Evidence Summary
A 2015 study of nine individuals Investigated the occurrence of delayed hypoglycemia after moderate intensity exercise for 40 minutes performed before an evening meal In both real life and laboratory environments. It found that there was occurrences of hypoglycemia in both environments post exercise at similar levels with a rise in occurrences in the real life environment at the 8 to 12 hour mark compared to the laboratory environment. Of the total of 18 hypoglycemic occurrences post evening meal in both groups eight were found to have no awareness of their hyperglycemia. The paper then goes on to recommend that Evening exercises perform blood glucose monitoring between 8 to 12 hours post exercise. [1]
A 2015 randomised control trial of 10 Individuals investigated methods of preventing delayed hypoglycemia post evening exercise. It found that the combination of Reducing basil insulin dose pranjul insulin dose and the consumption low GI carbohydrates Provided protection from hypoglycemia both during and for 24 hours after evening exercise. [2]
Grade – C
Recommendation – 1
Conclusion
These are relatively small studies with only nine and ten participants respectively casting doubts on the quality of the conclusions which can be drawn from it. Paper ones concluding recommendation regarding blood glucose monitoring is drawn from the opinions of authors. The minimal number of negative effects to monitoring blood glucose post exercise in specific time frames makes this a reasonable recommendation as long as it doesn’t detract from other regular glucose monitoring. Recommending changing insulin regimes and dietary components based on such a small study although unlikely to result in significant harm with appropriate blood glucose monitoring is a less reasonable recommendation.
Patient should be recommend to monitor blood glucose post evening exercise especially in eight to 12 hour window. They should also be warned of the possibility of delayed hypoglycemia post evening exercise.
References
[1] – Charlton, J., Kilbride, L., Maclean, R., Darlison, M. G., & McKnight, J. (2015). Delayed hypoglycaemia in people with type 1 diabetes after performing moderate intensity exercise before the evening meal. Practical Diabetes, 32(3), 99–102.