Altitude, skiing, and crazy low hypogylcemia

So it’s now happened almost every time I’ve skied this season. Help me figure this one out that is confusing me so much. Here are the details.

  1. I’m an ex-ski racer, in great shape, ski almost every weekend.
  2. Use food to treat low blood sugars/keep me from going low - glucose tabs and high protein Balance bars.
  3. Blood sugar in parking lot while booting up, mid 100’s - very little active insulin from previous bolus
  4. Keep basal the same because temp basal shoots me up very high in the evening.
  5. Test first chairlift ride - no skiing yet - blood sugars in the low 30’s - what? Test on another meter - same reading. No symptoms, just a baseline test. Full motor control, talking, skiing.
  6. Pop glucose tabs/energy bar.
  7. Still ski while low (I know I shouldn’t but if there’s powder, someone has to get it) and have no challenges with motor control.
  8. Test in 10-15 minutes, today my reading was 22 - the lowest I have ever been - still full motor control.
  9. Sit in powder and wait until blood sugar is above 100, so frustrated and have no confidence in my body so I can barely ski down terrain I usually rip down.
  10. MiniMed CGMS doesn’t alarm, doesn’t even track a decreasing blood sugar - want to throw the system into the trees because it isn’t giving me any more data than I have when testing.
  11. Exhausted - drive back to Seattle and attend the ADA Tour De Cure kick-off because I will be biking 100 miles in a few months.

Here are my thoughts…

  1. Altitude gain without physical activity (chairlift ride) might have something to do with it. Doesn’ t happen biking, hiking, backpacking.
  2. Less oxygen means better absorption of insulin?
  3. Less oxygen means less ability to get glucose into the blood stream?
  4. My body is producing insulin again, after 14 years of a vacation? I wish.

Let me know if you have any personal experience or knowledge about altitude and blood sugars. I have two diabetic friends in Seattle who have experienced the exact same thing.

I have no personal knowledge, but here’s an article ( which is highly technical (for me at least) and which also suggests that part of the problem might have been the high altitude’s affect on your METER as opposed to on your blood sugar!!

BTW, if you find out that the correct answer is Number 4 - please let us all know so we can all move to the mountains!

Good luck,


Curious, what’s the altitude difference? I’m from Colorado, and I haven’t noticed much of a difference with my blood glucose, or meter, with a 3,000 foot altitude change (5k - 8k). Maybe I just haven’t noticed though.

My guess is that your meter was giving you bad (bogus) numbers.

Usually altitude isn’t problem for meters at most ski areas, since most of meters are rated to 10,000 or more feet, but some of them top out at 7,000 feet. How high were you and what meters were you using?

A more likely cause for bogus readings when skiing is cold temperatures. There’s a chemical reaction taking place when the blood is tested, and chemical reactions are sensitive to temperature. The best strips I know of are only rated to 4 C (~39 F) and some are only rated to 10 C (50 F). Some people say you can keep your meter and strips in a warm pocket and use them in the cold, but in my experience it does not work. The strips cool off far too quickly and can give seriously low readings. How cold was it?

Here’s a good reference for temperature and altitude limits on various meters: Diabetes Health Meter Reference

Hmm… that’s a hypertext link, even if it doesn’t look like one.

Though I’m reading these postings a few years later, I would lean toward believing the problem is a combination of altitude and temperature and unfortunately not number 4. Ripping down hill takes a fine degree of coordination and I find that being even slightly ‘off’ changes my ability to ski drastically. Thus I find myself trying to watch my own ski ability as an early warning sign. Or my ski buddy Jim tells me I look like ■■■■ and to go check my blood, well before I’m aware of the problem. How to keep things warm though is a problem whose solution I have yet to resolve to my own satisfaction.
These days lately with the low temperatures, I’m happy to keep from getting frostbite.