Can people with hypoglycemia exercise?

Written by Zhao Xin Lan
Endocrinology
Updated on February 27, 2025
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Hypoglycemia refers to a plasma glucose concentration lower than 2.8 mmol/L, at which point patients may exhibit signs of sympathetic nervous excitement, such as trembling hands, palpitations, pale complexion, profuse sweating, feelings of hunger, and fatigue. There can also be brain function disturbances, leading to symptoms like dizziness, blurred vision, hallucinations, and bizarre behavior. At this time, it is not advisable to exercise. Instead, immediate rest is recommended, along with the consumption of sugary foods to raise blood sugar levels. Exercise is strictly prohibited as it can lead to unnecessary physical injuries, such as falls.

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What is hypoglycemia?

Hypoglycemia refers to a condition where the concentration of glucose in the bloodstream is too low, leading to insufficient energy supply in the body. This can excite the sympathetic nervous system or disrupt central nervous system functions, resulting in a range of clinical syndromes. Hypoglycemia is relatively common in our daily lives. Its symptoms often include palpitations, dizziness, trembling limbs, apathy, abnormal behavior, and in severe cases, even coma or sudden death. Therefore, timely diagnosis and treatment of hypoglycemia are very important.

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Hypoglycemia is caused by what?

Hypoglycemia is most commonly seen in patients with type 2 diabetes. During the treatment of diabetes, hypoglycemia can occur due to excessive use of medication or insulin, failure to eat on time after exercise, or decreased appetite without appropriately reducing the medication. Another common cause is insulinoma, a type of tumor that secretes excessive insulin, resulting in lowered blood glucose levels. A third cause relates to the early stage of type 2 diabetes, where insulin resistance and delayed insulin peak times often lead to pre-meal hypoglycemia, especially before lunch and dinner. Lastly, hypoglycemia is also commonly observed in some young women with specific coloring, potentially due to gastrointestinal motility issues or other reasons leading to pre-meal hypoglycemia. It is also common in patients with hepatitis or cirrhosis, where the liver's ability to output glucose is diminished, increasing the risk of hypoglycemia when fasting.

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Hypoglycemia complications

Complications of hypoglycemia encompass aspects of both the central nervous system and the heart. Firstly, the central nervous system, due to hypoglycemic episodes, can lead to brain cells lacking energy, which may then cause cerebral edema. This results in severe neuroglycopenic syndrome. Common symptoms include confusion, apathy, and abnormal mental and behavioral actions. If hypoglycemia persists or recurs, it can lead to coma and death. Secondly, cardiac complications arise during hypoglycemic episodes because excitement of the sympathetic nervous system leads to an increased heart rate or sinus tachycardia. Very few patients may experience bradycardia. Additionally, other arrhythmias, including premature atrial contractions, supraventricular tachycardia, ventricular premature beats, and short episodes of ventricular tachycardia, can occur.

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What are the symptoms of hypoglycemia?

Hypoglycemia, in fact, is diagnosed in healthy individuals when blood glucose levels are less than or equal to 2.8 mmol/L, and in diabetic patients when levels are less than or equal to 3.9 mmol/L. Common symptoms of mild hypoglycemia typically involve sympathetic nervous system activation, such as dizziness, palpitations, cold sweats, trembling hands, and a feeling of hunger. It is recommended that food be consumed promptly when these symptoms occur. If hypoglycemia is not immediately addressed, severe outcomes can occur, including altered mental status, coma, and unresponsiveness. In some cases, hypoglycemia may trigger seizures or abnormal cerebral vascular accidents, such as stroke or cardiac ischemia, leading to a heart attack. Therefore, preventing hypoglycemia is of utmost importance.

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What to eat for low blood sugar?

For already occurring hypoglycemia, our treatment goal is to quickly alleviate the symptoms of hypoglycemia. The primary method is to provide sugar, either through sugar water, sugary drinks, or sugar-containing fruits, bread, etc. After providing sugar, the symptoms of hypoglycemia can be quickly relieved. At the same time, to prevent hypoglycemia, we need to do the following: first, eat meals regularly every day, avoiding eating too late or not enough. Second, it is not advisable to exercise on an empty stomach; it is appropriate to eat something before exercising. Third, avoid excessive alcohol consumption, as it can inhibit the conversion of liver glycogen into glucose in the body, making it easy to develop hypoglycemia, so avoid excessive drinking. Fourth, once common symptoms such as palpitations, dizziness, sweating, and other symptoms occur, we should quickly provide sugar.