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Diabetes And High Altitude: Your Complete Travel Guide

I've experienced the challenges!

Written on
December 4, 2016
Diabetes

My Experience With Diabetes At High Altitude And What You Need To Know

Does altitude affect your diabetes? Some people say yes, some say no. As with many aspects of diabetic care, it depends largely on the individual.
Panarama of Cusco in Peru
Cusco in Peru (3,400 metres up)

What is altitude sickness?

Altitude sickness...as defined by Google is... “Illness caused by ascent to high altitude, characterised by hyperventilation, nausea, and exhaustion resulting from shortage of oxygen.” So basically if you are going higher in the world than what you are used to...Then you are likely to experience altitude sickness. 

It affects everyone differently- I have had people tell me they couldn’t leave their hotel rooms, to people who managed it easily. Everyone is brilliantly unique! Diabetes and altitude sickness is then a whole other ball game.

Blood glucose and altitude

Does altitude affects blood sugars?

Altitude can impact your blood sugars in a variety of ways...

1) Hypoglycemia and altitude

The symptoms of altitude sickness are quite similar to those of low blood sugar (hypoglycemia), such as, sickness, feeling light headed & dizzy, actual headaches & out of breath; so it can make it difficult to actually work out whether you are in a hypo or suffering from attitude sickness- this happened quite frequently with myself in Bolivia & Peru, and I would recommend testing your blood sugars even more frequently to make sure you know the difference.

2) Hyperglycemia and altitude

Altitude can potentially cause your blood sugars to go high- now I have seen articles argue for and against this, but I will tell you that in my own experience, this is completely true. At high altitude my blood sugars took a turn for the worst and were a lot harder to control. I frequently had high blood sugars for no other logical reason- and when you have the continual symptoms of a high blood sugar, and the symptoms of altitude, it can be an absolute nightmare and you are left feeling like crap. The reason behind this “high” is that when you go higher your body can release a stress hormone (and we all know stress cause havoc for diabetes). Yay!

3) Carbohydrate absorption

This was something I wasn’t clued up on until I did my research. Being high up may cause altitude induced insulin resistance- this is because carbohydrates to be ineffectively metabolised. This can in turn have a detrimental effect on your health as it can lead to frequent high blood sugars and resulting ketoacidosis- research has shown that ketoacidosis is more common at altitude.

high altitude blood sugar graph

Altitude and diabetes equipment

Does altitude affect my insulin pump? Does altitude affect my blood glucose monitor?

Two valid questions & unfortunately yes, there is this potential effects on blood glucose monitor performance.

1) Glucose metres

Sometimes glucose meters, Freestyle Libre & CGMs may not work effectively or at all, this is because the higher you go, the colder it is. I found that if I take my Freestyle Libre up a mountain in a high altitude country, it tends to struggle with a scan! Most meters are only guaranteed for reliable readings up to a height of 5000m so you need to contact your user manual or even the company themselves via phone or social media (I think they respond quicker here) and ask them do they have any particular guidelines on their product and altitude- they may be able to recommend something!

2) Blood sugar accuracy

Many research studies have been conducted to find out whether the readings you are getting at high altitude are actually correct. I have read three of these research articles and with regards to Accu-Chek (the product I use) they had this to say... “In this study, we evaluated the performance of Roche Accu-Chek Go glucometer device at a moderately high altitude and found no significant difference between measurements made with Accu-Chek Go and reference laboratory." You can read more about that here:

galenos.com 

NCBI

3) Insulin delivery

Insulin pumps & insulin delivery can also be affected by altitude sickness. Altitude when flying may stimulate the release of extra insulin and cause a hypo- however, the amount of insulin delivered is very small (if it is delivered) and it depends on your own body- how insulin sensitive you are etc. For example, research has shown that as the planes ascend, pumps can deliver an extra 1-1.4 units of insulin- so this amount will affect everyone differently. For me, this wouldn’t do anything drastic to my blood sugars. You can read more about flying and diabetes here.

hiking Isla del sol in Bolivia
The Llama wasn't as happy to see me (Isla del Sol, 4,000 metres up)

How can I help attitude sickness?

  1. You can ask your doctor for a tablet for the duration you are in that zone- they can help relieve the symptoms of altitude sickness and therefore make it easier to differentiate from low blood sugars. But a word of warning, some tablets can make you feel dehydrated and cause the concentration of glucose in your blood to rise (not ideal), so keep hydrated!! Here's a list of recommended medications & advice on taking them. 
  2. Ascend slowly...this can eliminate the need for medication too. Take your time going to higher levels, so don’t just jump into the highest altitude you can find as you won’t give your body or diabetes time to acclimatise. When I was travelling, we gradually got higher and higher- but we did jump to the one of the highest cities in the world (Potosi in Bolivia) very quickly, and even walking a small duration was a struggle!

Hiking and walking at altitude

From my experience hiking Torres del Paine in Patagonia, this is a challenge. The higher you are, the less oxygen you get, and you can feel extremely out of breath and tired quickly. I personally need to take it really slow otherwise I just feel terrible. You need to consider a variety of things when hiking at altitude with diabetes and Diabetes UK has a fantastic guide filled with advice! Just because it is a little more challenging, it doesn’t mean you shouldn’t do it- preparation is key, and be sensible during the activity.

hiking torres del paine
Peak of Torres del Paine almost 3,000 metres up

If anyone has any experience at altitude with their diabetes then comment. And for any questions then just ask and I will do my best to help :)

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