| Abstract: |
In keeping with recommendations to stay physically fit, increasing numbers of people with type 1 diabetes now participate in extreme forms of physical activity, including high-altitude trekking and mountain climbing. However, exercise at altitude imposes a number of unique challenges for people with type 1 diabetes, including impairment in glycemic control and additional problems for patients with complications. This article reviews what is known about the impact of altitude on individuals with type 1 diabetes, then offers strategies for dealing with these challenges. High altitude is defined as 3,000 to 5,000 meters (10,000 to 16,000 feet) and extreme altitude as that greater than 5,000 meters. The author reviews three studies in this area, then discusses acute altitude sickness (also called acute mountain sickness or AMS), the effects of altitude on glycemic control and on glucose meter performance, altitude-induced anorexia, altitude and temperature, and other concerns including the impact of long-distance travel, poor hygiene, gastrointestinal disturbances, food supplies, and isolation. The author concludes that there are no absolute contraindications to travel at high or extreme altitudes for the knowledgeable individual with type 1 diabetes who is free of complications. However, there is some risk, including the possible consequences of hypoglycemia, illness, or injury. Specific recommendations for individuals with type 1 diabetes traveling at altitude are summarized in a table. 1 figure. 3 tables. 78 references. |