When can exercise-related hypoglycaemia occur?

When can exercise-related hypoglycaemia occur?

• A. During exercise or hours to days later, especially after moderate to high intensity exercise lasting longer than 30 minutes.
• B. Only during sleep after exercise.
• C. Only after meals following exercise.
• D. Only if insulin is not adjusted before exercise.

Answer: (A)

Exercise drives glucose into active muscles, and contracting muscles can take up glucose from the blood even with little or no insulin. After a workout, insulin sensitivity remains elevated for hours, and hepatic glucose production may not fully compensate for the ongoing rate of glucose use. This combination means blood glucose can drop during exercise and continue to fall for hours afterward, with the risk being especially high after moderate to high‑intensity activity that lasts longer than about 30 minutes. The potential for late hypoglycemia can extend into the night after a long or intense session. It isn’t limited to sleep or meals, and it isn’t only about not adjusting insulin beforehand—hypoglycemia can occur even with careful planning, due to the prolonged effects of exercise on glucose handling. Monitoring and planning—such as extra carbohydrates around workouts or adjusting insulin—help mitigate the risk.

Exercise drives glucose into active muscles, and contracting muscles can take up glucose from the blood even with little or no insulin. After a workout, insulin sensitivity remains elevated for hours, and hepatic glucose production may not fully compensate for the ongoing rate of glucose use. This combination means blood glucose can drop during exercise and continue to fall for hours afterward, with the risk being especially high after moderate to high‑intensity activity that lasts longer than about 30 minutes. The potential for late hypoglycemia can extend into the night after a long or intense session. It isn’t limited to sleep or meals, and it isn’t only about not adjusting insulin beforehand—hypoglycemia can occur even with careful planning, due to the prolonged effects of exercise on glucose handling. Monitoring and planning—such as extra carbohydrates around workouts or adjusting insulin—help mitigate the risk.