Article Text
Abstract
Objective Physical activity is important for well-being but can be challenging for people with diabetes. Data informing support of specialist activities such as climbing and high-altitude trekking are limited. A 42-year-old man with type 1 diabetes (duration 30 years) attended a Multidisciplinary Physical Activity and Diabetes Clinic planning to climb Mont Blanc during the summer and trek to Everest Base Camp in the autumn. His aims were to complete these adventures without his diabetes impacting on their success.
Methods We report the information provided that enabled him to safely facilitate his objectives, in particular, the requirement for frequent checking of blood glucose levels, the effects of altitude on insulin dose requirements, and recognition that acute mountain sickness may mimic the symptoms of hypoglycaemia and vice versa. Real-time continuous glucose monitoring was made available for his treks.
Results The effects of high altitude on blood glucose results and glycaemic variability while treated on multiple daily injections of insulin are reported. In addition, we present a first-person account of his experience and lessons learnt from managing diabetes at high altitude.
Conclusions A dedicated Multidisciplinary Physical Activity and Diabetes Clinic delivering individualised, evidence-based, patient-focused advice on the effects of altitude on blood glucose levels, and provision of real-time continuous glucose monitoring enabled uneventful completion of a trek to Everest Base Camp in a person with type 1 diabetes.
- diabetes
- glucose
- mountain
- walking
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Footnotes
↵* GM contributed to this article but is not affiliated with an academic institution.
Contributors GM wrote the first person account part of the manuscript, undertook trek. SR and CJ contributed to the trekking advice part of the manuscript, advised GM. SS and NO undertook the analysis of CGM, contributed to the trekking advice part of the manuscript. SC contributed to the trekking advice part of the manuscript. NH coordinated and wrote the manuscript, advised GM.
Competing interests NO has received honoraria for advisory board membership from Roche and Abbott Diabetes. NH has received continuous glucose monitoring equipment from Dexcom (San Diego, California) for research.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.