What is a suitable workout plan for individuals with reactive hypoglycemia?

Workout Plan for Reactive Hypoglycemia

For individuals with reactive hypoglycemia, moderate-intensity exercise combined with resistance training is recommended, with careful attention to timing relative to meals and monitoring of glucose levels before, during, and after exercise. 1, 2

Exercise Recommendations

Aerobic Exercise

• Frequency: At least 150 minutes per week spread over at least 3 days with no more than 2 consecutive days without activity 1
• Intensity: Moderate intensity (65-75% of maximum heart rate)
• Duration: Sessions of at least 10 minutes, building up to 30 minutes per session 1
• Timing: Best performed 1-2 hours after meals to avoid hypoglycemic episodes

Resistance Training

• Frequency: 2-3 sessions per week on non-consecutive days 1
• Exercises: Include at least one set of 5 different exercises involving large muscle groups 1
• Intensity: Start with lighter weights and gradually increase as tolerated

High-Intensity Interval Training (HIIT)

• Can be beneficial but requires careful monitoring as it may cause transient increases in post-exercise blood glucose levels 1
• Short bursts (10 seconds to 4 minutes) at 75-95% of maximum heart rate alternated with recovery periods 1
• May help improve glucose regulation with shorter time commitment 3

Precautions for Reactive Hypoglycemia

Pre-Exercise Preparation

• Check blood glucose before exercise; if below 90 mg/dL, consume 15g of carbohydrate before starting 1
• Have quick-acting carbohydrates readily available during exercise
• Consider consuming a small protein-carbohydrate snack 30-60 minutes before exercise 4

During Exercise

• For longer sessions (>30 minutes), consider consuming 5-15g of carbohydrate every 30 minutes 1
• Stay well-hydrated throughout the workout
• Monitor for symptoms of hypoglycemia (shakiness, dizziness, confusion, sweating)

Post-Exercise Considerations

• Consume a balanced meal or snack within 30 minutes after completing exercise 1
• For glycogen-depleting workouts, consume 5-30g of carbohydrate during and within 30 minutes after exercise 1
• Monitor blood glucose for several hours after exercise, as hypoglycemia can occur later due to increased insulin sensitivity 1, 5

Monitoring Strategies

• Use blood glucose monitoring before, potentially during (for longer sessions), and after exercise 1
• Consider using continuous glucose monitoring (CGM) if available, though be aware it may be less accurate during high-intensity exercise 6
• Keep a log of exercise type, duration, intensity, and glucose responses to identify patterns

Special Considerations

• Avoid exercising during peak insulin action times if taking insulin or insulin secretagogues 1
• Intense activities may actually raise blood glucose levels instead of lowering them, especially if pre-exercise glucose levels are elevated 1
• Break up prolonged sedentary time with brief periods of activity to help maintain stable glucose levels 1

Warning Signs to Stop Exercise

• Feeling dizzy, confused, or unusually fatigued
• Excessive sweating, shakiness, or heart palpitations
• Visual disturbances or headache
• Blood glucose below 70 mg/dL

By following these guidelines and monitoring glucose levels appropriately, individuals with reactive hypoglycemia can safely engage in regular physical activity while minimizing the risk of hypoglycemic episodes.