Intermittent Hypoxia for Blood Sugar Levels

Overseen By Sophie Lalande

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Must not be taking: Insulin, Antihypertensives

Disqualifiers: Hypertension, Smoking, Pregnancy, Cardiovascular, Lung, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

18 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are taking insulin or more than one blood pressure medication.

What data supports the effectiveness of the treatment Intermittent Hypoxia for Blood Sugar Levels?

Research shows that intermittent hypoxia can lower blood sugar levels in diabetic rats and may improve blood glucose concentrations in patients with type 2 diabetes, suggesting potential benefits for managing blood sugar. ^{1 2 3 4 5}

Is intermittent hypoxia safe for humans?

Research on intermittent hypoxia in animals suggests it may have protective effects on the brain and heart, and it has been studied for its potential benefits in managing blood sugar levels. However, specific safety data for humans is limited, so it's important to consult with a healthcare provider before considering this treatment. ^{2 3 5 6 7}

How does the treatment Intermittent Hypoxia differ from other treatments for blood sugar levels?

Intermittent Hypoxia is unique because it involves periodic exposure to low oxygen levels, which can improve glucose metabolism and insulin sensitivity by stimulating certain genes related to oxygen and glucose regulation. Unlike traditional treatments that may focus on medication or diet, this approach uses controlled oxygen deprivation to potentially manage blood sugar levels, especially in prediabetic and diabetic conditions. ^{2 8 9 10 11}

What is the purpose of this trial?

The aim of this research project is to determine the effect of intermittent hypoxia on glucose uptake in response to an oral glucose tolerance test in healthy individuals, individuals with prediabetes and patients with type 2 diabetes.

Research Team

Sophie Lalande

Principal Investigator

UT Austin

Eligibility Criteria

This trial is for healthy individuals, those with prediabetes, and patients with type 2 diabetes to study how low oxygen levels affect blood sugar control. Specific eligibility details are not provided.

Exclusion Criteria

I have a history of lung disease.

I am taking insulin or more than one blood pressure medication.

I have been diagnosed with diabetes-related complications by my doctor.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intermittent Hypoxia Exposure

Participants undergo intermittent hypoxia protocol consisting of eight 4-minute hypoxic cycles interspersed with normoxic cycles

1 hour

1 visit (in-person)

Oral Glucose Tolerance Test

Participants undergo a 2-hour oral glucose tolerance test with plasma glucose levels measured at specified intervals

2 hours

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the hypoxia exposure and glucose tolerance test

4 weeks

Treatment Details

Interventions

• Intermittent Hypoxia
• Intermittent Normoxia

Trial Overview The trial investigates the effects of intermittent hypoxia (periods of low oxygen) versus normal oxygen levels on the body's response to a glucose tolerance test.

Participant Groups

Group I: Intermittent hypoxia Experimental Treatment 1 Intervention

The intermittent hypoxia protocol will consist of eight 4-minute hypoxic cycles (arterial oxygen saturation of 80%) interspersed with normoxic cycles (room air) to resaturation.

Group II: Intermittent normoxia Placebo Group 1 Intervention

The intermittent normoxia protocol will consist of eight 4-minute normoxic cycles (compressed air) interspersed with 1-minute normoxic cycles (room air).

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Findings from Research

In a study of 183 patients with type 2 diabetes, 43% were found to have intermittent hypoxia, which was linked to poorer blood sugar control, indicated by higher HbA1c levels.

The study suggests that routine screening for sleep-disordered breathing is necessary in diabetes patients, as current questionnaire methods were ineffective, and further research is needed on how CPAP therapy might improve blood sugar management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus]. Burchakov, DI., Mayorov, AY.[2022]

Intermittent hypoxia treatment in type 1 diabetic rats significantly maintained lower fasting blood glucose levels compared to normoxic treatment, suggesting a protective effect on blood glucose metabolism.

The study found that intermittent hypoxia reduced plasma fructosamine levels and improved insulin resistance (HOMA-IR) in diabetic rats, indicating potential benefits for managing diabetes-related metabolic issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia maintains glycemia in streptozotocin-induced diabetic rats. Chen, X., Zhao, T., Huang, X., et al.[2018]

Moderate intermittent hypoxia (IH) over 10 sessions significantly reduced low-density lipoprotein cholesterol (LDLc), the LDLc/HDLc ratio, and systolic blood pressure (SBP) in overweight and obese subjects, indicating potential cardiovascular benefits.

While a single session of IH decreased blood glucose levels, no sustained changes were observed after the full 10 sessions, suggesting that IH may primarily impact certain lipid profiles and blood pressure rather than glucose metabolism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia revisited: a promising non-pharmaceutical strategy to reduce cardio-metabolic risk factors? Costalat, G., Lemaitre, F., Tobin, B., et al.[2019]

A single session of intermittent hypoxia (IH) in 14 patients with type 2 diabetes led to significant improvements in cardiorespiratory reflexes, including increased hypercapnic ventilatory responses and reduced ventilatory recruitment threshold, along with a notable decrease in blood glucose levels.

The beneficial effects of IH, such as improved oxygen saturation and blood pressure, were observed to last for up to 6 hours after the session, suggesting that longer-term IH interventions could provide further benefits for managing diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a single bout of interval hypoxia on cardiorespiratory control and blood glucose in patients with type 2 diabetes. Duennwald, T., Gatterer, H., Groop, PH., et al.[2021]

Intermittent hypoxia training (IHT) in Kunming mice led to significant reductions in body weight and serum glucose levels, while increasing serum leptin, insulin, and erythropoietin (EPO) levels after 40 days of treatment.

The study suggests that IHT may promote weight loss and improved glucose metabolism through increased EPO synthesis, which subsequently enhances leptin and insulin production in the liver.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Erythropoietin as a possible mechanism for the effects of intermittent hypoxia on bodyweight, serum glucose and leptin in mice. Qin, L., Xiang, Y., Song, Z., et al.[2016]

Intermittent hypobaric hypoxia (IHH) effectively protects the brain from injury caused by acute severe hypoxia (ASH) in rats, as shown by reduced oxidative stress and apoptosis-related damage.

The neuroprotective effects of IHH are linked to the downregulation of NF-κB and an increase in erythropoietin (EPO) levels, suggesting a mechanism that prevents oxidative injury and promotes cell survival.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intermittent Hypobaric Hypoxic Preconditioning Provides Neuroprotection by Increasing Antioxidant Activity, Erythropoietin Expression and Preventing Apoptosis and Astrogliosis in the Brain of Adult Rats Exposed to Acute Severe Hypoxia. Coimbra-Costa, D., Garzón, F., Alva, N., et al.[2021]

Chronic intermittent hypobaric hypoxia (CIHH) treatment in type-2 diabetic rats improved insulin resistance and reduced blood pressure, triglycerides, and cholesterol levels after 28 days of exposure to simulated high altitude.

The mechanism behind these benefits involves the enhancement of insulin signaling proteins and the reduction of harmful proteins, suggesting that CIHH could be a potential therapeutic approach for managing diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anti-diabetes effect of chronic intermittent hypobaric hypoxia through improving liver insulin resistance in diabetic rats. Tian, YM., Liu, Y., Wang, S., et al.[2016]

Intermittent hypoxia (IH) can enhance athletic performance at sea level by increasing blood oxygen capacity, although laboratory studies have not consistently shown significant physiological benefits.

The ideal commuting schedule for high altitude workers using IH is being researched, as well as the effects of oxygen enrichment at altitude, highlighting the need to understand the physiological mechanisms behind IH compared to continuous hypoxia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physiological effects of intermittent hypoxia. Powell, FL., Garcia, N.[2020]

Intermittent hypoxia training (IHT) over three weeks significantly improved blood glucose levels and glucose tolerance in prediabetic individuals, with the most notable effects observed one month after the training ended.

IHT also enhanced tolerance to acute hypoxia and increased the expression of hypoxia-inducible factor 1α (HIF-1α) and its target genes, suggesting a mechanism that may help prevent the progression to type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia training in prediabetes patients: Beneficial effects on glucose homeostasis, hypoxia tolerance and gene expression. Serebrovska, TV., Portnychenko, AG., Drevytska, TI., et al.[2019]

A study involving 8 healthy participants showed that 3 hours of intermittent hypoxia significantly increased plasma glucose levels from baseline, indicating a potential link between sleep apnea and elevated glucose concentrations.

Despite the increase in glucose levels, there were no changes in insulin sensitivity, suggesting that intermittent hypoxia affects glucose metabolism independently of insulin response.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Three hours of intermittent hypoxia increases circulating glucose levels in healthy adults. Newhouse, LP., Joyner, MJ., Curry, TB., et al.[2022]

In a study involving 10 overweight/obese men, hypoxic exercise (HE) did not significantly change mean 24-hour glucose levels compared to normoxic exercise (NE), indicating similar effects on glucose homeostasis under both conditions.

However, a greater reduction in systemic oxygen saturation during HE was linked to lower 24-hour and daytime glucose concentrations, suggesting that a stronger hypoxic stimulus may enhance glucose regulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of hypoxic exercise on 24-hour glucose profile and substrate metabolism in overweight and obese men with impaired glucose metabolism. van Meijel, RLJ., Blaak, EE., Goossens, GH.[2023]

References

1. Russia (Federation) pubmed.ncbi.nlm.nih.gov

[Intermittent hypoxia due to sleep apnea syndrome in patients with type 2 diabetes mellitus]. [2022]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia maintains glycemia in streptozotocin-induced diabetic rats. [2018]

3. Germany pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia revisited: a promising non-pharmaceutical strategy to reduce cardio-metabolic risk factors? [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Effects of a single bout of interval hypoxia on cardiorespiratory control and blood glucose in patients with type 2 diabetes. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Erythropoietin as a possible mechanism for the effects of intermittent hypoxia on bodyweight, serum glucose and leptin in mice. [2016]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Intermittent Hypobaric Hypoxic Preconditioning Provides Neuroprotection by Increasing Antioxidant Activity, Erythropoietin Expression and Preventing Apoptosis and Astrogliosis in the Brain of Adult Rats Exposed to Acute Severe Hypoxia. [2021]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Anti-diabetes effect of chronic intermittent hypobaric hypoxia through improving liver insulin resistance in diabetic rats. [2016]

8. United States pubmed.ncbi.nlm.nih.gov

Physiological effects of intermittent hypoxia. [2020]

9. England pubmed.ncbi.nlm.nih.gov

Intermittent hypoxia training in prediabetes patients: Beneficial effects on glucose homeostasis, hypoxia tolerance and gene expression. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Three hours of intermittent hypoxia increases circulating glucose levels in healthy adults. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Effects of hypoxic exercise on 24-hour glucose profile and substrate metabolism in overweight and obese men with impaired glucose metabolism. [2023]