BG Drops Hours After Exercise

Has anyone found a way to avoid a drop hours after exercise?

My son always drops almost exactly 6 hours after hockey. Last night at 11:30pm after a 5:30 hockey practice, his BG was 35. After drinking two sodas, eating two Reeses Cups, a package of goldfish and suspending his basal for a while his BG came up enough for him to return to bed with a temp basal. Even after all of that with no insulin, his BG was 90 this morning.

It seems i have the same problem after 2+ hours of running, triathlons,etc… and it starts at 4-6 hours after, …since on the pump now, will decrease my basal by 30% for right at 3 hours after the event…and keep that temp basal for 4 hours…i am sure you know, insulin has an approx 4 hour lifetime…and so anything done takes awhile…wow, he must really be pushing hard during hockey…another thing i like is the product teamtype1 uses called chocolate9, it is pure natural carbs, but does not spike your sugars as bad so it is like a prolonged sugar …not sure what else you can do but interested to hear abou this

Obviously you have to tweak this based on his activity level and personal trends, but when I play soccer I have about 50 grams of carbs with half of my normal bolus dose for dinner. Someone correct me if I’m wrong, but my understanding is that when you engage in intense exercise you deplete glycogen stores in the liver and muscles, which your body then tries to replenish afterward as you recover. In order to replenish, the body basically pulls glucose out of the blood. It’s not always easy, but you have to estimate how much glucose needs to be replenished and over what time period, and try to match that. For me, with intense exercise, I do this as a factor of time. I typically need 1 gram of carb for 1.5 minutes exercised. I spread this out a bit too, to try to better match the rate at which my blood sugar is dropping.

Note - after exercise a body becomes more sensitive to insulin. Also, if you have hardly any active insulin in the body, blood sugar might not come down on its own despite the exercise. Therefore, If I just ate the carbs I needed to replenish, but didn’t take any insulin, then my blood sugar won’t come down. However, a meal with half my normal insulin dose seems to do the trick.

Good luck. It takes a little bit of trial and error, but it’s possible. Look on the bright side - it’s a rare chance for him to have some forbidden foods without high blood sugar.

I play too… and have not had this problem… AND I have to take insulin before games or my BS will become in the 200+… BUT anyway… don’t know why this is happening… May have something to help… when i go out drinking with the girls I know my BS will be droping something in the early morning hours… how I fight this is that I just make sure I eat something before going to bed… maybe this will work for you too… try and fight it off befor it happens… Just an idea maybe for you.

fairly new to all this - that is Diabetes (LADA Type 1.5) and insulin etc and just getting back into training etc after a bit of time off with high bgl etc and getting sorted and diagnosed etc.
I have been finding I have the exact same problem. Scared me a bit at first but am finding extra carbs in between the meal sometimes helps. also have found I need to carry and eat some carbs as my bike rides get longer. Running seems to effect me more and am wondering how I am going to cope as runs get longer. Also greater intensity work outs seem to make it worse . . .
Was really feeling like I was in struggle town for a while. Good to know there are others dealing with the same probs and great to read everyones replies and sugestions.
good luck Hockey Mom


Did he eat dinner after practice? And if so, was it protein/fatty or carb based? It’s possible that he’s much more insulin sensitive from the strenuous exercise, so if he bolused normally at dinner, that’s likely what caused the problem (or is at least one idea of what caused the problem :slight_smile:
If it happens almost 6 hours after hockey every time, what is the routine between the end of practice and the BG dropping? If he’s eating in there and taking insulin, it’s probably related to the insulin he’s taking for that bolus. If he’s not, then it’s likely a delayed effect of still being more insulin sensitive. What are his basal rates during that time period? Does he have a marked increase in the evening or early morning hours? For example, I run at at .5 u/h from mid-afternoon through about 8 pm. Then I ramp back up to about .7 u/h, and then overnight I run .8 or .85 (can’t recall exactly and my pump’s not right here next to me to verify right now). If your son’s basal increases at some point during that interim period, it could be that you need to either change this permanently, or set yourself reminders to turn it to a reduced rate (say, -15% for 2 to 4 hours after he’s done practicing). Remember that any basal rate change you make now is not actually going to have an effect for 60 to 90 minutes. So if you need to reduce your basal rate around midnight, you actually need to set it to reduce at about 11 pm so that the insulin hitting your son’s system around midnight will be that reduced rate.
I wish you luck in trying to find out what might be the root cause of this happening (b/c BGs of 35 before bed are never fun!).

I have always had a similar problem and have still not figured out how to deal with the insulin sensitivity with no problems. The good thing is that you are seeing a definite timeline for when the sugars bomb, so you can work with that knowledge. For what it’s worth: I reduce the basal 75% an HOUR BEFORE exercise, sip 50/50 juice/water during exercise, eat after w/reduced bolus (depending on my bs - may be just -10% or -70% - just so long as it’s less) and very carefully correct a high after (because sometimes when you exercise your bs drops low without you realizing it, so a high can be a rebound #). It is safer to run high before bed than low and eating all the juice and candy at bedtime makes my body (and brain) feel foggy and sluggish in the a.m., regardless of where my bs#s are. A good pre-bed snack might be chocolate milk - w/2% fat or something to help him stay even through the night. Hope he keeps juice boxes by his bed! Good luck.

I have struggled with these sorts of lows. They are sometimes called postexercise hypoglycemia, or late-onset hypoglycemia. From what I understand, they occur because your body initiates an action to replenish glycogen stores. Usually there will be one occurrence, but some people have two. Mine occur two hours after exercise, the timing is consistent. One particularly memorable hypo required 90g of carbs to restore normal levels. It is like my body became a “huge glucose sucking monster.” I felt that the hypos I experienced were quite out of proportion to the insulin on board and as these occured after exercise and during times where I was fasting and only had my basal on board it was confusing. Then when I looked into it, the whole glycogen replenishment explanation seemed to make sense. Sheri Colberg recently talked about it over at diabetesincontrol and explains it more in her book "The Diabetic Athlete’s Handbook."

And as Bradford notes, eating seemed to be the key in my case. I found that eating a normal sized meal within two hours of my workout has virtually eliminated the problem. Yes, you will need to make basal and bolus adjustments, but the eating made a world of difference. But you may find that scheduling an meal/snack at the right time (4-5 hours after exercise?) can really help manage these hypos.

Thanks. I have her book and will have to reread her chapter on this.

Our new CDE did not agree with the temp basal during his playing because it was causing him to go up into the 300s. With insulin during the game and temp basal after, he is lower but we are still having these drops.

I have sometimes had exercise lead to elevations in blood sugars, but this was in the summer during day-long competitions in the heat. Hydration seemed to be a factor. Does that help? Highs are just as bad (feeling) as lows because you feel a slave to blood sugar control and it ruins the fun of the exercise.