Metabolic effects of high altitude trekking in patients with type 2 diabetes

Abstract

Objective: Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes.

Research design and methods: Thirteen individuals with type 2 diabetes took part in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco, after 6 months of exercise training. Energy expenditure, body weight, blood glucose, fasting insulin, lipids, and HbA(1c) were assessed.

Results: Training reduced fasting glucose (-0.7 ± 0.9 mmol/L, P = 0.026) and increased exercise capacity (+0.3 ± 0.3 W/kg, P = 0.005). High altitude trekking decreased fasting insulin concentrations (-3.8 ± 3.2 μU/L, P = 0.04), total cholesterol (-0.7 ± 0.8 mmol/L, P = 0.008), and LDL cholesterol (-0.5 ± 0.6 mmol/L, P = 0.007).

Conclusions: High altitude trekking preceded by exercise training is feasible for patients with type 2 diabetes. It improves blood glucose, lipids, and fasting insulin concentrations, while glucose control is maintained.

Figure 1

Daily energy expenditure (upper panel, ▲), fasting glucose (n = 10 [insulin users excluded]; middle panel, ■), and AMS score (lower panel, ●) during the training period and the 12-day expedition. The altitude presented (right y-axis, shaded gray area) refers to the highest altitude reached that specific day. Data are presented as mean ± SD. *P < 0.05. Note: Days 0, 9, and 12 represent resting days. Energy expenditure and fasting glucose monitoring were unavailable during the fifth month (day −60 to day −30) of the training period. A diagnosis of AMS is based on the presence of a headache, at least one other symptom (gastrointestinal symptoms, dizziness or being light headed, difficulty sleeping, fatigue or weakness) and a total score of ≥4.