Altitiude Adjustments?

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Permalink Reply by Jack on December 25, 2008 at 11:11am

Also my digestive system is way out of whack. I think that it is a normal problem with adjusting to altitude.

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Permalink Reply by Teresa on January 5, 2009 at 12:48pm

My husband and I visit Lake Tahoe every couple years, and I'm always doubly challenged to control my BGL when we go. I've come to believe it is an effect of altitude sickness. From what I've read on the subject, your body should become accustomed to the elevation over time, after moving there. (Congratulations on being able to move to such a beautiful area!)

I don't use a pump (I use an insulin pen) but, I wonder if the lower air pressure at the high 6,000 ft. elevation impacts the delivery of the pump's insulin. Does Medtronic have any info. about that? I think of the times I've opened a tube of lotion in Tahoe, that I hadn't opened since leaving home (at 1,000 ft.), and have it spurt out due to the higher air pressure that was on the inside - in relation to the lower air pressure surrounding it when I opened it.

So, what you experienced during your stay at Tahoe may have been a combination of things, including a form of altitude sickness (try an internet search on the topic for more info) and surrounding air pressure issues for your pump - especially impacting the change of an infusion set the first time you do it at the higher elevation (the first change, I would hope, allows for the air pressure on the inside to equalize with that on the outside - and the reverse would apply upon returning to a low elevation.)

My One Touch Ultra2 glucose meter seems to, thankfully, work just fine in higher elevations. So does my NovoPen insulin pen - but, I'm going to be paying closer attention next time we "go up the hill". Thanks for bringing your situation to light!

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Permalink Reply by Jack on January 5, 2009 at 3:09pm

Teresa,

Thanks for the info. I noticed that my blood was thinner when taking a test. I think that insulin is more effective or faster acting at altitude due to the blood being thinner. Not sure of course. I will ask a doctor at some point. By the end of the week I spent at Tahoe I was able to manage everything pretty good.

I did not notice a problem with the pump reservoir and the change in air pressure. Although, I guess I'm not sure.
I had one really bad low blood sugar a day after arriving. I am still not sure what caused me to throw up!

I also have a One touch Ultra. I think it did ok at altitude. I wasn't quiet sure at first. I had read a couple of articles saying that they test meters at high altitudes and report that they are accurate.

Over all, you guys sure have it nice in Northern California. I am really looking forward to spending time there.
Also, I guess everybody says "going up the hill" and "coming down the hill" I had heard that and had a laugh when you said it.

Jack

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Permalink Reply by Tracy on February 19, 2009 at 1:08am

Hello Everyone,
I just thought I would chime in (although sadly I have no real advice to share) since I am dealing with the opposite situation! You see, I was born and raised in Lake Tahoe so my body is used to nothing but the oh-so-thin air we have here at altitude. Being that I am new to the diabetes bandwagon (going on 6 weeks since I was diagnosed..) I sadly don't have any hints as to what does or doesn't work here as opposed to lower elevations. I DO know that if you are using vials of insulin you need to be careful to account for pressure changes, although it looks like neither of you are newly diagnosed so perhaps you have outgrown the vial-reliant stage of diabetes. But, just in case, pressure can be released from your vial by simply inserting a syringe with the stopper removed. Please excuse me if this is a widely known fact, being the newbie I am I delight in getting to share whatever I can, even if it is common knowledge :) If it's any cancellation I will be making my first trip away from home next week. I will be heading "down the hill" to the bay area. I will surely report any differences I notice, although sadly I'm pretty sure it's far too soon for me to be recognizing patterns/differences just yet.

Jack, please feel free to send any questions you may have about Tahoe my way, I'd be happy to help. What side of the lake are you moving to?

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Permalink Reply by Jack on February 19, 2009 at 6:05am

Hey Tracy. We are moving to the west shore, Homewood. I'm sure I'm gonna have a few questions as it gets closer to when we move. So thanks and enojy the bay area next week.

Jack

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Permalink Reply by Jack on April 1, 2009 at 5:28pm

Do you have a doc in the area?

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Permalink Reply by Tracy on April 1, 2009 at 9:07pm

Hey Jack,
Funny you should ask about docs...I've been through quite a few of them lately. Over in homewood I don't know what kind of choices you'll have, I think the closest docs I'd actually be comfortable referencing are those that work out of TTMG-Tahoe Truckee medical group. The office I'm referring to is located in Tahoe City, and depending on where you live in h.wood it should be a 15ish min drive for you. The medical group has offices at northstar, squaw, Truckee, Tahoe city, and maybe one other location in the basin. I used to see them regularly, and in fact it was in their Truckee office that my diabetes was diagnosed in January. If you decide to go through TTMG, I'd be happy to give you a little insight into the docs I would/wouldn't recommend visiting, since I have seen all of them over time. For me, I ended up getting frustrated with trying to schedule appointments with the doc I wanted since he was so busy and basically worked one day a week at every TTMG location.
On the recommendation of an EMT friend I started seeing a husband/wife team at a multi-specialty clinic here in truckee. They're AWESOME and I would highly recommend seeing them if driving to truckee doesn't bother you. As for Endo's, mine is in reno and she's awesome, too! Dr. Abbott is her name...
if you're interested in any of these, I'd be happy to send you numbers and contact info. Don't know what kind of doc you're looking for- if it's anything specific or anything I didn't cover let me know, I'd be happy to help! Happy doctor shopping :)

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Permalink Reply by Tanya (Baby Tee) on November 15, 2009 at 7:42pm

Jack,

I don't have a pump, so I can't comment on that.

Not sure if you are there in Tahoe yet or not (you said it would be about a year.). I live in Sacto and still have family up in Tahoe. I think insulin seems to work more efficiently, at least short term, when you are at higher altitude because of altitude sickness, they call it.

When you go to higher altitude, your breathing rate increases because there is less oxygen. The more frequently you breathe, the more you exhale. Each time you exhale, you release fluid. You should be more dehydrated for approximately 3 to 5 days when going from near sea level to Tahoe. I think insulin may seem to work more effiiciently for that time frame, either because your body is working more to breath, or because of dehydration. I have no idea.

I do know, however, I probably increase my carb intake by 20 - 30% when I am up there, because I can't figure out the insulin. Since I travel up there frequently, I would love to hear what you figure out when you are settled up there. I wonder if the different insulin requirements are long term or short term, until your body gets acclimated.

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Permalink Reply by Jack on November 15, 2009 at 8:02pm

Tanya,

I have been at Tahoe since May. I travel to Chicago about once every other month for work. So far it has been very interesting trying to figure out what dosages to configure. I think you are spot on about the short term effects due to dehydration and increased output.

So living at altitude is really no different after a month. Watching hydration levels is important. Increased exercise really is the same as at sea level, at least in my experience. Otherwise the increased exercise put my latest A1c at 6.6 which is an all time best for me. It is kinda weird cause I think I might be eating more starches now than before.

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