Exerciserelated Hypoglycemia

Exercise has numerous therapeutic benefits. Physical activity improves insulin sensitivity; helps maintain body weight, and can reduce postprandial hyperglycemia. However, despite these and numerous other benefits, exercise often results in hypoglycemia in adults with T1DM. Counterregulatory hormones are activated during exercise in a similar fashion to hypoglycemia. However, norepinephrine levels are higher and epinephrine levels are lower during exercise as compared to hypoglycemia. Nevertheless, the metabolic role of counterregulatory hormones during exercise is to allow the individual to match glucose production to the needs of the working muscles. Therefore, neuroendocrine mechanisms are invoked to stimulate EGP, while simultaneously limiting glucose uptake in muscles. If glucose production cannot match glucose uptake then hypoglycemia will develop.

Until recently, the mechanisms responsible for exercise-associated hypoglycemia in T1DM were thought to be due to a relative or absolute excess of insulin and inadequate glycogen repletion. Neuroendocrine counterregulatory responses are amplified during exercise in the presence of hypoglycemia (5). However, reports by Bottini et al. (33) and Schneider et al. (34) demonstrated that T1DM patients had reduced counterregulatory responses during exercise. Furthermore, the responses appeared to be attenuated by intensive metabolic control. These studies provided the first indication that deficient neuroendocrine



Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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