Which medication class increases the risk of exercise-induced hypoglycemia?

Insulin secretagogues, which include medications like sulfonylureas and meglitinides, increase the risk of exercise-induced hypoglycemia through their mechanism of action. These drugs work by promoting insulin release from the pancreas, regardless of blood glucose levels. During exercise, the body utilizes glucose more efficiently, and if insulin levels are elevated due to these medications, it can lead to a significant drop in blood sugar levels, resulting in hypoglycemia.

In the context of exercise, the body increases glucose uptake by the muscles, and if insulin is also pushing more glucose into the cells, it can lower blood sugar faster than the body can compensate, leading to hypoglycemic events during or after physical activity.

Other medication classes may have interactions or effects that could theoretically influence blood sugar levels, but they do not exert the same direct impact on insulin secretion or action during exercise as insulin secretagogues do, thereby not posing the same risk for exercise-induced hypoglycemia.