There are a lot of videos out there of people demonstrating how their blood sugar rises after eating all kinds of meals - it's supposed to do that!

Additionally, a separate process occurs independent of insulin in working muscles. You see, muscles can uptake and utilize glucose all by themselves, without insulin. Mother Nature created this 'fail safe' system so that our muscles would never be deprived of energy to work.

Now, imagine for a moment what could happen if both of these processes were to occur at their full capacity at the same time. The combined action of insulin lowering blood glucose coupled with voracious muscles that are also pulling glucose from the bloodstream can drop blood sugar levels extremely quickly - this is what's known as reactive, or rebound hypoglycemia also known as "bonking" in athletic circles.

In other words, your blood sugar plummets and is too low. Bonking is that feeling when you truly run out of gas. Most athletes have had this happen, regardless if you're a swimmer, runner, triathlete or any other type of athlete. Fortunately, it's an easy condition to prevent.

But that's the key, you've got to prevent it. Because once the dreaded bonk occurs, there goes your race! Historically, it was recommended to avoid carbohydrates before exercise altogether to prevent this phenomenon from happening; however, our viewpoint on this has changed.

In those that have experienced reactive hypoglycemia or are prone to it, the timing and type of carbohydrates before exercise is important. The sugar from the carbs is then released as the working muscles start requiring it, and this keeps insulin mostly out of the picture.

This is thought to result in a much less precipitous, reactive drop in blood sugar. Also, choosing low glycemic index GI carbohydrates, such as a slightly under-ripe banana, may also help. The glycemic index refers to how quickly a food can raise blood sugars. A low glycemic carbohydrate will cause sugars to rise more slowly than high glycemic carbohydrates, resulting in a gradual versus rapid rise in blood glucose and therefore insulin levels will also be lower.

If neither of these strategies work for someone who is prone to reactive hypoglycemia, avoiding all carbohydrates within 90 minutes of exercising might be worth a try.

At this point, blood sugars should be stable and no longer affected by any changes in insulin levels. Note: You may be thinking "oh my gosh, no food before a workout?

In truth, we all have multiple hours of stored carbohydrate in our liver and muscles, known as glycogen. Unfortunately we've all been sold by the makers of sports drinks, bars and gels that we need energy right then and there or we'll crash.

Not true - give it a try no food before a workout lasting under 75 minutes and you'll do just fine. Outside of exercise, paying close attention to the timing and composition of meals and snacks can help manage reactive hypoglycemia.

Despite these dietary solutions, some individuals still struggle with reactive hypoglycemia. These are the cases where we need to look at and evaluate the use of specific nutrients which can help improve how the body deals with carbohydrates.

The botanical medicines Momordica charantia and Gymnema sylvestre slow how glucose is absorbed from the gut and support the pancreas where insulin is made.

Chromium, vanadium, zinc, copper and magnesium are all minerals that play a vital role in how our cells interact with insulin. By supplying these nutrients, the pancreas releases insulin in a more measured way and the cell's ability to absorb and utilize sugars is improved as well.

Supplementing with all of these nutrients has helped a lot of our client-athletes minimize their reactive hypoglycemic symptoms along with getting more detailed with their diets as far as understanding each person's unique tolerance or intolerance to simple carbohydrates.

We really like Glycemic formula because it contains all of these nutrients in a synergistic combination - it contains the 9 most effective natural ingredients known for their ability to optimize blood sugar levels so they stay balanced.

You can read more about how it works here. Everyone is different in how their body tolerates carbohydrates. If you do suffer from reactive hypoglycemia, experiment with the type and timing of meals prior to working out.

This is a treatable symptom of dietary imbalance that can be improved and corrected with strict attention to meal timing with exercise, type of carbohydrates that are tolerated by the individual, protein and fat to carb ratio, and supporting it all with the blood sugar balancing nutrients found in Glycemic Formula.

Any recommendations for what to eat post heavy workout when reactive hypos prevent me from eating tons of carbs in a single sitting? Eager to get your advise.

I just found your post after searching for answers about the hypoglycaemic events I get when I consume carbs before workouts.

I also get nocturnal hypo if I eat carbs in the evening. Any more information or suggestions you can provide would be appreciated.

I am having what feels like hypo episodes around 11am. At 7 I have weak coffee sweetened with equal, then at 8 or so breakfast of 2 fried eggs and some cheese sprinkled on top. I walk my dogs and then do some cardio on my own around 9am.

I am flummoxed how this gets triggered without carbs. I did have a bad hypo response in march after trying a new probiotic which also seemed to drop my heart rate to around I ate some carbs and recovered but it was scary. Can these hypo responses be related to not enough carbs?

Disrupted microbiome? Additionally, many of these studies were conducted following a 6—12 h fast, and studied effects of feeding 15—90 min before exercise.

Few people, however, truly fast prior to exercise resulting in a postprandial state when initiating exercise. Early literature suggests that there is a risk of rebound hypoglycemia if exercise follows the meal too closely. Recently, Kondo et al. Moreover, they noted that individuals with an enhanced insulin response to the pre-exercise meal tended to be more prone to transient hypoglycemia in the fasted state.

Much of the previous work 5 , 6 has shown hypoglycemia in well-trained individuals, usually in males, and in response to prolonged exercise. It is unclear if untrained individuals experience hypoglycemia, or if hypoglycemia is impacted by metabolic health. This project examined if hypoglycemia occurs during moderate-intensity exercise in the evening in non-obese and obese individuals with and without type 2 diabetes T2D.

Previous work by our group 7 showed that resistance exercise 45 min post dinner meal reduced glucose in T2Ds but had a rebound glucose response following exercise.

Delaying an exercise session until after the dinner meal may provide an optimal time to improve glycemia prior to bedtime. We hypothesized that non-obese and obese individuals without T2D would have better counterregulatory control and thus would have tighter glucose control. of age were recruited and signed an informed consent approved by the University of Missouri Institutional Review Board.

Subjects were weight stable for at least the prior 6 months, and non-smokers. All subjects also had a screening oral glucose tolerance test OGTT.

Subjects also had a screening exercise stress test. Women on oral contraceptives were tested in the pill phase.

Pregnant women were excluded. Diabetic participants withheld medications for glucose control the night prior to and during the study day. This study is part of a larger project in progress clinicaltrials. gov, NCT Study day arrival was ~1, h and standardized dinner meal consumption began at 1, h.

Blood sampling was initiated from ~1, h until h, however this paper will focus on the first 5 h of sampling. Height, weight, and waist circumference were measured. Fat mass, fat-free mass, and percent body fat were assessed using a Bod Pod Life Measurements, Concord, CA or DEXA Horizon A, Hologic, Marlborough, MA.

All subjects had a screening OGTT, and hematocrit Hct was measured. Further, questionnaires were completed on the screening day to determine their inclusion in the study, and included a health inventory 9 and sleep apnea Berlin questionnaire All subjects completed a peak oxygen consumption test VO 2 peak on a treadmill.

Prior to starting the test, electrodes were placed for EKG and heart rate measurements during the test. The ventilation, and percent oxygen and carbon dioxide were measured by True One Metabolic Measurement Cart; ParvoMedics Sandy, UT and VO 2 was calculated.

The test began with 2 min of very slow walking 2 mph. Speed and incline of the treadmill were increased every 2 min until the subject reached volitional exhaustion Following the exercise test, subjects actively cooled down and were monitored for 5—10 min until HR and BP returned to near baseline.

The evening prior to the study night, subjects were provided with a dinner meal ~ kcal; Subjects consumed the breakfast at ~ h and lunch at 1, h.

Subjects then fasted, except for water for the remainder of the day. There was no exercise or alcohol consumption for the 24 h prior to the study day. Table 1. Subject characteristics and meal composition for the non-obese, obese, and type 2 diabetic subjects. At 1, h, subjects reported to the lab ~5 h fasted.

An intravenous catheter was placed into a forearm vein. Baseline blood samples began at ~1, h. Following the meal, subjects sat quietly until bedtime. Blood samples were analyzed for glucose YSI STAT PLUS, YSI Incorporated, Yellow Springs, OH , and insulin and glucagon concentrations Human Metabolic Hormone Panel, Milliplex, Millipore Sigma , as well as other hormones not reported here.

There was a minimum of 3 weeks between study days. Baseline characteristics were analyzed by one-way ANOVA for statistical differences between groups.

Post-hoc analysis were performed with a one-way ANOVA and Tukey comparison to explore group differences within dependent variables.

The mean age for all subjects was Fasting glucose levels were in the normal range for both the non-obese and obese subjects. Baseline glucose levels ~1, h were similar between study days, but the individuals with T2D Figure 1. Individual glucose values at time point and time point in each group on the NOEX day B or PMEX day D.

Mean ± SE. Peak glucose responses to the meal were similar between study days, but individuals with T2D had peak values of The time of the glucose peak was not different between study days or groups. Glucose concentrations 2 h post meal consumption start time of PMEX were elevated during NOEX Subjects with T2D had higher glucose concentrations The blood glucose nadir was different between study day and groups, with a nadir of During NOEX, 17 non-obese, 12 obese, and 4 T2D experienced hypoglycemia, while during PMEX, 17 non-obese, 17 obese, and 5 T2D experienced hypoglycemia.

During PMEX, insulin concentrations in obese individuals were elevated compared to non-obese participants from 20 to min post meal, and insulin concentrations in subjects with T2D were elevated compared to non-obese subjects at times , , , , and Figure 2C.

Five hours after the dinner meal, insulin concentrations were similar between all groups in all conditions. Figure 2. Peak insulin responses to the dinner meal were not different between study day, but non-obese participants had lower peak insulin concentrations Time of peak insulin was not different between study days or groups.

Two hours post meal, insulin concentrations were not different by study day, but insulin concentrations were lower in non-obese subjects Participants experienced the lowest insulin concentrations during PMEX Non-obese participants had a higher Matsuda index than participants with T2D 7.

No gender differences were noted for the Matsuda index. Insulinogenic index to the dinner meal was not different between study days but was significantly different between groups. Obese subject's insulinogenic index 1. Glucagon concentrations were similar after 5 h.

During PMEX, peak glucagon concentrations were elevated A gender by group interaction was also seen for peak glucagon concentrations with T2D males having higher peak values than females The time of peak glucagon concentrations occurred earlier with PMEX Additionally, obese males peak later than females Figure 3.

Two hours post meal consumption, no differences in glucagon concentrations were observed by study days. In response to PMEX time to , glucagon levels increased by This is one of the first studies to examine the occurrence of moderate-intensity exercise related hypoglycemia in untrained individuals following a dinner meal.

We demonstrate here that in a group of relatively sedentary individuals, a dinner meal itself resulted in low glucose levels ~2 h post dinner, and in many individuals, there was a further exercise-induced decline, increasing the likelihood of hypoglycemia. How to Avoid Hypoglycemia When Exercising Knowing how to avoid hypoglycemia when exercising is essential for people living with diabetes.

Including the following habits in your routine will help you stay safe: Check your blood sugar every hour if you plan to exercise longer than 2 hours. Keep a fast-acting sugar source nearby in case glucose levels drop during exercise.

Options include glucose tablets, juice or regular soda, or a tablespoon of sugar. Remain hydrated during exercise. How to Prevent Hypoglycemia After Exercise These are some important ways to prevent or help reverse hypoglycemia after exercise: Have a meal within an hour following exercise to replenish carbohydrates and protein.

Check your blood sugar when you finish your workout. If it drops too low, plan to adjust the insulin dosage you take before exercise to prevent low blood sugar next time. Avoid very hot places, such as saunas, immediately after exercise. The heat will elevate your heart rate and can continue to deplete your glucose levels.

Continue checking your blood sugar throughout the day, as your levels may drop for up to 48 hours after an intense workout. Adjust your next workout session if your workouts are too intense and lower your blood sugar levels to unsafe levels.

Develop a Safe Routine A safe workout routine is a valuable part of diabetes management. Ready to Have Freedom at Your Fingertip? Learn More Buy Today. Discreet, On-The-Go, All-In-One Glucose Checks Learn More.

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Exercise can also make the body more sensitive to insulin. When this happens, insulin works more effectively and lowers glucose levels faster. This can place you at a greater risk of hypoglycemia, especially if you take medications to lower insulin levels.

People are more likely to experience hypoglycemia for the following reasons:. People with type 2 diabetes may also experience exercise-induced hypoglycemia. To reduce your risk of experiencing exercised-induced hypoglycemia when you have diabetes you can:. This may include a glass of juice, a piece of hard candy, or glucose tablets or sugar to help raise your glucose levels.

Also, be aware that fast-acting carbs will only boost your blood sugars temporarily. For many people, eating or drinking some carbohydrates and then resting is all they need to treat it. To prevent it in the future, you might eat a small meal an hour or two before working out.

If you have diabetes and experience hypoglycemia related to exercise, you may need to adjust your medication and carbohydrate levels before and after exercising.

These include:. You might consider consulting your doctor if symptoms remain after resting and consuming carbohydrates, or if you experience exercise-related hypoglycemia frequently. They can help guide you toward any needed medication or routine changes to prevent this from happening in the future.

Working out makes your body use up more energy than usual and can increase insulin sensitivity. Especially if a workout is intense, it may cause hypoglycemia to occur whether you have diabetes or not.

If you experience frequent or severe exercise-induced hypoglycemia, you may want to talk with your doctor or healthcare team. They can rule out any related medical conditions and offer recommendations to prevent hypoglycemia in the future. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Learn more about its symptoms, causes, and treatment. Your blood sugar can also dip too low, a condition known as…. Hormones can impact every body system. Growth hormones and even insulin imbalances may even play a role in penis size and function. Anorexia can lead to low blood sugar hypoglycemia , especially in people with a BMI under Very low blood sugar is a medical emergency.

Relative hypoglycemia happens when your body is used to high blood glucose levels, and you blood sugar drops by about a third of its average level…. It may lead to the following:.

Exercise places additional energy demands on the body, so the body needs to respond by burning more glucose. Hypoglycemia can occur in people who already have low glucose levels, or those whose bodies metabolize glucose quickly.

Certain factors can contribute to EIH, including :. In some people, exercise triggers a considerable spike in insulin, which removes glucose from the blood.

This spike can cause sudden hypoglycemia, even when a person is well nourished and does not take medications to lower their blood glucose. If a person experiences chronic EIH, a doctor may recommend medication to reverse the condition.

However, making appropriate lifestyle changes can address the problem for most people. EIH is not necessarily a sign of diabetes. Exercise alone can substantially lower blood glucose. However, people with diabetes have additional risk factors for hypoglycemia. Untreated diabetes causes hyperglycemia , which is high blood glucose.

Individuals who take medications to manage their diabetes are at increased risk of hypoglycemia if they take more than they need. Not eating enough food to match activity levels can also be a cause. Also, people with diabetes may become hypoglycemic if they take medication for diabetes when fasting or starting a restrictive diet.

Mild EIH does not usually require treatment. In many cases, the condition occurs because a person did not eat enough food before working out.

To avoid EIH, individuals should try eating a carbohydrate-rich meal 1—2 hours before a workout. Chronic EIH can sometimes signal an underlying issue with insulin production. If a person experiences chronic EIH, a doctor may prescribe diazoxide to treat low blood sugar.

In rare cases, a doctor may recommend removing a part of the pancreas to slow insulin production. Below are some strategies for preventing EIH in individuals with diabetes and those without the condition.

The American Diabetes Association ADA recommends that people who take diabetes medications to control their blood glucose check their blood glucose levels before exercising. According to the ADA, a person should recheck their blood glucose after 15 minutes.

A review notes that anaerobic exercise, such as high intensity interval training HIIT , may reduce the risk of hypoglycemia in people with diabetes.

HIIT involves brief bursts of intense activity, followed by a rest and then another brief burst of intense activity. Individuals who feel shaky or dizzy during a workout should stop and take a break.

They should try drinking 4 oz g of juice or eating a piece of toast, then resuming their workout later. Hypoglycemia can be life threatening if blood glucose levels drop too low.

A person who experiences one or more of the following symptoms requires emergency medical attention:. People should consult a doctor if they frequently experience EIH or hypoglycemia at other times. If the person has diabetes, this could be a sign that their diabetes medication dosage is incorrect or that they are taking too much insulin.

EIH is hypoglycemia that occurs during or following exercise. Knowing how to avoid hypoglycemia when exercising is essential for people living with diabetes.

Including the following habits in your routine will help you stay safe:. A safe workout routine is a valuable part of diabetes management. The key is knowing how to avoid hypoglycemia when exercising. To create a strategy that works for you, talk to your healthcare provider about your plans and keep track of your blood glucose levels.

An all-in-one glucose monitor like the POGO Automatic ® Monitor is a quick and efficient way to check your blood sugar levels before, during, and after exercise and will give you the confidence to embark on your exercise journey safely. POGO Automatic is the only FDA-cleared blood glucose monitor that lances and collects blood automatically, in one simple step, with its test cartridge technology, eliminating the need to carry separate lancets and test strips.

Reach out today to learn more about how you can check your blood glucose without interrupting your day. Jaclyn Owens is a product director specializing in diabetes management tools.

She is committed to using technology to empower people with diabetes and help them take control of their health. All content on this website is for educational purposes only and does not replace the guidance of your healthcare practitioner.

Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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