Elevation Sensitivity

Hi everyone,

I was wondering if anyone has experienced problems with T1D and elevation. I’m on vacation about 6,000 to 7,000 ft higher in elevation than where I live and I have been feeling off. My levels have been all over the place (extreme highs and lows). Normally when I go on vacation my levels fluctuate from a change in routine but not to this extreme. I wasn’t sure if anyone else has experienced this or if anyone knows if diabetics can be more sensitive to elevation change. For background information I also had this problem with one other trip I went on that had a large increase in elevation.

I have had nurses warn me to be watchful during air travel because elevation can have that effect, but I’ve never experienced it myself. I’ve been on planes. I’ve been up and down mountains. Hasn’t affected me that way. But it happens to enough people that I have been warned that it can be an issue. Unfortunately, I don’t know of a solution other than the usual - keep a close eye on your BG values and adjust your insulin and food intake to compensate as best you can.

1 Like

Hello @Madison029 No, high elevation or altitude does not affect me. Everyone is different though. There were 2 or 3 discussions on this you can do a site search or just click here: https://forum.jdrf.org/search?q=Altitude%20. Good luck

1 Like

Yes. My bs has always been lower at elevation until 4 years ago. Now my bs is higher with elevations 5000ft and above.

1 Like

There is a clear connection between diabetes and altitude. Unfortunately there is limited documentation on this. I have experienced this skiing (in between 7,000 feet and 10,000 feet), with high BGs typically the case… I decided to go on a hike up Mount Kilimanjaro in 2018 and prepared with my doctor as best we could for high BGs. This was a leap above the ski heights with the peak at 19,341 feet. I was doing OK until I hit 15,000 feet and at that point there was little I could do to keep my BGs in a reasonable range. In fact I learned the error message on my glucometer when you exceed the maximum reading! My son has recently bought a house in Squaw Valley where the elevation is 6,200 feet. We expect to have extended stays there and I will be able to see more clearly the effect. I can’t advise what the adjustment plan should be, but temporary basal settings on your pump (if you use one) may be a consideration.

1 Like

Wow, that’s quite a hike! I felt sick at 7,000ft I can’t imagine the struggle at over 15,000 ft.
I didn’t even think about using a temp basal. I don’t have much experience with that but it’s definitely something I’ll talk to my doctor about. Thanks for the advice!

Our daughter routinely requires significantly more insulin on ski trips. Glad to know it’s not just us!

After I was diagnosed about 5 years ago (at 38 years old), my endocrinologist in a research study told me that elevation has unpredictable effects on BG (some people go up, some go down, some remain steady), and researchers don’t have a good handle on why. I camp regularly in the high Sierra Nevada and other ranges in eastern California, and my research (I’m an archaeologist, if you can’t tell by my user name) often takes me to elevations above 11,000 feet in the White Mountains of California. I typically run low once I’m above about 7,000-8,000 ft elevation. I run a separate profile on my Tandem pump. My bolus settings remain the same as home (about 250 ft elevation), but I run my basal at about 50%. Some of this certainly has to do with activity–hiking, or even just moving around at low oxygen levels and increased exertion. One sleepless night after several days at high altitude my numbers kept crashing. I ended up stopping my basal altogether, my numbers flattened in the morning, and I ended up feeling “normal” for a day with no need for any basal insulin!

I’ll also add that I’ve had issues with BG meters at higher elevation. If you use OneTouch (and I’m sure some of the others), my recollection is that the manual includes fine print that readings can be affected by elevation. As such, I tend to trust my Dexcom over my meter at least for the first day or two, after which the BG meter seems to acclimate.

One other suggestion I read somewhere, possibly on this forum: if you’re using a pump at a high elevation, pop the cartridge out and put it back in. I do this when I am at higher elevations, and again when I return to lower elevations. I assume this has to do with changes in air pressure, and it seems to take care of some of the rollercoaster numbers.

Hope this helps, and the biggest (obvious?) advise is to carry lots of sugar with you!

2 Likes

Archaeoholic is correct about the glucometers…OneTouch meters state the operating range up to 10,000 feet. As I mentioned, a temporary basal setting was possible on my Medtronic pump. I would test this depending on if you experience highs and lows at a lower percentage (Medtronic 630 has a percentage change for temporary basal) and adjust as needed. Not sure how the other pumps handle this.

I have since started Looping (closed Loop system which mimics a pancreas), which integrates my Dexcom G6 and an older Medtronic pump. It has significantly improved my HA1c numbers. I have not used it for a prolonged stay at altitude, but will test it next winter. I think this will address the altitude issue somewhat better.