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Hypoglycemia complications in athletes

Hypoglycemia complications in athletes

Usually, you will not notice these changes unless they drop below the coplications range. What to Hypoglycemia complications in athletes Out Hypoglycsmia Your athletws will Hypoglycfmia you glucose control tips what blood sugar levels make it a good or bad time to exercise. Parents play an instrumental role in providing a safe and encouraging environment for their children. A joint position statement issued by the ACSM, the American Dietetic Association, and the Dietitians of Canada summarized general nutrient requirements for competitive athletes. This article describes what EIH is, including its symptoms, causes, treatment, and prevention. Hypoglycemia complications in athletes


Hypoglycemia: Symptoms, Treatments and Risk Factors - Pharmacology - Lecturio Nursing

Hypoglycemia complications in athletes -

Medically reviewed by: Melanie L. Pitone, MD. Listen Play Stop Volume mp3 Settings Close Player. Larger text size Large text size Regular text size.

What Coaches Should Know Diabetes affects how the body uses glucose, the main type of sugar in the blood. Low blood glucose symptoms include hunger, shakiness, fast heart rate, dizziness, headache, moodiness, and confusion. High blood glucose symptoms include thirst, peeing more than usual, dry mouth, and dehydration.

Students with diabetes who play sports may: need to monitor blood glucose levels before and after playing sports or practicing take insulin injections or wear an insulin pump need to use the bathroom frequently need plenty of water and extra snacks before, during, and after exercise need to sit out of practice or games if their blood sugar is too low or too high What Coaches Can Do Students with diabetes can play sports and exercise at the same level as anyone else.

CGM took place while participating in a study. The subject performed a submaximal and maximal test on a cycle ergometer in the morning and thereafter consumed a mixed diet.

Note the absence of increased interstitial glucose during maximal exercise also verified in capillary blood. The x axis shows the time of day, and the blue area marks the time of exercise. The normal glucose range between 4 and 8 mM is indicated with dotted lines.

The concept of relative energy deficiency in sports REDs has gained an increasing amount of attention [ 52 ]. Besides inducing hormonal changes that potentially could affect sports performance and the health of the athlete, a negative energy balance has direct metabolic consequences with reduced dietary carbohydrates that enter the circulation, increased fatty acid oxidation, and gluconeogenesis.

The lowest mean glucose levels were observed during the most severe energy deficit [ 53 ]. Also, female endurance athletes with secondary functional hypothalamic amenorrhea, which can be a consequence of low energy availability, have been found to exhibit lower capillary glucose levels during fasting and submaximal exercise than eumenorrheic subjects [ 54 ].

These, and other studies previously discussed by Bowler and colleagues [ 55 ] suggest that glucose measurements can be used as a marker of reduced energy availability.

Hypoglycemia during the night has the potential to disrupt sleep, which could affect recovery negatively. The release of epinephrine begins already at blood glucose concentrations around 3. Blood glucose levels below 2.

This awakening response has been shown in several studies to dramatically decrease sleep efficiency and increase wake time during the night [ 59 ]. However, it remains to be shown if the frequent nocturnal hypoglycemia seen in athletes own data in current projects and [ 31 ] also affect their sleep.

The use of CGM has expanded in recent years and the pro and cons of the method as well as the technique has been discussed with the healthy athlete in mind [ 55 , 60 , 61 ]. CGM has made it possible to assess glucose variability during daily life calculations can be found in [ 62 ] and time in the hyper- and hypoglycemic range can easily be calculated.

Studies that have implemented various forms of exercise in untrained and diabetic populations have indeed found that exercise reduces daily glucose variability and improves glucose control [ 63 ]. The interpretation of CGM data in endurance athletes is however still unclear, and it has been questioned whether the objectives of controlling glucose variability to optimize performance are possible using CGM data alone [ 61 ].

Using CGM readings to decide acute carbohydrate intake for managing blood glucose homeostasis also has some substantial limitations. Although interstitial glucose has been shown to represent the concentrations in the blood, variation can occur [ 64 ].

After carbohydrate intake, interstitial glucose increases with a delay of up to 15 min compared with concentrations in the blood, while during exercise, changes in interstitial glucose seems to occur more rapidly than in blood personal observations and [ 65 ]. A recent study using CGM also demonstrated that individual variability of postprandial glucose responses to identical meals was as large as responses to different meals in two nondiabetic cohorts [ 66 ], indicating that additional factors in combination with food intake affect the glucose response.

In addition, a lower precision of CGM measurements during exercise has been reported in type I diabetes subjects [ 67 ] and in subjects with normal glucose regulation [ 68 ].

Different sensors [ 69 ], and sites for sensor placement have also been shown to affect intestinal glucose after a glucose load, with sensors placed on the leg consistently reporting lower values than sensors placed on the upper arm during rest and when blood flow was elevated by heat exposure [ 70 ].

In all, blood and compartmental glucose are not the same, and the difference between the two measures increases when interstitial glucose fluxes change due to carbohydrate intake, blood flow, and muscular work.

Only a few scientific studies have used CGM in endurance athletes. Glucose variability and nocturnal basal glucose have also been suggested to increase as an inflammatory response to a strenuous exercise session and potentially be used as a marker of recovery [ 71 ].

Some general conclusions can be drawn from these studies. Firstly, endurance exercise affects glucose variability and the glucoregulatory response to meals, and secondly, endurance athletes are in general prone to exhibit hyperglycemia [ 31 , 32 , 75 ].

However, the study by Prins and colleagues show that different compositions of macronutrients in the daily diet can have a high impact on 24 h interstitial glucose and glucose variability, and that these changes are closely linked to alterations in fat metabolism [ 75 ].

Interpreting CGM data can therefore be challenging, as it involves separating the effects of exercise from the effects of the timing and composition of meals.

Despite this, CGMs hold promise as a tool for monitoring glucose variability, energy balance, and recovery status in endurance athletes. The daily life of an endurance athlete contains all the ingredients that can increase glucose variability, including exercise, high or low carbohydrate intake, and stress responses.

This underlines the importance of further research to study the complex interactions between exercise, nutrition, and glucose regulation in this cohort.

While the existing studies on the relationship between blood glucose levels and athletic performance have had limitations in sample size and study design, avoiding hypoglycemia during exercise has been associated with improved performance. Suzuki and colleagues compared two runners with different training backgrounds who performed 5 h of running.

Blood glucose levels were higher in the faster runner but were not affected by the timing or amount of ingested carbohydrates [ 72 ]. Ishihara and colleagues found that performance during an ultra-running event was associated with high carbohydrate intake, but normoglycemia was maintained regardless of carbohydrate intake and glucose variability was not dependent on the timing of carbohydrate ingestion [ 73 ].

In a recent cross-over study ten male athletes trained for 4 weeks while adhering to a low-carb—high-fat LCHF , or high-carb—low-fat HCLF diet [ 75 ]. When training on the LCHF diet, the athletes showed profound changes with reduced mean 24 h glucose and lower nocturnal glucose with more time in the hypoglycemic range but also lower glucose variability.

However, no differences were seen between groups regarding performance but during the LCHF occasion, the athletes had higher fat oxidation rates but also higher ratings of session affect a measure of perceived training stress.

Interestingly, the increase in capillary glucose after high intensity exercise was similar in the two groups, indicating that this specific response is not dependent on carbohydrate availability. This supports our argument above that accomplished endurance athletes have an improved intrinsic ability to maintain normal to elevated blood glucose during extended exercise.

However, a failure to increase glucose during high-intensity exercise has been associated with maladaptations to the training load during overreaching, possibly through a reduced catecholamine response during exercise [ 31 ]. Postexercise glucose measurements have therefore the potential to be used to detect early indices of overtraining [ 76 ].

A summary of possible usage of CGM in athletes is presented in Fig. Continuous glucose monitoring CGM can be used by endurance athletes to track glucose levels during exercise and recovery.

With knowledge of the typical glucose responses to exercise and diet in an athlete, deviations from expected glucose responses can be detected and be used to interpret levels of stress, energy availability and health. Finally, the advancements in sensor technology including other measures than glucose should be mentioned.

Sensors are currently being developed for continuous dermal interstitial monitoring of not only glucose but also lactate and possibly other biomarkers relevant to the athlete [ 77 ]. A sensor that with high accuracy can track multiple physiological responses to exercise and during recovery would certainly move the field forward.

One obstacle to this is that the International Cycle Union in prohibited the use of technology that captures metabolic data which includes CGM during competitions [ 78 ]. A common CGM sensor life is 14 days and, for example, cyclists that compete frequently can therefore not take full advantage of the technique.

It is important to note that there is no evidence suggesting that the use of CGM provides an unfair advantage during competitions. Instead, such a ban may represent a missed opportunity for researchers and coaches to monitor the health of athletes. As such, optimizing glucose levels to improve performance and health outcomes in athletes is a growing area of practice and research.

However, our knowledge of what the optimal glucose response to exercise and the following recovery period looks like is still untangled. Studies utilizing continuous glucose monitoring CGM have consistently shown that athletes have highly individual glucose profiles and often spend a significant amount of time with hypo- and hyperglycemia.

These findings challenge our traditional assumptions about glucose control and suggest that interstitial and blood glucose levels may be an overlooked parameter in optimizing athletic performance.

With the help of future researchers, athletes, and governing bodies in sports working together, we can uncover new insights into how glucose regulation affects performance, recovery, and overall health.

These insights may help athletes tailor their training and nutrition plans to meet their individual needs, ultimately leading to improved performance and better health outcomes. Wasserman DH. Four grams of glucose. Am J Physiol Endocrinol Metab.

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J Diabetes Sci Technol. Borghouts LB, Keizer HA. later I start crashing. Do you have a better idea for a post run meal?. Also do you offer meal plans or know of someone that does. who I can pay to help me with this?

Thank you! Thank you for this. When ever I pickup working out after a time away if I go to intensely I feel that shaky feeling. If I start slow I can usually do ok. Is that consistent? Your article gave me some good ideas of what to experiment with.

Thank you. I experienced this for a few years and stopped running because of it. Started taking metformin and I feel like a new person.

I had no idea I was insulin resistant but it all makes sense now. I had a ton of tests done, had a specialist tell me there was nothing medically wrong with me suggesting it was all in my head. Ended up on metformin for hormonal issues PCOS and finally feel normal again.

Hence the google search that led me here. Around the same time that I started suffering from feeling like I was bonking about minutes in to an easy run my family doc said that I need to shed a few pounds because my fasting glucose was getting in to pre-diabetes territory.

Mark — interesting. So, two thoughts: 1 — you might look into something like a micronutrient assay so you can assess nutrient status — when imbalanced or lacking, I could see something like this contributing to those symptoms.

Thanks for replying, Yes, 3 different times for a week, months apart. No arrhythmias were detected, also 2 stress tests with an echo immediately following a heart rate of over BPM.

Some days there are no symptoms at all after a work out. Hi Mark — were you wearing your monitor at the time of these episodes? So for approx 6 years, I have been experiencing an event at times after approx min of strenuous workout Mainly moderately heavy weightlifting.

I feel extreme anxiety, uncomfortable with heart palpitations. This usually last min and I then feel relatively fine. At first I thought it was heart related, but it after multiple tests EKG, Echo, Stress tests, weekly heart monitor, etc there was nothing found to be wrong.

Without a diagnosis, does this sound like hypoglycemia? It would be a relief if that is all it was. Also, would increasing in age make this more of an issue? I had no issues before , then it started at a once a month frequency. I am 46 and have been weightlifting fairly regularly for 30 years.

I am not diabetic and all my labs are excellent. Thank you, Mark. Hi Lou — thanks for your comments. Regardless glad you were able to help yourself! I started getting this when I had been on low carb diet for many months then switched to carb loading for half marathon.

I stopped running so much. My lows still happen but not as bad. I now belief the carb amount is the problem not the running. I never had to worry about this when I was young, I am Doctors have not given me reason for problem or solution.

Just to cope by eating 6 small meals spread through day. You say this not a medical condition, but if you are incapacitated by low sugar, if the hypos disrupt your day, it is as bad as a medical condition, for all intents and purposes. I think this has been the most helpful and thoroughly explained answer I have read.

Preventing Reactive Hypoglycemia with Exercise. How It Happens In response to eating carbohydrates our body releases insulin, a hormone that works to drive glucose the main breakdown product of carbohydrates into cells for storage or use.

Like, you want to lay down in the middle of the road kind of fatigue. No energy.

by Ed SusmanContributing Writer, MedPage Today June 18, CHICAGO — Complicatioms three-fourths of complicattions with Hypoglycemia complications in athletes 1 diabetes Ginger salad dressing recipe who engaged in aerobic activity failed to Hyopglycemia guidelines for preventing hypoglycemia, complciations to Hypoglycemia complications in athletes survey-based study. Henske reported at a press conference that less than a third of respondents said healthcare providers were their go-to sources for information on hypoglycemia and exercise. Other sources included social media, Google searches, and YouTube videos. Consensus guidelines on exercise management in T1D came out in Inthe European Association for the Study of Diabetes and the International Society for Pediatric and Adolescent Diabetes released a position statement for glucose management for exercise in T1D that was supported by the American Diabetes Association. Photo: Athletee Images "], "filter": { "nextExceptions": "img, blockquote, Joint health robustness, "nextContainsExceptions": "img, blockquote, Hypoglycmeia. btn, a. During exercise, as carbohydrate utilization increases Ni muscle glycogen stores begin Hypoglycemia complications in athletes decline, Hypoglycemia complications in athletes blood glucose levels can begin to drop. Low blood glucose levels can result in a brief spell of dizziness, confusion, nausea, headache, or blurred vision — all of which could impact exercise performance. Our bodies have evolved to keep blood glucose levels within a tight range by releasing counter-regulatory hormones, both at rest and during exercise. Certainly, everyone experiencing these disturbing symptoms should check with a medical professional to ensure everything in the body is functioning at optimal levels.

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