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March 7, 2007

Exercise and Sports, Hypoglycemia

Question from Sidney, New York, USA:

My son is a newly diagnosed type 1 diabetic and we are still trying to regulate his insulin needs. The problem I am having is with fluctuations during basketball practice. I was wondering if anyone could recommend a blood sugar range for before practice. Also, do you have any suggestions on the best thing to eat or drink if his blood sugar goes low during practice? I am looking for something that will not cause him to be high two hours after practice.


It is recommended to have a slightly higher blood sugar during exercise, especially if there is a pattern of low blood sugar during activity. Many athletes will strive to get their blood sugars in the 150 mg/dl [8.3 mmol/L] to 175 mg/dl [9.7 mmol/L] range when exercising. Since this is an individualized disease, seeing how one reacts to a particular type of exercise will aid in finding a good range during exercise.

Checking blood sugar is one of the best ways to keep on top of any low or high blood sugars. If there is a problem during exercise with high or low blood sugars, check about an hour before and a half hour before the start. This will allow you to compare two numbers to see if blood sugars are trending up or down. You will have thirty minutes to make any adjustments, if needed, with food or insulin. Checking frequently during activity can assure the athlete that he or she can go all out without fear of a low blood sugar. Checking afterwards is also important so a plan is in place to eat carbohydrates. If the blood sugar is too high (i.e., over 300 mg/dl [16.7 mmol/L]), it may not be a good idea to eat carbohydrates for fear of going even higher and spilling ketones. The presence of ketones in the urine is an indication the body is deficient of insulin and is breaking down fats for energy. A byproduct of this type of fat burning becomes toxic to the system. Continuing to exercise may cause the blood sugar to go even higher and spilling more ketones may eventually lead to diabetic ketoacidosis (DKA). Drinking a lot of water will help, along with insulin, to bring blood sugars down to the normal range. How much insulin depends on the individual’s correction factor and doctor’s advice.


[Editor’s comment: See our other questions on Exercise and Sports to learn more.

You should discuss the treatment of lows with your son’s diabetes team. In the meantime, you might want to use glucose tablets or small amounts of Gatorade. Some high blood sugars at the conclusion of a sport is related to adrenaline.