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Ask Ester: Exercising with hypoglycemia

Q: I have hypoglycemia. It is hard for me to exercise because my sugar drops so low. Any suggestions?
A: Hypoglycemia is the medical term used for a state produced by a lower-than- normal level of blood glucose (sugar). The term literally means “under-sweet blood”.
The most common forms of moderate and severe hypoglycemia occur as a complication of treatment of diabetes with insulin or oral medications. Hypoglycemia is less common in non-diabetic persons, but speaking from my own experience, it does happen. It can occur at any age, from many causes. Among the causes are excessive insulin produced in the body (the opposite of diabetes), inborn errors of carbohydrates, fat, amino acids; other causes can be medications and poisons, alcohol, hormone deficiencies, certain tumors, prolonged starvation, and alterations of metabolism associated with infection or failures of various organ systems.
Hypoglycemia is treated by quickly restoring the blood sugar level to normal by taking dextrose or carbohydrate foods which absorb quickly into the system. The level of blood sugar low enough to define hypoglycemia may be different for different people and circumstances. It also has created an occasional matter of controversy. Most healthy adults maintain fasting glucose at levels above 70mg/dl and experience symptoms of coldness, clamminess, dilated pupils, feeling of numbness when their blood sugar falls below 55 mg/dl.
Signs and symptoms can be, but are not limited to:
– Adrenergic manifestations (having to do with adrenaline and /or noradrenaline), including shakiness, anxiety, nervousness, tremor, palpitations, sweating, coldness, clamminess, dilated pupils, feeling of numbness.
– Glucagon manifestations (glucagon is an important hormone involved in carbohydrate metabolism.), including hunger, nausea, vomiting, abdominal discomfort, headache.
– Neuroglycopenic manifestations (shortage of glucose in the brain), including impaired judgment, anxiety, moodiness, depression, crying, negativism, irritability, personal change, fatigue, weakness, lethargy, daydreaming, sleep, confusion, amnesia, dizziness, slurred speech, incoordination, headache, stupor, coma, abnormal breathing.
On this list are just some of the possible manifestations that can occur with hypoglycemia. There is no consistent order to the appearance of symptoms if symptoms even occur.
Exercise and hypoglycemia:
Make sure you check your blood sugar before you exercise. I am a “self-diagnosed” hypoglycemic. My mother and sisters deal with the same problems when we do not eat or do not eat right: shakiness, moodiness, confusion, sweating, headache, irritability, weakness. I have found when I eat right and I eat regularly and in many settings, my blood sugar will stay normal. Actually, the symptoms of low blood sugar stay away.
I keep my carbohydrates low, my protein higher, and I eat frequent small meals. I always joke that I eat once a day ó from morning till evening!
I MUST eat before I exercise. If I do not eat before I exercise, the symptoms arise very quickly and my workout has to be cut short and cannot be intense.
Of course you need a doctor to diagnose you if you have hypoglycemia. He or she will refer you to a registered dietitian who will set up a plan that will work for you. Carbohydrates are very important in a daily diet but too many people eat too many carbohydrates because the portions are enormous. Example: one plate of spaghetti is NOT one serving! When exercising always have something to eat available like grapes, raisins or a drink like orange juice to take if you feel your blood sugar drop. Your goal is to arrange your eating so that you do not experience big lows in your blood sugar. Again, for me it works to eat frequent healthy, small portions. High sugar and quickly-absorbed carbohydrates will spike my blood sugar and make it drop drastically. A low-fat, low-carbohydrate (not NO carbohydrates), higher protein (not ALL-protein) diet works for me. My advice to you is to visit with your doctor and a registered dietitian to set up a diet for you that incorporates your plan for exercise so you can start enjoying your exercise routine. Good luck!
Contact Ester Marsh with health and fitness questions at 704-636-0111 or emarsh@rowanymca.com.

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