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Contributed by Catherine Price
09/07/12
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Dear Diabetes: High Altitude

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Dear Diabetes: Does high altitude affect diabetes?

I’ve taken type 1 diabetes with me to many adventuresome locations, but one of the most unusual – or at least, the highest – has to be the Mount Everest Base Camp in Tibet. I wasn’t climbing the mountain, but I was spending a couple of nights at over 16,000 feet above sea level (anything above 10,000 feet is considered high altitude; above 16,000 is extreme altitude). In addition to the general rigors of being at such a high altitude when my body was not accustomed to it, I was concerned about what the height might do to my blood sugar management and my diabetes supplies. 

It turns out that the same helpful advice for going to high altitudes for those living with type 1 or type 2 diabetes is similar to that for people living without diabetes: do it slowly! If you give your body time to acclimate, you are less likely to run into health issues period, including those associated with diabetes.

However, if a person living with diabetes does experience altitude sickness, it may potentially be more severe in several ways. For example, the symptoms of altitude sickness, like headaches and lightheadedness, are very similar to those of hypoglycemia, making it difficult to distinguish between altitude sickness and low blood sugar. In addition, the tools you may count on may not work well at high altitudes: for example, blood glucose meters often don’t function properly at high altitudes or at low temperatures (the higher you go, the colder it gets), potentially making it difficult to know what your blood sugar level actually is.

Finally, altitude may also increase the likelihood of high blood glucose levels. That may be in part because ascending to high altitudes can likely trigger your body to release extra cortisol, a stress hormone that helps your body cope with the lower levels of oxygen at high altitudes by stimulating the production of new red blood cells. This helps you acclimatize, but cortisol, like other stress hormones, may also raise blood sugar levels.

In short, coping with high altitudes may be a bit harder for those living with diabetes. But before you decide never to go higher than the second floor, remember that most of us aren’t planning on scaling Mount Everest. Other than undergoing some insulin resistance, I returned from my high altitude experience unscathed and armed with some simple steps to minimize possible health risks:  

  1. Consult with your doctor first about potential issues specific to you and your diabetes. Find out how to contact him or her in case of an emergency.
  2. Ascend slowly.
  3. Read your equipment’s instruction manuals to see how your meter and other devices might be affected by altitude; in general you should assume they will not work as well as they may at lower altitudes and at normal temperatures.
  4. Bring extra supplies. For me, this included high-carb snacks, syringes, insulin to cover a pump malfunction, and a spare glucometer and don’t forget the control solution – you will need it to determine if your meters are functioning properly.
  5. Have fun. Diabetes may add extra challenges, but that doesn’t mean you shouldn’t enjoy yourself!

For more stories in the Dear Diabetes series, visit The DX archive.

Catherine Price is a freelance journalist and type 1 diabetic who has written for The New York Times, Slate, Popular Science, and O Magazine, among others. She blogs about diabetes at asweetlife.org. Price is currently working on a book about the history and science of vitamins, to be published by the Penguin Press. Price is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewee, and not of Sanofi US, its employees, agencies, or affiliates.

© 2012 The DX: The Diabetes Experience

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