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Increased Insulin May Be Needed Over 5,000 Meters

Acute mountain sickness symptoms associated with insulin requirement and increased glucose levels

THURSDAY, March 10 (HealthDay News) -- For individuals with complication-free type 1 diabetes, there is an association between acute mountain sickness (AMS) and increased insulin requirement when trekking at very high altitudes, according to a study published in the March issue of Diabetes Care.

Pieter De Mol, M.D., from the Canisius Wilhelmina Hospital in Nijmegen, Netherlands, and colleagues investigated insulin requirements, energy expenditure, and glucose levels at very high altitudes. Eight individuals with type 1 diabetes without complications participated in a 14-day trek to Mount Meru (4,562 meters) and Mount Kilimanjaro (5,895 meters) in Tanzania. Daily insulin doses were determined and energy expenditure and symptoms of AMS were assessed, and compared to healthy controls.

The investigators found that, at up to 5,000 meters in altitude, there tended to be a decrease in insulin dose requirement by 14.2 percent compared to sea level (P = 0.41), although glucose levels were stable. At altitudes higher than 5,000 meters, the insulin dose requirement was unchanged from sea level, but both glucose levels and AMS symptoms increased. A significant association was found between AMS symptoms and insulin requirements (P = 0.041), and AMS symptoms and glucose levels (P = 0.014) for Mount Kilimanjaro. There was no significant difference in energy expenditure and AMS symptoms between the diabetes and control groups.

"In individuals with type 1 diabetes, insulin requirements tend to increase during very high altitude trekking despite high energy expenditure and reduced caloric intake," the authors write.

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