Malcolm Gary, Rilstone Sian, Sivasubramaniyam Sivasujan, Jairam Carol, Chew Stephen, Oliver Nick, Hill Neil E
Department Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Diabetes Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, St. Mary's Campus, London, UK.
BMJ Open Sport Exerc Med. 2017 Aug 16;3(1):e000238. doi: 10.1136/bmjsem-2017-000238. eCollection 2017.
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.
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.
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.
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.
身体活动对健康很重要，但对糖尿病患者来说可能具有挑战性。关于支持诸如登山和高海拔徒步等特殊活动的数据有限。一名42岁的1型糖尿病男性（病程30年）前往一家多学科身体活动与糖尿病诊所，计划在夏季攀登勃朗峰，并在秋季徒步前往珠峰大本营。他的目标是在不受到糖尿病影响的情况下完成这些冒险活动。
我们报告了所提供的信息，这些信息使他能够安全地实现自己的目标，特别是频繁检测血糖水平的要求、海拔高度对胰岛素剂量需求的影响，以及认识到急性高山病可能会模仿低血糖症状，反之亦然。在他徒步旅行期间提供了实时连续血糖监测。
报告了在每日多次注射胰岛素治疗的情况下，高海拔对血糖结果和血糖变异性的影响。此外，我们还展示了他的经历的第一人称叙述，以及在高海拔地区管理糖尿病所学到的经验教训。
一个专门的多学科身体活动与糖尿病诊所提供关于海拔高度对血糖水平影响的个性化、基于证据、以患者为中心的建议，并提供实时连续血糖监测，使得一名1型糖尿病患者能够顺利完成前往珠峰大本营的徒步旅行。
