Blood Glucose and Altitude
I am 72 years old and have had diabetes for 15 years. At sea level in Southern California, with a moderate activity level and normal eating habits, I need between 140 and 150 units of Humalog each day. When I exercise, my blood sugars rise, and I need insulin to come back down. I keep my blood glucose in check by measuring 4 to 6 times per day, and I use both a needle and a pump. I control to between 70 and 110 and have an A1C of 6.2.
I currently live in Aspen/Snowmass, Colo., at an altitude of 8,200 feet. Although I do exercise more, my insulin requirement is between 40 and 50 units each day. In addition, when I exercise, my blood sugars drop, so I can only ski or bike starting at an elevated blood sugar level. Quite the opposite from sea level.
The dawn phenomenon that I experience requires me to take an additional 15 units of insulin at sea level, but only an additional 6 units when I am at a higher altitude.
I have not found an explanation yet for this phenomenon.
William McArthur
Aspen/Snowmass, Colo.
Henry Rodriguez, MD, responds: It sounds like the increase in exercise that you engage in when at a higher altitude in Colorado is the major factor causing the decrease in your insulin requirement. In children’s diabetes camps I’ve seen that a cut of 20 to sometimes 50 percent of kids’ normal insulin allotment is required to address the physical activity of camp, depending on the child’s baseline activity. And where I’m located in Indiana, altitude is definitely not a factor!
However, at a higher altitude, combined with the element of increased exercise, the heart rate is higher and insulin may be absorbed more rapidly. My colleague, H. Peter Chase, MD, Professor of Pediatrics at the Barbara Davis Center for Childhood Diabetes at the University of Colorado, assists in a pediatric diabetes camp located in Colorado at an altitude of about 8,500 feet. He has observed similar effects in the children who attend. The medical staff has to decrease everyone’s insulin dosages by 20 percent. Again, this is largely due to the children’s increased activity level. Over time, we would expect the effect of altitude to dissipate.
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Comments are subject to review and will not be posted immediately. If you have an urgent medical question, please consult a health care professional. If you have a question for the staff of Diabetes Forecast, please send it to replyall@diabetes.org.Altitude affects blood glucose
The Stanford Center on Longevity views the challenge of keeping people physically active throughout their lifespans as a priority. The goal is to understand and remove key barriers to movement, be they physical conditions or diseases, psychological barriers to exercise, or environmental obstacles.
One of the SCL’s most intriguing projects involves a device that, from the outside, looks like it could have come straight from the set of a science fiction movie. Dubbed “pods” by researchers, the giant egg-shaped devices are altitude simulators in which users sit and are exposed to changing levels of atmospheric pressure.
Originally, Dr. Anne Friedlander, who heads the SCL Mobility Division, was testing whether the pods could help athletes and military personnel acclimatize faster to altitude and to perform better physically at sea level and high altitude. A Plexiglas lid lifts up and users climb inside, where they sit in a comfortable seat and can read or rest while air pressure in the pod is rapidly increased and decreased.
However, while studying the pods, Dr. Anne Friedlander became intrigued with evidence that such changes in pressure levels when combined with the intermittent hypoxia – or reduction in oxygen resulting from reduced atmospheric pressure - might be triggering other metabolic effects. For example, anecdotal evidence suggested that test subjects were experiencing less joint pain and improved overall feelings of energy and health. Blood tests suggested that the pods might be producing measurable metabolic changes in the subjects, including reduction of blood glucose levels and higher testosterone in men. The impact on blood glucose was a particularly interesting finding for Dr. Friedlander, who maintains a laboratory at the U.S. Department of Veterans Affairs Palo Alto Health Care System (VAPAHCS). Diabetes, which is characterized by insulin resistance and abnormally high blood sugar levels, is a major complication of aging and afflicts almost 200 million people around the world.
In August 2008, Dr. Friedlander reported promising results from a controlled clinical trial in which male subjects between the ages of 40-60 were exposed to what is called the “CVAC process” (Cyclic Variations in Altitude Conditioning) for 40 minutes, three times a week for 10 weeks. The subjects demonstrated a significant reduction in fasting blood glucose and a significant decrease in blood glucose during an oral glucose tolerance test (OGTT) following the 10 weeks of exposure. There was no significant change in the control group.
"CVAC could provide a unique way to lower blood glucose levels in certain individuals," says Friedlander. "Given that these positive results were achieved in middle-aged, non-diabetic volunteers, we are hopeful that CVAC will prove even more effective in diabetic subjects with higher initial fasting glucose levels.”
Diabetic patients are a segment of the population that is prone to obesity and joint problems and could greatly benefit from increased exercise. Stabilizing glucose levels is one approach to improving these patients’ overall health and mobility. However, the next phase of Friedlander’s research with CVAC will look at a related problem with an even more direct impact on individual mobility: diabetic neuropathy, or pain associated with diminished circulation that is another side effect of high blood sugar levels. "We are excited about the potential for the CVAC process to produce an improvement in both the condition and quality of life for diabetes and diabetic neuropathy patients," added Dr. Friedlander. "We are still researching the mechanism, but if use of CVAC attenuates insulin resistance, it is possible that CVAC could also be useful in treating other disorders related to insulin resistance and the aging process."
Dr. Friedlander is analyzing the data and preparing the results for publication.
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Study by Researchers at Stanford re:Altitude and Blood glucose
Here is a formal placebo controlled study regarding this effect:
http://longevity.stanford.edu/mobility/scl_affiliate_research/pods
New at this.
can you get the shakes, sweats with blood sugars in the 80"s and nineties. Is it normal for blood sugars not to move much with a good protien breakfast. And can you then get the headaches again with blood sugars in the 80"s and 90"s. Can you tell I'm new at this! I am trying to do this with diet and exercise so far I haven't gone to high my highest has been 394 to 294 only three times so far. I have only had type two for the last 3 weeks that we know of. And my feet have the crack heels. They just won't go away I wear socks all the time and use a fungus cream and soak them everyday. and get pedis done to help ha,ha.
diabetes 2 answer
I have learned from being diagnosed in 2000, that your sugars are within the range they are suppose to be. It could be, like I found out by a specialist, that you went undiagnosed for some time and your body, like mine, was use to the higher sugar levels. Now that they are getting within the normal range you notice a difference in the way you feel. I wouldn't worry too much unless it is affecting so much that you feel like you can't get things under control then you should see your doctor. Good luck! I think you doing great.
DIABETES AND STRESS IN HIGH ALTITUDES
November 08,2009 Connie Eaton
I am 70, a woman and have lived in Michigan most of my life.
I came down here to Colorado and the first day my sugar rose to 244 the highest I have ever seen since I became diabetic in Oct 1993. I am on no type of drugs.Just watching my sugar intatke, exercise, and stress. Each day it seems to come down until I start doing anything strenuous even walking and the sugar level goes up to where I become weak and sick to my stomach. Is this going to stay this way or will my system adjust in time to the altitude?
I control between 80 - 120. I just had my A1C checked and I was 5.9. So am puzzled as to what is going on and if I need to see a doctor. According to the article above it should be easier to control my sugar levels at a higher altitude am I wrong.
Altitude and Glucose levels
I am on many meds and just began taking Victoza this year. In July I visited Colorado staying at 6,000 feet and taking day trips to as high as 10,000 feet. I had one day when after eating extra cookies at dinner, my sugar spiked to 250, and I became excessively tired. My A1C has been 6.5 since being on the Victoza. I also noticed since coming back my daily readings are higher than usual. I just started a new Victoza pen, and think perhaps the victoza was not as effective because I could not refrigerate it for two days of my trip, although temperatures did not exceed 80 degrees where it was kept. I also think the altitude had some effect on my bodily reaction to foods and meds.
High altitude and type II
I too have type II diabetes and am visiting my daughter and grandchildren in CO. Since I have been here my sugars have been 195 and above. I am not doing anything differently then I do in WA state where I live, yet when I arrived here I notice that my sugar count has gone up higher than normal. I really believe that higher altitude is the problem. I am calling my doctor at home to get some answers on what I can do during the remaining time I will be here. Good luck!
Elevations and diabetes
I moved from New Mexico to Charlottesville V.A my Blood sugar went from 140 to 400 and my medication has been increased still have not got it below 200
A possible answer
I saw you comment about moving from VA to NM. I believe that NM is higher in altitude than Va. You should check what the altitude is and then call you doctor. I live in WA State and my sugar levels vary from 70-145 and my AC1 is 6.3. I really believe that altitude has something to do with it because I am visiting my daughter in CO and the altitude here is over 5800 and I have noticed that my sugars are not running in the 200s which they have NEVER done before. I would check with your doctor and be sure to let him know about the altitude change, if in fact, it is higher than VA. Good Luck! Think we both need it.
blood sugar levels and high altitude
I am 59 yrs old, and have come to Co. for the fall from Texas. We're staying Silverton, which over 9000ft. elevation, and with our jeeping, we are frequently as high as 11000ft. +. I'm newly diagnosed with Type 2, after being glucose intolerant for about 10 yrs. I got here after a crash course in blood sugar control, diet, etc., and I've been feeling crummy. My sugar is high for me, around 120's to low 130's every morning, and is up somewhat to same numbers at night. It does come down during the day, as low as 90's to 110 or so. I was prescribed 2 500mg Metformins, twice a day, and it makes me extremely nauseous and upsets my stomach. So, that along with high alt., eating only what the diet says I can have, and the proper amountss, I am in a bad way. CAn someone PLEASE help me? Suggestions? We love Silverton, but it's hard to climb steep paths and enjoy our normal lifestyle up here when I just don't feel like going. PLease help!
Thanks, Anonymous
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