Addition.
Hello again. I’m am currently on this trek. At 5000 metres. All going well but I am seeking advice. From anyone who may have suffered skin and soft tissue damage at this height. The skin on my face has been broken punctured. I have applied an iodine and covered with a dressing. I wonder whether I should commence a course of broad spectrum antibiotics? Seeking general informed advice.
Planning on walking the Annapurna Circuit in Nepal. Plus a few side trips. Anyone hiked to around this altitude. Any advice, tips? Wisdom.
My recent experience has only been to an altitude of about 4,200 meters and I was not hiking. I would encourage you to spend some time, a few days, acclimating your body to this altitude. This way you can experiment with reducing your insulin doses to account for the extra exercise your body will be doing before you even take the first step. I need less insulin when I spend any appreciable time at altitude, even without additional exercise. I would take with you at least three times the amount of emergency glucose that you think you may need.
You should be training for this adventure for some period, at least several weeks, before you depart. I would recommend that you always stick with another companion for safety’s sake.
Medtronic 670g is rated to about 3200m. Does that mean it was only tested to that elevation (atmospheric pressure really - 70 kPa) or does that mean it does not work properly above that elevation (below that pressure).
At 6000 meters there is about half the amount of oxygen in the air as at sea level.
(This never refers to pressurized airplanes. Clearly pumps are good at 40,000 feet or however high they go when in a pressurized airplane cabin.)
oooh, no. But, I think there used to be a guy, named ‘ShadowDragon’ or something on here that might have. He might have changed his name to @Shadow2. Hey, Shadow2, you a mountain climber? One of you guys is…trying to remember if it was you.
Thank you for reply. And thank you for your comments. Noting your comments about using less insulin. None of my medical team have mentioned that…so good to know. And good idea about emergency glucose. I will take lots of extra.
I’m going to approx. 5900 metres. (Hopefully)
I’m fit - so that should not be a prob. I’m using the G5 with a Medtronic pump.
Medtronic pump. G5 CGM. So at elevation does one assume the pump may push the insulin through a bit faster due to lower pressure? Thanks for your reply.
I only saw what the limits of the pump are listed per the manufacturer specifically for the 670g. I certainly have no experience at those sorts of altitudes. Whatever model pump (if not actually the 670g) you have could be different. You could try calling Tech Support and ask them but sometimes they are not allowed to say what happens if you use their device outside what it is listed.
I’ve hiked in the alps and dolomites at 2500-3000 meters on MDI. I had trouble adjusting my basal (was on Lantus at the time) and to be honest never satisfactorilly adjusted. Had a lot of overnight highs for the first week or so.
A few things to figure out a strategy for are jet lag and food. I stayed in huts with carby food choices and despite my best efforts had many dinner bolusses using a wild guess of carb content.
Do you need to think about freezing temps and protecting your insulin supply? How many days do you expect to be at that high altitude? Anyone who takes on a trip like this has to think about and prepare for many contingencies. Adding diabetes to mix ratchets up the complexity. I look forward to reading your report!
If your in the cold, on a tubed pump, that thing needs to be checked frequently. If the tubing comes out from beneath your jacket, it will freeze and you might not notice until the numbers are a mess. Consider getting ‘short’ tubing. Consider taping excess tubing to your body so it doesn’t get loose. Medical devices that need to operate should be kept in an inside jacket pocket, close to your body. Don’t forget to account for time zone changes that will alter your pump settings. That got me once real bad. You may need to reset your pump clock on the flight over. Remember to check the travel warnings before you go.
Oh, bummer. I don’t recall who it was then. But, I remember seeing a pic of someone who was doing that. I’ll look back through older posts. I recall, now, I think it may have been @niccolo
I am MDI. No pumps. I have gone back country camping in temperatures ranging from -15C to -30C. You need to keep all of your diabetic toys close to your body. The closer you get to 0C, the less predictable they are. I am quite sure Big Pharm does not consider testing them below 0C. I did not have a CGM when camping in these temperatures. My glucometer worked fine when I kept it close to body temp and tested quickly. I have hiked above 3,300 metres. I know that many people have a difficult time breathing above 3,300m / 10,000ft. The air is thin, there is significantly less oxygen. The closer you live to sea level the harder it is to adjust to the thin air. I know people who lived at sea level and jogged every day. They moved to Calgary and had no idea why they had such a hard time jogging. They needed time to acclimatize - weeks or even months. Definitely bring much more emergency glucose / sugar bombs than you would at normal elevations.
Be very cautious with your insulin calibrations. When I am active at high elevations I have a hard time with my glucose levels. It can take a while to get my metabolism going, but once I do the insulin matabolism can be extremely efficient. If I expect to be active I cut my insulin by ~50%. I check glucose an hour or so after bolus and decide if I need to make adjustments. There have been many times when I took too much bolus and had to eat ridiculous amounts of food to stabilize
I ski at altitudes of up to 3500 meters. I’ve found that the cartridge in my Animus Ping pump has a lot more bubbles at altitude. The insulin vial that I use to fill the cartridges, is under greater pressure due to the expansion of air in the cartridge. I suspect that some of this air makes its way into the insulin that’s in the vial.
Bottom line, keep a close eye on the air bubbles in the cartridges you use with your pump.
I’ve found my Dexcom to be accurate at high altitude.
I keep both the CGM and pump (along with the tubing) & BG meters very close to my body to avoid cold related problems. At low temperatures, above freezing, BG meters won’t work.
Thanks for your reply. Very helpful info. Good to hear the Dexcom remains accurate at temperature.
May I ask how you carry insulin cartridges? I’m heading off for about seven weeks with quite a lot of time in below freezing temperatures? Leaving tomorrow.
