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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how intermittent hypoxia (short periods of low oxygen) affects blood sugar levels in healthy individuals, those with prediabetes, and those with type 2 diabetes. The study compares two groups: one experiences hypoxic cycles, while the other undergoes normoxic cycles (normal oxygen levels) as a control. Ideal candidates for this trial have type 2 diabetes or prediabetes, do not have serious heart or lung conditions, and are not on insulin or multiple blood pressure medications. Participants should also have well-controlled diabetes without complications such as nerve or kidney problems. As an unphased trial, this study offers participants a unique opportunity to contribute to groundbreaking research on diabetes management.

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 prior data suggests that this protocol is safe for glucose uptake studies?

Research has shown that intermittent hypoxia, which involves alternating between low and normal oxygen levels, is usually well-tolerated. One study found that it can help control blood sugar in people with type 2 diabetes after just one session, suggesting it might be safe for individuals with similar health conditions.

Another study found that moderate hypoxia, or reduced oxygen levels, can lower blood sugar and cholesterol and improve insulin use. Insulin is a hormone that helps manage blood sugar levels.

While these findings are encouraging, they mainly focus on short-term effects. More research is needed to understand long-term safety. Those with concerns should consult a healthcare provider before joining a trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Intermittent hypoxia is unique because it offers a novel approach to managing blood sugar levels by alternating between low oxygen (hypoxia) and normal oxygen (normoxia) states. Unlike traditional treatments like insulin or oral medications that directly target blood sugar levels, this method aims to improve metabolic health through controlled oxygen variation. Researchers are excited about this technique because it has the potential to enhance insulin sensitivity and glucose metabolism in a non-invasive way, potentially providing an alternative or complementary option to existing therapies.

What evidence suggests that intermittent hypoxia could be effective for blood sugar levels?

This trial will compare the effects of intermittent hypoxia and intermittent normoxia on blood sugar levels. Studies have shown that intermittent hypoxia, which involves short periods of low oxygen, can affect the body in various ways. Some research suggests it might boost performance and health by encouraging positive changes, especially when combined with exercise. However, one study found that intermittent hypoxia raised blood sugar levels in healthy people without altering their insulin response. While there might be benefits, its effect on blood sugar remains unclear and requires further investigation. Overall, intermittent hypoxia shows promise, but more research is needed to fully understand its effects on blood sugar and diabetes management. ^{4 6 7 8 9}

Who Is on the Research Team?

Sophie Lalande

Principal Investigator

UT Austin

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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 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]

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 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]

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]

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]

Citations

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Three hours of intermittent hypoxia increases circulating ... Circulating glucose is increased after 3 h of intermittent hypoxia in healthy humans, independent of any lasting changes in insulin sensitivity.

2. liebertpub.com liebertpub.com/doi/10.1089/ham.2019.0053

Intermittent Hypoxia/Hyperoxia Versus ... The present study was devoted to a detailed comparison of two types of hypoxic training, namely hypoxic/normoxic and hypoxic/hyperoxic ...

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Intermittent hypoxia conditioning as a potential prevention ... This review discusses the preclinical perspectives on IH conditioning as a potential treatment for neurovascular injury and highlights IH pre and ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9961389/

Effectiveness of Intermittent Hypoxia–Hyperoxia Therapy in ... Intermittent oxygen therapy (IHT), initially used in the hypoxic administration variant, has been shown to be effective in various pathologies studied.

5. sportsmedicine-open.springeropen.com sportsmedicine-open.springeropen.com/articles/10.1186/s40798-022-00450-x

Effects of Intermittent Hypoxia–Hyperoxia on Performance ... Intermittent hypoxia applied at rest or in combination with exercise promotes multiple beneficial adaptations with regard to performance and health in humans.

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Intermittent Hypoxia Conditioning: A Potential Multi-Organ ... Intermittent hypoxia conditioning hormesis alternates exposure to hypoxic and normoxic conditions, facilitating adaptation to reduced oxygen availability.

7. journals.physiology.org journals.physiology.org/doi/full/10.1152/ajpheart.00060.2018

Cardioprotection by intermittent hypoxia conditioning IHC improves glycemic control in patients with type 2 diabetes, reducing blood glucose and postprandial glucose tolerance after one session (45). These ...

8. frontiersin.org frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.878278/full

Effects of Intermittent Hypoxia in Training Regimes and in ... This review aims to systematically summarize the available studies on the effects of IHNT, IHHT, and OSA on aging and age-related diseases.

9. journals.physiology.org journals.physiology.org/doi/full/10.1152/ajpregu.00208.2014

Therapeutic potential of intermittent hypoxia: a matter of dose Moderate hypoxia (14.6% inspired O2) reduces blood glucose and cholesterol levels (33, 116) and increases insulin sensitivity in subjects with Type 2 diabetes ...