Shortly after arriving in Guatemala, we went to a friend’s house for lunch and then back to the hotel. One of the things that I hadn’t paid much attention to was that I went from sea level to 4,804 feet above sea level. I later found out that altitude could play a part on how your blood sugar reacts to different events, like exercise.
During the trip, I had adjusted my insulin according to the fact that I wasn’t going to be moving a lot on a five-hour flight. I also remember that the emotional stress of flying would impact my blood sugars as well. Luckily, I had remembered that I would be walking a lot after getting off the plane. After disembarking the plane, I ate a 15g carbohydrate snack to compensate for the walk. Eating a snack worked out very well for me, because if I had changed my insulin, I would’ve had to wait for my baseline insulin to go down. All in all, it was a good flight, my blood sugar is staying in control, and for me, that meant my blood sugars were in range the whole trip.
Unfortunately, day two was not as good. My blood sugar spiraled out of control and with all my expertise I could not figure it out. I asked myself, what factors impact my blood sugar and what factors can cause such resistance?
On that day, my activity was much lower than when I am back home in New York City. I relaxed at the hotel, and I got a massage. However, I did exercise for a half hour while making the appropriate adjustments for my typical workout. All in all, I expected to be fighting high blood sugars. That wasn’t the case.
Could it be the altitude?
Truth, I wasn’t sure. When I got home from this trip, I searched Google, online, to see how altitude can impact one’s blood sugars. I was astonished to find that there is a lot of controversy around this issue. Mainly, articles about weight loss and moving to a higher altitude, overall there is not much difference between individuals who live in a higher or lower altitude. What I did find amongst the conflicting views on this topic is that when you change altitude from lower to higher in the first few weeks, there is an adjustment period. And your body works harder.
Various factors can change blood sugar levels in our body. Based on my experience with the higher altitude, it can impact blood glucose levels. My clinical view is the body has to work harder, therefore, burning off more sugar. Lower blood sugars occur when moving to a higher altitude due to less oxygen and increased dehydration.
However, unless you’re climbing Mount Kilimanjaro this is a rather small factor, but one to keep in mind when exercising at a high-altitude.
So what is the mystery factor around my blood sugar going low when I’m doing less work? Everyday life can be very stressful. If someone goes from a stressful state of living to a rather stress-free vacation, his or her cortisol production reduces. Cortisol is a hormone that causes the production of glucose in the human body. As a result of less cortisol, the body has less insulin resistance.
Vacations can be challenging for people who live with diabetes. No day is the same. Our patterns of behavior, mood (including stress) and exercise change. Try to predict for complications, do your best to adapt, relax and enjoy your vacation.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.