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Exercise-induced hyperinsulinemic hypoglycemia

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I have been a distance running coach for many years, and in that time have had about a half dozen athletes who develop hypoglycemic like symptoms about half way through a 5K race. What are the signs and symptoms of exercise-induced hyperinsulinemic hypoglycemia? How can this condition be treated? What other conditions might be causing these symptoms? Looking for possible answers and treatments. Thanks.

The following information may help to address your question:


What is exercise induced hyperinsulinemic hypoglycemia?

Exercise induced hyperinsulinemic hypoglycemia is characterized by a sudden and exaggerated spike in insulin and drop in blood sugar levels. The condition is triggered by vigorous exercise. Signs and symptoms include fainting (syncope),[1] shakiness, nervousness, sweating, dizziness or light-headedness, sleepiness, confusion, difficulty speaking, anxiety, and weakness.[2]
Last updated: 12/4/2013

How might exercise induced hyperinsulinemic hypoglycemia be treated?

There is limited information regarding the treatment of exercise induced hyperinsulinemic hypoglycemia. The following treatments were effective in treating individual patients:[1]

Diazoxide therapy (a drug that lowers insulin production)
Diazoxide therapy and partial pancreatectomy (surgical removal of a portion of the pancreas)
Exercise avoidance
Last updated: 12/4/2013

What are some other causes of breathlessness and exercise intolerance?

Breathlessness and exercise intolerance can have many causes. These symptoms could be a sign of an undiagnosed heart or lung condition/abnormality, exercise-induced bronchospasm, or exercise-induced asthma.[3] To know for certain the cause of your student's symptoms we strongly recommend that he/she speak with his/her healthcare provider.
Last updated: 12/4/2013

We hope this information is helpful. We strongly recommend you discuss this information with your doctor. If you still have questions, please contact us.

Warm regards,
GARD Information Specialist

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  1. Hyperinsulinemic hypoglycemia, familial, 7; HHF7. OMIM. November 2008; http://omim.org/entry/610021. Accessed 12/4/2013.
  2. Hypoglycemia. NIDDK. November 6, 2012; http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/#symptoms. Accessed 12/4/2013.
  3. Weinberger M, Abu-Hasan M. Perceptions and pathophysiology of dyspnea and exercise intolerance. Pediatr Clin North Am. 2009 Feb; 56(1):33-48, ix. http://www.ncbi.nlm.nih.gov/pubmed/19135580. Accessed 12/4/2013.