I was at the gym the other day and a medical emergency happened to a man I’ll call John. He was lying face down on the treadmill, unconscious.
Immediately, I rolled him over on his back and checked to see if he was breathing. Yes, he was! I decided not to do CPR procedures at this point. Normally, a doctor, nurse or other medical professional would be at the gym working out but it was about 11 p.m. So, I was in charge of John’s fate. At this point, I’m assuming his life is at stake.
I instruct a gym member to call 911 for Emergency Medical Services and go back to trying to figure out what was wrong with John……….
He was trying to lie down again on the treadmill and go to sleep.
With the help of another member, we get him upright and I try to force him to stay awake by:
a. spraying cold water in his face
b. talking to him (he mumbled back to me) and
c. gently slapping him across the jaws
I’m also continuing to check to see that he was still breathing
This worked to keep him semi-conscious until Emergency Medical Services arrived about 10 minutes later.
What was wrong with John? He is diabetic (type 2) and he had a severe case of hypoglycemia (low blood sugar).
Type 2 diabetes is associated with obesity, especially abdominal obesity. Type 2 diabetics usually produce enough insulin but their cells are insulin resistant. This can result in hyperglycemia (high blood sugar). If left uncorrected, it leads to kidney, heart, eye and nerve damage.
The paramedics injected a solution directly into his veins to stabilize his blood sugar levels. The procedure took about 20 minutes.
After talking with John about 30 minutes later, his glycogen stores (from carbohydrates) were depleted. He had eaten very little during the 2-3 hours prior to exercise. During intense exercise your body depends on glycogen stores for energy.
According to Mayo Clinic:
“If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That’s because your brain needs glucose to function. Recognize the signs and symptoms of hypoglycemia early because untreated, hypoglycemia can lead to seizures, loss of consciousness or death.”
“On the other hand, be careful not to overtreat your low blood sugar. If you do, you may cause your blood sugar level to rise too high (hyperglycemia). This, too, can be dangerous and eventually may damage your nerves, blood vessels and various organs.”
“Hypoglycemia is most common among people who take insulin, but it can also occur if you’re taking oral diabetes medications. Common causes of diabetic hypoglycemia include: taking too much insulin or diabetes medication, not eating enough, postponing or skipping a meal or snack, increasing exercise or physical activity without eating more or adjusting your medications and drinking alcohol.”
So, where does exercise fit in with diabetics? As a personal trainer, I’m trying to help the client avoid hypoglycemia and hyperglycemia during and after exercise. If you are diabetic, you should keep a snack on hand for a quick source of carbohydrates to avoid hypoglycemia.
And, its important for everyone, not just diabetics, to eat every 2-3 hours to keep the body energized and blood sugar levels stable.
My other exercise recommendations for diabetics:
1) Glucose levels should be measured before, during and after exercise (especially for those newly diagnosed).
2) Quality footwear is important and the feet should be checked often for blisters.
3) Post-exercise carbohydrate consumption is advisable.
4) You can do strength training. The workload should be monitored carefully.
5) Cardio exercise intensity should progress from low to moderate to high as you get in better shape.
6) Very intense exercise may induce hypoglycemia if you are not eating properly during the day, before exercise and after exercise.
That was quite a night at the gym! We all learned a lesson from John’s experience.
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