Situations & Solutions
Case Study: Avoidance of Hypoglycemia with Exercise. A 32-year-old male
with Type 1 diabetes approached the diabetes educator with a complaint of
increased exhaustion, excess sweating and feeling shaky on the days he worked
out at his exercise facility. During the assessment and interview, the
educator asked the following questions. Listed below each question is the
rationale and information the educator hoped to gain.
QUESTION 1. Have you tested your blood glucose when you get these feelings, and if so, was it low?
Q1 Rationale. His symptoms very well could be reflective of hypoglycemia. This question is attempting to either establish or rule this out.
QUESTION 2. How long after your workout do these symptoms occur?
Q2 Rationale. He may not associate the symptoms as being related to exercise if they occur hours later. However, the educator knows that exercise can increase insulin sensitivity for up to 36 hours after the session.
QUESTION 3. What symptoms do you usually get when your blood glucose is low and what is your usual treatment?
Q3 Rationale. Again, this is to confirm that the symptoms he is experiencing are related to his usual symptoms with hypoglycemia. If they are different, it may be that he experiences different symptoms depending on how low his blood glucose is, and this would be good information for him to have. Also, the educator needs to make sure that his treatment of hypoglycemia is adequate.
QUESTION 4. What time of day do you go to the health club?
Q4 Rationale. It is important to know if his exercise session is at the same time every day.
QUESTION 5. What type of exercise do you do and for how long?
Q5 Rationale. The intensity and duration of exercise affect the utilization of glucose and may determine the necessary precautions that need to be taken.