One of our readers wants to know whether a physically fit patient of blood sugar can join a mountaineering course.
We start the answer on an optimistic note because individuals suffering from Type 1 diabetes climbed Mount Cho Oyu (8,201 meters) in 2002.
Our preliminarily review of a part of online medical literature tells that a physically fit patient of Type 1 diabetes can participate in high altitude mountaineering and trekking expeditions provided s/he takes precautions. For example, according to one of the scientific research studies (http://care.diabetesjournals.org/content/28/10/2563.full.pdf+html), a person suffering from Type 1 diabetes without any complications can successfully participate in adventure activities at high altitude (3,000-5,000 meters) and extreme altitude (> 5,000 meters). The study did not find any difference between the performance of these patients and that of normal mountaineers. However, the scientific studies have also highlighted the associated risks. So weigh pros and cons!
- High altitude impairs glycemic control in Type 1 diabetes patients, especially if diabetes is accompanied by complications. Even in normal people, altitude decreases glycemic control. Altitude reached and climbing duration also impact glucoregulation. Therefore, these factors should be taken into account while planning the expedition.
- The diabetes subjects should undergo a thorough medical check-up, including general, diabetes, and dental check-ups before starting the expedition.
- Diabetics should attain a reasonable physical fitness level.
- Carry appropriate high altitude gear.
- Maintain hygiene.
- Discuss the expeditions with their physicians, especially if they have complications. They should follow the advice of the physicians.
- Learn diabetes management such as how to monitor glucose, what to eat, and what should be the insulin dose.
- Take adequate nutritive food and liquids to avoid dehydration.
- Avoid infections and illness during the expedition.
- Monitor level of blood glucose regularly.
- They should not directly join an expedition to climb a peak in an extreme altitude area.
- Acclimatize properly.
- Climb gradually and slowly.
- During Diabetes Federation of Ireland Expedition to Kilimanjaro (http://www.ncbi.nlm.nih.gov/pubmed/11606174), the researchers observed climbers suffering from Type 1 diabetes and concluded that the mountaineers should consult their physicians before joining an expedition because retinal hemorrhage, ketoacidosis, and hypoglycemia may develop in diabetic climbers.
Despite taking all precautions patients of Type 1 diabetes without complications may face some risks, such as hypoglycemia, injury, illness, ketoacidosis, and retinal hemorrhage. The team therefore should be aware of medical condition of all the members. The team members should know how to manage diabetes related issues.
Retinal vessel hypoxia (poor supply of oxygen to tissues) increases possibility of retinal hemorrhage at extreme altitude.
As mountaineers gain altitude, their bodies require more carbohydrates. The cold weather may hinder with the process of breaking down the fat. These two conditions may cause hypoglycemia.
Most of the people crossing 4,500 meters experience acute mountain sickness (AMS).
The sickness increases the chances of getting ketoacidosis. Therefore, take all possible measure to reduce the symptoms of AMS.
A Note of Caution
We have collated the scientific facts from various sources for your information. But we are not doctors. You should consult your doctor before joining a mountaineering course and / or expeditions.