercise. Nevertheless, hypoglycemia may develop for an extended period after exercise [ 12 , 16 , 17 ].…”