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September 27, 2000

Exercise and Sports, Hypoglycemia

Question from Corpus Christi, Texas, USA:

My 14 1/2 year old daughter has had diabetes for almost six years. She does fine until she has had a few days of frequent exercise, then she tests her blood sugar before bed, thinks everything is okay, but she has a seizure between 2 am and 5 am. She has even checked at 10 pm, her blood sugar is around 100 mg/dl [5.6 mmol/L], again at midnight her blood sugar was 205 mg/dl [11.4 mmol/L] and crashed at 5 am. I am concerned about this, but more about the seizures and wondering if she will come out of them on her own, because we do not hear her. Fortunately, she has always had a sister or friend around who has been alerted to her seizures.

Answer:

If this is a recurring pattern, then why not give her extra food high in fat (for example, ice cream) on those evenings after vigorous exercise. Ice cream as a bedtime snack works exceedingly well to provide a slow-acting sugar effect. Also, why not decrease her overnight insulin either (supper and/or bedtime cloudy insulins) to prevent excessive and severe recurring hypoglycemia like this? Discuss these ideas with your daughter’s diabetes team.

SB
Additional comments from Lois Schmidt Finney, diabetes dietitian:

Let’s get some blood sugars at about 2-3 am since the midnight ones are okay. We might have a big drop a little later in the early morning, so please check then.

I would be reluctant to add the ice cream due to the high number of calories. A small glass of milk and one or two crackers might work. Also, you might want to consider using an insulin pump and then turn down the rate when she is engaging in intense exercise, not only for the time period of the exercise, but for several hours afterwards. Check with your diabetes team.

LSF