Management of diabetes at high altitude

Going High with Type 1 Diabetes

“…On expeditions, meals tend to be disordered in time and can last many hours. A tendency to postprandial hypoglycemia has been reported (Admetlla et al, 2001), probably due to delayed CH absorption at altitude (Heath and Williams, 1981). In these situations the insulin bolus can be reduced, delayed, and spread through and beyond the meal.…”

“…During the Aconcagua (6950 m) expedition (Admetlla et al, 2001(Admetlla et al, , 2003 7 out of 8 diabetics reached the summit. There were 8 more diabetic people in the trekking team.…”

Adventure Travel and Type 1 Diabetes

“…diabetes at extreme altitude, which was prevented by insulin administration after food intake (6,7). Although this was attributed to an altitude-induced delay in carbohydrate absorption, most studies have shown that nutrient absorption is not significantly affected by altitude (53,55).…”

“…In keeping with this philosophy, increasing numbers of people with type 1 diabetes now participate in extreme forms of physical activity, including high-altitude trekking and mountain climbing, as evidenced by several recent publications (3)(4)(5)(6)(7)(8)(9)(10). However, exercise at altitude imposes a number of unique challenges for people with type 1 diabetes, including impairment in glycemic control, and it may have negative consequences in patients with complications.…”

“…There was no significant difference in success rates between the individuals with type 1 diabetes and the control subjects. Similarly, 88% of climbers (seven of eight) with type 1 diabetes reached the summit of Aconcagua, with the one failure to summit not being caused by a diabetes-associated problem (6,7). Only in the Kilimanjaro study did all individuals with type 1 diabetes (n ϭ 15) fail to achieve their goal, reaching a lower final altitude than the normal subjects (5,187 vs. 5,654 m) and with a much lower summit success rate (0 vs. 27%) (4,5).…”