How do prior exercise and glycaemic control affect hypoglycaemia risk?

How do prior exercise and glycaemic control affect hypoglycaemia risk?

• A. Prior exercise enhances adrenergic responses.
• B. They increase the risk of hypoglycaemia during the next day.
• C. They generally have no effect on adrenergic responses.
• D. Prior exercise or recent hypoglycaemia can blunt normal adrenergic responses.

Answer: (D)

The important idea is that prior exercise and recent hypoglycemia can blunt the body's normal counterregulatory response to low blood glucose. When glucose falls, the body normally kicks in adrenergic signals (like sweating, trembling, fast heart rate) and releases hormones to raise glucose. If you’ve recently exercised or had a hypoglycemic episode, these counterregulatory responses can become less sensitive—a phenomenon known as hypoglycemia-associated autonomic failure. With weaker adrenergic warning signs, hypoglycemia can occur with less notice and have a higher risk of becoming severe. Exercise also boosts insulin sensitivity and muscle glucose uptake, which can contribute to lower glucose levels and, paired with blunted warning responses, increases risk. That’s why this option correctly captures how prior exercise or recent hypoglycemia affects risk. The other statements aren’t accurate: adrenergic responses aren’t enhanced; there is typically some effect on these responses; and while next-day risk can exist, the core concept is the blunting of adrenergic signals.

The important idea is that prior exercise and recent hypoglycemia can blunt the body's normal counterregulatory response to low blood glucose. When glucose falls, the body normally kicks in adrenergic signals (like sweating, trembling, fast heart rate) and releases hormones to raise glucose. If you’ve recently exercised or had a hypoglycemic episode, these counterregulatory responses can become less sensitive—a phenomenon known as hypoglycemia-associated autonomic failure. With weaker adrenergic warning signs, hypoglycemia can occur with less notice and have a higher risk of becoming severe. Exercise also boosts insulin sensitivity and muscle glucose uptake, which can contribute to lower glucose levels and, paired with blunted warning responses, increases risk. That’s why this option correctly captures how prior exercise or recent hypoglycemia affects risk. The other statements aren’t accurate: adrenergic responses aren’t enhanced; there is typically some effect on these responses; and while next-day risk can exist, the core concept is the blunting of adrenergic signals.