Managing diabetes at high altitude: personal experience with support from a Multidisciplinary Physical Activity and Diabetes Clinic

Abstract

Objective: Physical activity is important for well-being but can be challenging for people with diabetes. Data informing support of specialist activities such as climbing and high-altitude trekking are limited. A 42-year-old man with type 1 diabetes (duration 30 years) attended a Multidisciplinary Physical Activity and Diabetes Clinic planning to climb Mont Blanc during the summer and trek to Everest Base Camp in the autumn. His aims were to complete these adventures without his diabetes impacting on their success.

Methods: We report the information provided that enabled him to safely facilitate his objectives, in particular, the requirement for frequent checking of blood glucose levels, the effects of altitude on insulin dose requirements, and recognition that acute mountain sickness may mimic the symptoms of hypoglycaemia and vice versa. Real-time continuous glucose monitoring was made available for his treks.

Results: The effects of high altitude on blood glucose results and glycaemic variability while treated on multiple daily injections of insulin are reported. In addition, we present a first-person account of his experience and lessons learnt from managing diabetes at high altitude.

Conclusions: A dedicated Multidisciplinary Physical Activity and Diabetes Clinic delivering individualised, evidence-based, patient-focused advice on the effects of altitude on blood glucose levels, and provision of real-time continuous glucose monitoring enabled uneventful completion of a trek to Everest Base Camp in a person with type 1 diabetes.

Keywords: diabetes; glucose; mountain; walking.

Conflict of interest statement

Competing interests: NO has received honoraria for advisory board membership from Roche and Abbott Diabetes. NH has received continuous glucose monitoring equipment from Dexcom (San Diego, California) for research.

Figures

Figure 1

Continuous glucose monitor readings during a trek to Everest Base Camp shown as a per cent of total readings with CGM glucose below 3.9 mmol/L, 3.9–10 mmol/L, 10–15 mmol/L and more than 15 mmol/L for each day (Days 1-18, correlates with location and sleeping altitude in table 1). CGM, continuous glucose monitoring.