Programming Pre-Exercise Snacks to Prevent Post-Exercise Hypoglycemia in Intensively Treated Insulin-Dependent Diabetics

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Abstract
Five intensively treated, insulin-dependent [human] diabetics exercised for 45 min after fasting while receiving basal insulin injections. Plasma glucose concentrations remained stable during exercise but then declined, resulting in clinical hypoglycemia 1-2 h later. Efficacies of 3 preexercise snacks in preventing the hypoglycemia were compared in a randomized crossover design. Orange juice, whole milk and skim milk, each containing 13 g of carbohydrate, all prevented postexercise hypoglycemia. However, the more rapidly absorbed snacks, orange juice and skim milk, caused a greater increase in plasma glucose concentrations and the area under the glucose curve during exercise. From the recognized glucose profiles that occur after consumption of different carbohydrates, snacks as well as exercise and insulin can now be programmed for intensively treated, insulin-dependent diabetics. Because plasma glucose levels remain stable during exercise done after fasting and only fall late after exercise, a lente carbohydrate snack, such as whole milk, is an appropriate preexercise snack.