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High Altitude Affecting Blood Sugar

How Many Factors Actually Affect Blood Glucose?

How Many Factors Actually Affect Blood Glucose?

A printable, colorful PDF version of this article can be found here. twitter summary: Adam identifies at least 22 things that affect blood glucose, including food, medication, activity, biological, & environmental factors. short summary: As patients, we tend to blame ourselves for out of range blood sugars – after all, the equation to “good diabetes management” is supposedly simple (eating, exercise, medication). But have you ever done everything right and still had a glucose that was too high or too low? In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22! – including food, medication, activity, and both biological and environmental factors. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions. As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. But after 13 years of type 1 diabetes, I’ve learned it’s just not that simple. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors. I’ve provided arrows to show the ge Continue reading >>

Ain't No Mountain High Enough: Managing Diabetes In High Altitudes (part Ii) | Speaking Of Diabetes | From Joslin Diabetes Center

Ain't No Mountain High Enough: Managing Diabetes In High Altitudes (part Ii) | Speaking Of Diabetes | From Joslin Diabetes Center

Zack McCune snowboarding in Squaw Valley, California While there are many people who enjoy snowboarding, skiing, and hiking in the mountains, there are others who like push the limits even further. Some consider climbing into the clouds to reach mountaintop summits to be the ultimate test of mind and body. For people managing diabetes, mountain climbing can present even more challenges. In the second installment of our two part series, we take a look at what you need to know when your winter activities involve extreme altitudes. In the U.S., some of the highest ski resort summits are Beaver Creek at 11,440 ft, Vail at 11,570 ft, and Breckenridge at 12,998 ft. But what if youre planning on going even higher? Mount Whitney in California has a 14,505 foot summit, Kilimanjaro is 19,308 feet above Tanzania, and Ojos del Salado is a whopping 22,608ft in the air. Theres a lot more to think about than the cold . At those altitudes its pretty complex in that there are a lot of physiological changes that impact the diabetes, says Jacqueline Shahar , M.Ed., RCEP, CDE, a Certified Diabetes Educator and Manager of Exercise Physiology at Joslin Diabetes Center. Although it hasnt been studied extensively, there have been a few studies monitoring climbers with type 1 diabetes as they ascended steep peaks. Besides being attentive to problems experienced at lower mountain altitudes like decreased temperatures, exacerbated diabetic neuropathy from the cold, and increased risk of low blood sugar from low oxygen and increased physical activity, you also have to be aware of worsening diabetic retinopathy . The increased altitude can worsen the affect diabetes has on your eyes and even cause retinal hemorrhages, so make sure to have a thorough eye exam and an okay from your doctor before emb Continue reading >>

High Altitude And Diabetes

High Altitude And Diabetes

As I noted in my previous post, I recently took my diabetes with me on a trip to Tibet. (I offered to let it stay home, but it refused.) In addition to the whole altitude sickness/swollen-brain thing, which seemed likely to occur, given that we were going to be at altitudes up to 5100 meters above sea level, I was worried about how my diabetes equipment was going to function. What if my glucose meter stopped working? What if I was setting myself up for a week and a half of inaccurate readings and altitude-induced insulin resistance? Well, Im back at relatively normal heights now (1700 meters or so above sea level) and I have good and bad news. First, the good: my meter (an Abbott Freestyle and an Abbott Freestyle Navigator CGM) appeared to stand up admirably to my 16,000-foot ascent. I busted open my little bottle of control solution (am I the only diabetic out there who never usually uses the stuff?) and every time I checked, the result came back within the control solutions range. A big relief, even though the change in altitude made the bottle squirt red liquid all over my pants. Why the blood-colored control solution? Why? What the accuracy of my meter made clear, though, was that my second fear altitude-induced insulin resistance was indeed happening. Or, at least something was causing my blood sugar to refuse to budge after correction boluses. It could have been because I got food poisoning on our second day on the road, and spent several mornings vomiting on the toilet (Im all for multitasking, but thats taking it a step too far). But even once I felt better, my blood sugar remained so stubborn that I switched insertion sites to see if something had gone wrong. The tubing was fine; the insulin just wasnt working. I need to do more research on the causes behind a Continue reading >>

Diabetes And High Altitude: Your Complete Travel Guide

Diabetes And High Altitude: Your Complete Travel Guide

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. 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 altitu Continue reading >>

Effect Of High Altitude On Blood Glucose Meter Performance.

Effect Of High Altitude On Blood Glucose Meter Performance.

Abstract Participation in high-altitude wilderness activities may expose persons to extreme environmental conditions, and for those with diabetes mellitus, euglycemia is important to ensure safe travel. We conducted a field assessment of the precision and accuracy of seven commonly used blood glucose meters while mountaineering on Mount Rainier, located in Washington State (elevation 14,410 ft). At various elevations each climber-subject used the randomly assigned device to measure the glucose level of capillary blood and three different concentrations of standardized control solutions, and a venous sample was also collected for later glucose analysis. Ordinary least squares regression was used to assess the effect of elevation and of other environmental potential covariates on the precision and accuracy of blood glucose meters. Elevation affects glucometer precision (p = 0.08), but becomes less significant (p = 0.21) when adjusted for temperature and relative humidity. The overall effect of elevation was to underestimate glucose levels by approximately 1-2% (unadjusted) for each 1,000 ft gain in elevation. Blood glucose meter accuracy was affected by elevation (p = 0.03), temperature (p < 0.01), and relative humidity (p = 0.04) after adjustment for the other variables. The interaction between elevation and relative humidity had a meaningful but not statistically significant effect on accuracy (p = 0.07). Thus, elevation, temperature, and relative humidity affect blood glucose meter performance, and elevated glucose levels are more greatly underestimated at higher elevations. Further research will help to identify which blood glucose meters are best suited for specific environments. Continue reading >>

High Altitude And Diabetes

High Altitude And Diabetes

I often feel like living with diabetes is an extreme sport. It may not involve much physical exertion, but the mental effort required counting carbs, measuring exercise against insulin, worrying about lows while you sleep is just as tiring, if not more so, than preparing for a test of athletic endurance. I mean, hell a race eventually ends. Diabetes aint over till youre dead. Partially for this reason, I am not really into things labeled extreme (or, god help us, x-treme). Not extreme skiing, not extreme surfing, and certainly not Extreme Pizza, a chain near my old house in California. No, I prefer safety to adrenaline and while Im always up for adventure, I like there to be a safety harness attached. Unfortunately, Im about to wade into the waters of what Ive decided can be classified as extreme diabetes spending time at high altitude. My husband and I are currently traveling for several months before settling back down on the east coast, and our next adventure is traveling overland to Tibet. (Tomorrow, we take the train from Xining to Lhasa, on the worlds highest railway.) Im forgetting the precise numbers right now, but Lhasa is pretty damn high. And its not the highest place well be at the end of our overland journey, just before the Nepal border, well be at over 4,900 meters above sea level. Thats right: meters. Thats more than 16,000 feet. Its up there. So what does this have to do with diabetes? Several things. First, the symptoms of Acute Mountain Sickness which include dizziness and confusion are close to those of hypoglycemia. (If only our bodies had evolved more precise warning systems. There could be little codes an itchy left ear means altitude sickness. Tingling in your right buttock means low blood sugar. Wouldnt that be easier?) Second, if youre dehydra Continue reading >>

Trekking With Diabetes | High Altitude | Metabolic Effects

Trekking With Diabetes | High Altitude | Metabolic Effects

Trekker to escape. Discover. Meet. Get rich. Going further, higher, longer. Why our diabetes it would prevent us from living our projects, and achieve some of our dreams even the craziest? Know is the key to success. To go step by step, to learn from each experience. Our bodies, our diabetes are "machines" complex. The characteristics of the trek (duration, intensity, altitude, weather conditions), the available supply, our moral and physical condition all have an influence on our blood sugar control. From an article "Sports & Diabetes: a history of hormone", article I wrote for the journal "Nutrition Endocrinology" - No special EASD September 2014 Increasingly diabetes type1 (T1D) is engage in high-altitude treks, sometimes at a key summit. But the specific conditions at high altitude (> 3000 m) make the mountain a hostile environment for humans. Extreme temperatures aloft, the wind amplifies, are associated with a reduced atmospheric pressure, responsible for the partial pressure of O2 drops of the inspired air. The altitude is thus linked to a decrease in blood pressure in O2. The 'high mountain acclimatization thus refers to the reaction to physiological processes that prolonged exposure to hypoxia (= less oxygen) mandatory adjustments to the human body. Hypoxia is accompanied by hyperventilation with hypocapnia and respiratory alkalosis associated with an increased urinary elimination of bicarbonates. The buffering capacity of the blood decreased, promotes faster decompensation to ketoacidosis in a diabetic subject which would be unbalanced. Hypoxia also affects the concentration of certain hormones. The release of catecholamines (adrenaline and noradrenaline) is accompanied by hepatic glucose production when cortisol is responsible for insulin resistance. The alt Continue reading >>

The Altitude Highs And Lows How High Altitude Affects Bloodglucose

The Altitude Highs And Lows How High Altitude Affects Bloodglucose

The Altitude Highs and Lows How high Altitude affects BloodGlucose Few things feel better than summiting an epic peak or racing down a mountain on skis, and few things feel worse than a bouncing blood sugar forming jagged peaks across your cgm monitor and ruining your epic day. Some of my favorite outdoor activities take place above sea level, but exercising at high altitude can be a glycemic nightmare for a type 1 diabetic. Curious as to why this is, I set about to understanding whats happening on the inside that could be impacting blood glucose at high altitude. The answers I found boil down to physiology and biochemistry, and Ill do my best to lay it out for you.Please see the end of the article for more research on these topics. Why do I tend to be hyperglycemic at high altitude? There is less oxygen and air pressure at higher altitudes. The earths gravity holds oxygen close to the surface, so that half of the oxygen in the atmosphere is found below 18,000 feet. This means that as you climb above sea level atmospheric pressure and oxygen pressure fall. Our bodies have multiple ways to adapt to existing at high altitude and having less oxygen,and there are short term adaptations as well as longer term adaptations. For the purpose of explaining altitudes effect on blood glucose, I will focus primarily on the shorter term responses. Why am I always winded when working out at high altitude? If youve ever hiked at higher altitudes, youll recognize the first one-hyperventilation. As you ascend you often find yourself breathing heavily, and you may feel easily winded. For most of us living close to sea level, this is normal. With less oxygen available, you begin to hyperventilate as a means of releasing excess CO2 (carbon dioxide), and increasing the rate of fresh air thr Continue reading >>

Blood Glucose And Altitude

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, Colorado Continue reading >>

Living At High Altitude Could Reduce Type 2 Diabetes Risk

Living At High Altitude Could Reduce Type 2 Diabetes Risk

Living at high altitude could reduce type 2 diabetes risk Living at high altitude could reduce type 2 diabetes risk Sitting less and walking more could reduce fasting insulin levels by 11 per cent 27 January 2017 People living at higher altitudes have a reduced risk of type 2 diabetes , heart disease and stroke , according to Spanish researchers. Scientists at the University of Navarra suggest that the geographic area in which you live to contribute to the risk of metabolic syndrome. This is the medical term for the combination of high blood sugar , blood pressure and cholesterol , which contributes to a higher risk of type 2 diabetes , heart disease and stroke. "We found that those people living between 457 to 2,297 metres had a lower risk of developing metabolic syndrome than those living at sea level (zero to 121 metres)," said co-senior author and PhD candidate Amaya Lopez-Pascual. Obesity, smoking and sedentary behaviours are among the leading risk factors for metabolic syndrome, but not a lot is known about how our environment could affect this risk. The researchers analysed data from a Spanish project that asked participants to submit their health information twice-yearly since 1999. This data was then used to track the development of metabolic syndrome in relation to the altitude of where participants lived, of whom were initially health at the beginning of the study. It was shown that the higher the altitude where a person lived, the less likely they were to develop metabolic syndrome. This association existed even after analysis of family history. "Living or training at high altitudes or under a simulated hypoxic [oxygen deficient] environment seems to help with heart and lung function, losing weight , and improves insulin sensitivity ," said co-senior author Continue reading >>

High Altitude's Never-ending Love For Hypoglycemia - Diabetes Daily Grind | Real Life Diabetes Podcastdiabetes Daily Grind | Real Life Diabetes Podcast

High Altitude's Never-ending Love For Hypoglycemia - Diabetes Daily Grind | Real Life Diabetes Podcastdiabetes Daily Grind | Real Life Diabetes Podcast

High Altitudes Never-Ending Love For Hypoglycemia On trail to Mt. St. Vrain in the Rocky Mountain National Park 2 days. 8 low blood sugars. The numbers tellthestory:the higher you climb, the lower you fall.We all enjoy good paradox, right? Am I a mountain man? No, partlybecause it takes me 3 weeks to grow a 5 oclock shadow, and I spend the majority of my life at sea level. Oxygen likes to have a good time at sea level. It glides into my lungs with relative ease, slips into my blood, and enjoys homeostasis. At high elevations, especially those approaching 10,000 feet, oxygen gets depressed. It hides out with its cats and starts crocheting. In response to this hermitism, the heart works double time. Being that the heart is a relatively selfish organ in its oxygen (and subsequently glucose) use, it singlehandedly elevates our metabolism, by 10-20% at my best guess. So whats the end result for the insulin-deficient? Low blood sugars. When you toss in a bit of strenuoushiking on a non-acclimated body, youve got yourself the perfect recipe for consistent hypos. Its now day 3. Im about to set out on a hike. Just scarfed down a healthy sized breakfast and Im defying all logic with a no bolus policy. Why? Well, because its hard to bounce back from a low just 30 minutes into a hike. Ill check every 30 minutes, avoid complete diabetes management ignorance, and bask in some mountain air. If youve traversed the high altitude diabetes management journey, drop us a few tips below! Continue reading >>

Altitude |

Altitude |

Aside from the in-flight experience, you may need to deal with the effects of high altitude if you are traveling to one of various popular destination spots renowned for their high altitude sports such as cross country skiing, snowboarding, or mountain climbing. Having an awareness of how altitude may affect your blood glucose readings in these situations is a must for anyone with diabetes. Most blood glucose meters are dependent on oxygen to work properly. At altitude, the amount of oxygen in the air decreases and can negatively affect the performance of a meter, leading to errors in working out dosages. Most people only pause to wonder about altitude once they are boarding a plane for a long-haul flight, but what about people who live at altitude? There are numerous cities across the globe that are situated in high altitude settings. Individuals with diabetes who live in these cities may regularly administer erroneous insulin dosages. Cities such as these include Colorado Springs, USA (1840 meters, 6040 feet), Mexico City, Mexico (2200 meters, 7220 feet), and La Paz, Bolivia (3640 meters, 11940 feet). For many blood glucose meters, there is about a 1-2% underestimation of blood glucose levels for every 300 meters (1,000 feet) of elevation. This could mean nearly 25% error in the daily meter readings if you live in La Paz! No wonder many individuals have a hard time establishing strong control of their levels while traveling. Even if they are able to hit their target numbers, their meters may not be reading accurately. How frustrating! Further research needs to be conducted to check the performance of glucometers as various altitudes in order to better understand the relationship between altitude and glucometer performance. Until then, speak with your team of medical Continue reading >>

Managing Diabetes At High Altitude: Personal Experience With Support From A Multidisciplinary Physical Activity And Diabetes Clinic

Managing Diabetes At High Altitude: Personal Experience With Support From A Multidisciplinary Physical Activity And Diabetes Clinic

Managing diabetes at high altitude: personal experience with support from a Multidisciplinary Physical Activity and Diabetes Clinic Find articles by Sivasujan Sivasubramaniyam 2 Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK, 1 Department Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK, 3 Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK, 1 Department Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK, 2 Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK, 3 Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK, Correspondence to Dr Neil E Hill; [email protected] *GM contributed to this article but is not affiliated with an academic institution. Author information Article notes Copyright and License information Disclaimer Copyright Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: 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 t Continue reading >>

High Altitude And Blood Sugars | Diabetic Connect

High Altitude And Blood Sugars | Diabetic Connect

By 1FLYCHIK Latest Reply2013-03-01 15:31:51 -0600 Hi Everyone. I wanted to see if anyone knows or has experienced this. I am traveling to Peru in 2 weeks to do some charity work and I am wondering if the high altitude there will affect my levels? If so, how did you manage them or what precautions did you take??? Everything else effects it, so why not high altitude?! Then the question becomes does low altitude send it the other way? I live and work at 1300-1400 feet, so where does high altitude start? May the Lord bless you and keep you and your team be safe from harm and disease. When I traveled to New Mexico a while back I found that my levels were elevated when we were camping. I was exercising more, eating better and less, but my levels still seemed to climb the mountains with me. Not really bad, but I would say I struggled with an additional 40 points of average. I go up to the Grand Canyon every year for a week for work, and the altitude there (8800 feet) doesn't mess with my levels at all! I do, however, get alititude sickness badly after my 2nd day up there, which is no fun at all, and makes it hard to work! Remember to drink lots and lots of water-it is supposed to help with that, and enjoy your time there. Sounds like you will be doing good things and enjoying your visit as well :) Continue reading >>

Asknadia: Why High Altitudes Will Give You High Blood Sugars

Asknadia: Why High Altitudes Will Give You High Blood Sugars

AskNadia: Why High Altitudes Will Give You High Blood Sugars Why do my BGs run high when I hike in higher altitudes? When you exercise in elevations your body is accustomed to, chances are you have a good idea of how your blood sugar will respond. Exercising in high altitudes such as hiking generally, reduces your oxygen intake and stresses your body. Stress releases cortisol, the stress hormone, causing blood sugars to go up. Additionally, research demonstartes that carbohydrate metabolism may be comprised at higher altitudes causing insulin resistance. On the flip side, If you get dehydrated from hiking you will experience similar symptoms to hypoglycemia; shortness of breath, nausea, and rapid heart beats. Blood Glucose Meters, CGMs & Insulin Pumps Medical devices can vary in their accuracy at higher elevations. If one device is less accurate, it will be confusing to isolate which one is impacting your blood sugar. Calibrate all your devices to affirm their accuracy before you start your trip. This will add anther layer of security to assure your blood sugar readings are within the proper range for your devices. I would also recommend testing your blood sugar before, during and after your hike to give you a baseline on how higher elevations impact your blood sugars, making your return trip less stressful and more predicable. If possible, bring back up diabetes supplies just in case you ascertain accuracy issues with one medical device. Nadias feedback on your question is in no way intended to initiate or replace your healthcare professionals therapy or advice. Please check in with your medical team to discuss your diabetes management concerns. AskNadia and receive her unique perspective on your question. Or share your story with us. Nadia was not only born into a fa Continue reading >>

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