1 Centre for Altitude, Space and Extreme Environmental Medicine, University College , London, United Kingdom .
High Alt Med Biol. 2013 Sep;14(3):197-204. doi: 10.1089/ham.2013.1020.
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.
随着糖尿病发病率的不断上升和当前的社会赋权理念，越来越多的糖尿病患者前往高海拔地区，而 1 型糖尿病登山者高原反应的发生率与非糖尿病患者并无差异。运动的诸多影响，包括程度和持续时间、饮食改变、疾病、压力、高原反应、代偿性激素和海拔升高的交感神经输出，以及儿茶酚胺，导致了关于在高海拔地区胰岛素需求增加或减少的相互矛盾的说法。总的来说，饮食和运动的影响似乎超过了海拔的影响。良好的控制需要持续的胰岛素剂量调整，并通过频繁的血糖测试进行反馈，但血糖仪在高海拔地区可能会读数偏高或偏低。此外，热或冷暴露会降低胰岛素的疗效；本文还描述了储存胰岛素的策略。
