Climbing Kilimanjaro as a diabetic is a huge possibility as the necessary medical kit for people with diabetes can be carried easily on the mountain with the help of caring and understanding mountain guides and crew. That being said, however, you should monitor your sugar levels and at high levels, the effects of altitude and cold need to be keenly considered.
With high metabolic demands, a high risk of developing acute mountain sickness (AMS), and a distant location from medical treatment, high-altitude climbing is becoming more and more of a concern for persons with diabetes. According to the American Diabetes Association, “those with type 1 diabetes who do not have problems and are under good blood glucose control can conduct all levels of activity, including leisure activities, recreational sports, and competitive professional performance.” 2 But are patients with type 1 diabetes allowed to participate in all sports? Medical professionals are reluctant to recommend high-altitude mountaineering for diabetics due to a lack of information on how altitude affects blood glucose management.
For diabetic climbers, the Diabetes Federation of Ireland Expedition to Kilimanjaro (4559 m) provided some insight into the possible risks of severe altitude. Altitude sickness is not specifically caused by diabetes, according to the well-validated Lake Louise scoring system, which found that both diabetic and non-diabetic climbers experienced the same frequency of symptoms. Only the non-diabetic group experienced severe altitude-related complications, such as high-altitude pulmonary oedema and high-altitude cerebral oedema. Retinal hemorrhages, which have been reported to happen in one-third of climbers above 5000 m,5 happened in two diabetic climbers (one of whom had pre-existing retinopathy) and three non-diabetic climbers.
Although the average height obtained was lower in the diabetic group, six out of sixteen persons with diabetes and sixteen out of twenty-two climbers without diabetes were able to reach the mountain’s peak.
Despite the fact that the diabetic climbers did not report more frequent altitude issues, several of this group had significant challenges. The identification of hypoglycemia was hampered by some altitude sickness symptoms, such as headache and lightheadedness, as well as paraesthesia brought on by taking acetazolamide to prevent AMS. Patients relied more on the findings of blood glucose tests since there were no reliable warning indications for hypoglycaemia.
However, at elevations over 3700 m, blood glucose meters showed values that were 60-80% of conventional glucose solutions, particularly when the ambient temperature was low, which is consistent with earlier studies6-8. 3 When the temperature dropped to 22°C the night before the summit attempt, some meters stopped working entirely. Because of this, precise glycemic control was unattainable.
Additionally, a variety of variables worked together to raise the danger of ketoacidosis. Climbers often reduced insulin to make up for inadequate carbohydrate intake when anorexia related to AMS developed in order to avoid hypoglycemia during activity. Four climbers who lowered their insulin in this way had ketosis and moderate hyperglycemia, and two of them soon after the summit experienced more severe AMS.
Both climbers experienced nausea and vomiting, which led to the development of hyperglycemia and ketonuria. This course was sped up by the tendency to get dehydrated at high altitudes if fluid intake is insufficient. Since both climbers had to descend from a high altitude before being removed from the mountain, the added exertion aggravated the production of ketones and the progression of ketoacidosis. At 4000 meters, treatment with intravenous saline and intramuscular insulin was started, followed by evacuation by stretcher, after which one climber made a fast recovery. The other climber required hospitalization, and even when ketonuria and blood glucose levels quickly returned to normal, acidosis remained for a number of days.
This climber had been using acetazolamide as a preventative measure against AMS; this medication has been shown to cause metabolic acidosis and may have contributed to the prolonged acidosis in this patient. Acetazolamide limits bicarbonate reabsorption in the renal tubules.
What guidance would you provide someone with type 1 diabetes who is thinking about climbing a high mountain? According to the six climbers who made it to the top of Kilimanjaro, persons with diabetes may engage in this strenuous and possibly hazardous activity. But for people with diabetes, high-altitude mountaineering poses serious risks. Those who have severe retinopathy should be discouraged from ascending to high altitudes due to the risk of retinal hemorrhage.
Because of AMS symptoms and the unreliability of blood glucose meters, hypoglycaemia, which happens more frequently while hillwalking than in other sports9, is difficult to diagnose. Additionally, there is a high probability of developing diabetic ketoacidosis, a dangerous consequence that has been found in one study of trekkers to be responsible for 8% of deaths at high altitudes, once AMS symptoms, notably vomiting, start to appear. 10 Acetazolamide, which has recently been reported to only be effective in preventing AMS at high doses of 750 mg per day11, may also put diabetic climbers at risk for developing ketoacidosis. Once something goes wrong, climbers might have to trek far distances from isolated mountains before being rescued and taken to a hospital, which could make developing ketoacidosis worse.
Patients will decide whether to engage in high-altitude climbing on their own, but they should do so with the advantage of knowledge about the risks. There are significant risks associated with developing ketoacidosis in people with type 1 diabetes, which might have catastrophic consequences. The emergence of AMS appears to be the primary risk factor for the onset of ketoacidosis, so any steps taken to lower the risk of AMS—the most crucial of which is a gradual ascent to allow acclimatization—should be encouraged.
How do you prepare for your climb if you are diabetic?
You must keep up a healthy lifestyle and walk between 30 and 40 kilometers every week to keep your body in shape. To become accustomed to carrying a backpack up a mountain, you may also go on weekend-long hikes or sometimes ascend a flight of stairs with a heavy backpack on your back. Read about the Kilimanjaro training plan here.
How to manage your blood sugar levels & know what to eat and drink while climbing?
Spending between 7 and 8 hours a day climbing constantly will make it difficult to maintain blood sugar balance. On Kilimanjaro, it may be challenging to strike a balance between the amount of activity and the food that is provided.
Your blood sugar should be tightly under control, and you should check it frequently. After determining what to eat and how much insulin to take, your blood sugar level should be well under control.
Advise for diabetics that want to climb Mount Kilimanjaro
Every diabetic who is having difficulty, in my opinion, has to establish a lifestyle pattern that includes getting up in the morning, checking your blood sugar, determining how much insulin you need, and planning your day’s meals. You must establish and adhere to a daily living regimen. A diabetic must practice discipline. You won’t be able to deal with it for 50 years if you don’t have a routine and discipline.
One of the fastest-growing diseases
Diabetes is a condition when the body stops producing enough insulin to control blood sugar levels. When a person has type 1 diabetes, their pancreas completely quits making insulin, necessitating daily injections of synthetic insulin and ongoing blood sugar monitoring. Being overweight can occasionally result in type 2 diabetes, which is characterized by an ineffective utilisation of the body’s insulin. A combination of medication, insulin injections, and lifestyle modifications may be necessary for type 2 diabetes.
With 1.4 million Americans receiving a diagnosis of diabetes each year, it is one of the diseases with the greatest rate of growth in the country. Nearly 10% of all Americans, or 29 million people, have diabetes. It is present in 415 million persons worldwide. By 2040, that number is projected to increase to 642 million. Yet it is uncertain what causes diabetes. Although obesity may contribute to some occurrences of type 2 diabetes, this is not always the case, and there are no similar indicators for type 1.
Diabetes still carries a stigma, partly due to a lack of knowledge and awareness. But people continue to disprove it by demonstrating that living with diabetes need not mean accepting restrictions or limitations.
It might require more preparation, but that’s no excuse to pass up any opportunity.
Making diabetes work for you
You have the most compelling reason to eat well, exercise, and take better care of yourself even if diabetes necessitates daily insulin injections and frequent blood sugar monitoring: a functioning life.
Serious consequences of diabetes can develop if you don’t maintain a healthy lifestyle and control your blood sugar levels, including nerve damage, eye damage, cardiovascular disease, and many other conditions. People with diabetes can control their blood sugar levels with regular exercise and a nutritious diet.
Even if it means you are constantly carrying a medical time bomb that is just waiting for you to make a mistake, diabetes should be the driving force behind your lifestyle adjustment.
The lack of conclusive solutions to diabetes is arguably its most frustrating aspect.
Such as “how did I receive it?” or “will there ever be a cure?” must be left unanswered for the time being. An artificial pancreas (a device that automatically maintains blood sugar) is on the horizon, and there are treatments that show promise for decreasing or eliminating the need for insulin, but a real cure for diabetes is still unattainable. Understanding the reason is no different in this regard.
However, it is a treatable illness. Diabetes shouldn’t ever be an excuse for saying “no,”, especially with experience, discipline, and a network of support. Finding out what preparations are necessary to enable you to respond “yes” just takes a little thought.