Mystery Solved: Why Living at High Altitudes Protects Against Diabetes

Researchers have long known that people who live at high altitudes, where levels of oxygen are low, have lower rates of diabetes than those living at sea levels. But until recently researchers were in the dark about why this was the case. Now researchers at the Gladstone Institutes believe that they have solved the blood glucose levels and high altitude mystery. [1]

At the root of the phenomenon is the ability of red blood cells to function as glucose sponges in low-oxygen conditions, such as those found in the world’s highest mountain regions. When oxygen levels fall, red blood cells switch gears into a new metabolic mode wherein they absorb large amounts of glucose from the bloodstream, effectively acting like sugar sponges and lowering blood glucose levels. At the same time, red blood cells can more efficiently deliver oxygen throughout the body. The Gladstone study findings were published February 19 in the journal Cell Metabolism.

Isha Jain, PhD, the senior study author, said that “Red blood cells represent a hidden compartment of glucose metabolism that has not been appreciated until now. The discovery could open up entirely new ways to think about controlling blood sugar.”

Jain has been studying how reduced blood-oxygen levels, called hypoxia, affect health and metabolism. In a previous study mice breathing low oxygen air had significantly lower blood glucose levels than normal. This meant the animals were using up glucose quickly after they ate, which normally indicates a lower risk of diabetes. However, the puzzle was where the glucose was going since imaging did not show up glucose in major organs. Further experiments showed that the mice not only produced more red blood cells; these cells were absorbing more glucose than cells formed under oxygen levels that were normal.

A drug called HypoxyStat developed in Jain’s lab mimicked the effects of low oxygen air. The drug, a pill, completely reversed high blood glucose levels in mouse models of diabetes, working better than existing treatments. The drug paves the way to thinking about diabetes treatment in an entirely new way – by recruiting red blood cells as glucose sinks, which is a term used to describe anything that pulls in and uses a lot of glucose from the bloodstream.

Lifestyle changes for blood sugar control

While research continues to look at how to help lower glucose levels in blood, there are changes in your lifestyle that can help. Following are five steps to consider as part of your daily diabetes management regimen for the control of blood sugar.

Make healthy food choices

The key to managing blood glucose is to eat healthy foods in the right amounts at the right time to keep blood sugar in your target range as much as possible. Work with your health care team to create a meal plan that works for you.

A good diabetes meal plan will help manage the carbohydrates you eat, which is a key to good blood glucose control. Carbohydrates can contribute to an increase in blood sugar. However, a diabetes diet plan still should make sure to get adequate amounts of carbohydrates.  That is why it is important to understand that not all carbohydrates are the same, which will help you in making the right food choices.

Some foods that contain carbohydrates also include other key nutrients that, if taken in the right amount, can be a benefit to someone with diabetes. Fruits, vegetables, and whole grains have lots of nutrients. They have fiber that helps keep blood sugar levels more stable too. Eat fewer refined, highly processed carbs, such as white bread, white rice, sugary cereal, cakes, cookies, candy, and chips.

Diabetes meal planning for blood glucose levels control also involves watching portion sizes. Read labels and use measuring cups to understand what an appropriate amount consists of. And talk to your health care team about the best time to eat or drink. That may depend on: [2]

• What medicines you take for diabetes
• What level of physical activity or your work schedule is
• Whether you have other health conditions or diseases

Exercise

Exercise is good for your heart, lungs, and state of mind. Regular exercise also can lower blood pressure and triglyceride (fat) levels. Harvard Health also points out that for people with diabetes, exercise can help lower glucose levels and boost your body's sensitivity to insulin, countering insulin resistance.[3]

The American Diabetes recommends even if you have not been active, start now. However, it is important to consult your doctor and start slowly. A great place to start is with light walking. To give you more incentive, walk with someone in your family or a friend, walk with your dog, or listen to an audio book while walking alone. Set daily goals and meet them.[4] 

Manage stress

Stress can cause your body to release stress hormones, which make it harder for insulin to work properly. Here are steps to take to manage stress to help control and lower glucose levels in blood. [5]

·         Find stress-reducing activities: You can lower your stress through meditation, yoga, and more time spent with friends and family. Good self-care can also include going for walks, getting a massage, relaxing with an enjoyable book, and focusing on a hobby.

·         Build a support system: Your support system can include family and friends who know about your condition and how to help when you need help. Talking to friends and family may help to relieve the stress you experience dealing with the disease. Friends and family also can be of help reminding you to take your medications and monitor blood sugar levels. Also talking with other people who have diabetes can help since they may offer advise on how to deal with the disease – what works for them.

·         Talk to your healthcare providers: Share your feelings and anxiety with your healthcare providers. Your healthcare team can help problem-solve these issues or refer you to other providers who can.

·         Pace yourself: Do not try to make all changes at once. You already have patterns that dictate certain aspects of your life – the foods you eat, how much you exercise, time spent on outside interests. Rather than making radical changes, manage your diabetes with slight changes to gradually adapt to your new management guidelines.

·         Take time to do things you enjoy: Give yourself a break. Make time each day to do something you really love to do. Plan something with a friend or a family member or work on a project that engages your mind and your creativity.

Moving to the mountains may not be in your near or long-term plans but following these steps can help keep blood glucose levels under control.