I have a client who is hypoglycemic. One of her goals is to complete a triathlon within the next two years. She reports having difficulty during aerobic workouts, however, and believes this difficulty relates to her hypoglycemia. Apparently, she can maintain a very low intensity level for long periods or a high intensity level for short periods, but struggles with training at moderate intensity levels. Any ideas about information sources?
This is a difficult question to deal with; your client may have several reasons as to her intolerance.
First, we do not know any Blood Glucose(BG) values at rest or at work? That is a major question that needs to be answered. Before I ramble on about possible your question, you need to contact your client's Health Care Professional(HCP) and get medical clearance.
Now, back to the BG thing. Most people who present hypoglycemia have insulin issues. As you state, she can work at slow rates and fast rates with no problem. This may be due to the slow work rate being just above resting rate and relying on the Beta oxidation(fat burning); the real fast work may be possible because of the stored phosphates in the skeletal muscle making ATP locally. The time at work is unknown, so it is hard for me to distinguish the energy systems.
We really have other questions to answer, like why does her BG drop when working? Possible questions to ponder are;
- Diabetes usually make people run high BG. However, it can go low during work( has she been tested, family history...)
- Is there a hormone deficiency? ( Does she produce adrenaline & nor-adreniline, which should be referred to as epinephrine and nor-epinephrine, glucagon, growth hormone).
- Is she taking any medication that may stimulate insulin production?,(check with the HCP)
- Does she have Liver problems?( elevated enzymes and dysfunction.Check w/HCP)
Another question, is how long after she eats does the drop in BG occur? Also, you may want to consider using some carbohydrate-protein solution While Training. This appears to create a better internal environment for the body, while at work, and decreases catabolism in "normal" people. I would suggest a solution with 30-40grams of carbs. and 10-20grams of protein. Branch chain amino acids seem to be most effective in uptake of carbs and proteins.
You need to contact her HCP and ask some questions. This is a start in trying to dial in your client. Metabolic issues and exercise are interesting and can be quite challenging, but very rewarding once positive results occur. Good Luck and keep us posted.