An elegant control system prevents hypoglycemia despite dramatic increments in glucose usage by working muscle. Insulin excess disrupts this control system, leading to hypoglycemia. Recent hypoglycemic episodes blunt the glucoregulatory response to subsequent exercise, and exercise blunts the glucoregulatory response to subsequent insulin excess. These mechanisms of glucoregulatory failure may cause hypoglycemia in insulin-dependent diabetics during and after exercise.
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