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Updated: May 7, 2026

Evaluation of Blood Lactate and Plasma Insulin During High-intensity Exercise by Antecubital Vein Catheterization
Published on: May 18, 2018
The practical aspects of insulin at high altitude
Paul Richards1, David Hillebrandt
11 Centre for Altitude, Space and Extreme Environmental Medicine, University College , London, United Kingdom .
Abstract:
With the increasing prevalence of diabetes and current social philosophy of enablement, many more diabetics are travelling to high altitude where the rate of AMS in Type 1 diabetic mountaineers is no different than nondiabetics. Numerous effects of exercise, both degree and duration, dietary change, illness, stress, mountain sickness, counter-regulatory hormones, and altitude increased sympathetic output, and catecholamines have led to conflicting accounts of insulin requirement increasing or decreasing at altitude. Overall, it would appear that the effects of diet and exercise outweigh those of altitude. Good control requires continual insulin dose adjustment with frequent feedback from blood sugar testing, but glucometers can over- or under-read at altitude. Additionally, heat or cold exposure can degrade insulin efficacy; strategies for storing insulin are described.
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