Rebreathing for Hypoxia Effects on Glucose 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: 1

Duration: 2 hours

20 Participants Needed

Trial Summary

What is the purpose of this trial?

The aim of this research project is to determine the effect of repeated maximal voluntary apneas on glucose uptake during an oral glucose tolerance test in healthy individuals, individuals with prediabetes and patients with type 2 diabetes.

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 Rebreathing-induced hypoxia on glucose levels?

Research shows that intermittent hypoxia, similar to what might occur during rebreathing, can increase glucose levels in healthy adults. This suggests that the treatment could affect glucose metabolism, although more studies are needed to understand its full impact. ^{1 2 3 4 5}

Is rebreathing-induced hypoxia safe for humans?

Studies on intermittent hypoxia, which is similar to rebreathing-induced hypoxia, show that it can affect glucose levels and increase sympathetic nervous system activity (part of the body's stress response). However, these studies do not report any severe adverse effects, suggesting it may be generally safe in short-term exposure for healthy individuals. ^{1 2 3 4 6}

How does the treatment of rebreathing-induced hypoxia affect glucose levels compared to other treatments?

Rebreathing-induced hypoxia is unique because it involves controlled exposure to low oxygen levels, which can increase glucose levels in the blood without affecting insulin sensitivity. This approach is different from other treatments as it uses intermittent hypoxia to potentially influence glucose metabolism, a method not commonly used in standard diabetes treatments. ^{1 2 7 8 9}

Research Team

Sophie Lalande

Principal Investigator

UT Austin

Eligibility Criteria

This trial is for men and women aged 18 to 80 who are healthy, prediabetic, or have type 2 diabetes but not on insulin or multiple blood pressure meds. Smokers, pregnant individuals, those with lung diseases, uncontrolled high blood pressure, heart disease history or diabetic complications cannot participate.

Inclusion Criteria

I am between 18 and 80 years old.

Exclusion Criteria

You smoke cigarettes.

I have a history of heart or blood vessel disease.

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

Treatment

Participants undergo rebreathing-induced hypoxia or spontaneous breathing during an oral glucose tolerance test

2 hours

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Rebreathing-induced hypoxia
• Spontaneous breathing

Trial Overview The study tests how holding one's breath (rebreathing-induced hypoxia) affects blood sugar levels during a glucose tolerance test in different groups: healthy people, those with prediabetes and type 2 diabetics.

Participant Groups

Group I: Rebreathing-induced hypoxia Experimental Treatment 1 Intervention

Participants will rebreathe room air from a low-volume closed-circuit system for a period of 2 minutes.

Group II: Spontaneous breathing Placebo Group 1 Intervention

Participants will be spontaneously breathing during an oral glucose tolerance test.

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Findings from Research

Intermittent hypoxia, simulating conditions of obstructive sleep apnea, significantly decreased insulin sensitivity and glucose effectiveness in 13 healthy volunteers, indicating a potential link to metabolic dysfunction.

Despite the negative impact on insulin sensitivity, pancreatic insulin secretion remained unchanged, suggesting that intermittent hypoxia may disrupt glucose metabolism without affecting insulin production.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. Louis, M., Punjabi, NM.[2022]

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]

Mild intermittent hypoxia (MIH) exposure for 7 days significantly decreased oxygen levels in adipose tissue and skeletal muscle in 12 overweight/obese men, leading to increased glycolytic metabolism and enhanced carbohydrate oxidation.

Despite these metabolic changes, MIH did not improve tissue-specific insulin sensitivity, indicating that while MIH alters metabolic pathways, it may not directly address insulin resistance in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mild intermittent hypoxia exposure induces metabolic and molecular adaptations in men with obesity. van Meijel, RLJ., Vogel, MAA., Jocken, JWE., et al.[2022]

In a study of 3,310 participants, REM-related sleep-disordered breathing (SDB) was found to be associated with insulin resistance, while non-REM SDB was linked to fasting and post-prandial glucose levels.

This suggests that the impact of SDB on glucose metabolism differs between REM and non-REM sleep, highlighting the importance of considering sleep stages when assessing metabolic health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between Glucose Metabolism and Sleep-disordered Breathing during REM Sleep. Chami, HA., Gottlieb, DJ., Redline, S., et al.[2018]

In a study involving 12 men with type 2 diabetes, hyperbaric oxygen (HBO) therapy significantly reduced fasting blood glucose levels by 19% and improved insulin sensitivity in the whole body, liver, and white adipose tissue by about one-third compared to a control group.

The improvements in insulin sensitivity from HBO therapy are likely due to reduced endoplasmic reticulum stress and enhanced mitochondrial function, suggesting a potential mechanism involving low-dose reactive oxygen species that may benefit glucose metabolism in individuals with type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hyperbaric oxygen rapidly improves tissue-specific insulin sensitivity and mitochondrial capacity in humans with type 2 diabetes: a randomised placebo-controlled crossover trial. Sarabhai, T., Mastrototaro, L., Kahl, S., et al.[2023]

In a study involving 39 participants, including those with diabetes, traumatic brain injury, and healthy volunteers, blood glucose levels (BGL) decreased during both hyperbaric oxygen treatment (HBOT) and normobaric air sessions, indicating that the reduction is not unique to HBOT.

The decrease in BGL was statistically significant only in the control air session for the diabetic group, suggesting that the observed changes in BGL during HBOT may not be directly caused by the hyperbaric environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of hyperbaric oxygen on blood glucose levels in patients with diabetes mellitus, stroke or traumatic brain injury and healthy volunteers: a prospective, crossover, controlled trial. Peleg, RK., Fishlev, G., Bechor, Y., et al.[2014]

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]

Insulin action on glucose uptake significantly decreases within the first two days of exposure to high altitude (4559 m), with rates halving compared to sea level, but shows improvement by day seven.

Despite unchanged hepatic glucose production during altitude exposure, increased levels of glucose and counter-regulatory hormones like noradrenaline suggest that altitude hypoxia affects glucose homeostasis and insulin sensitivity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of altitude hypoxia on glucose homeostasis in men. Larsen, JJ., Hansen, JM., Olsen, NV., et al.[2019]

In young dogs, glucose-induced insulin release remains normal during chronic hypoxia, but is significantly inhibited during acute severe hypoxia, indicating that extreme low oxygen levels can disrupt insulin secretion.

Moderate hypoxia, whether acute or chronic, does not negatively impact the insulin response to glucose, suggesting that only severe hypoxic conditions affect this metabolic process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Glucose-induced insulin release during acute and chronic hypoxia. Baum, D., Griepp, R., Porte, D.[2018]

References

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

Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. [2022]

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

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

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

Mild intermittent hypoxia exposure induces metabolic and molecular adaptations in men with obesity. [2022]

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

Association between Glucose Metabolism and Sleep-disordered Breathing during REM Sleep. [2018]

5. Germany pubmed.ncbi.nlm.nih.gov

Hyperbaric oxygen rapidly improves tissue-specific insulin sensitivity and mitochondrial capacity in humans with type 2 diabetes: a randomised placebo-controlled crossover trial. [2023]

6. Australia pubmed.ncbi.nlm.nih.gov

Effects of hyperbaric oxygen on blood glucose levels in patients with diabetes mellitus, stroke or traumatic brain injury and healthy volunteers: a prospective, crossover, controlled trial. [2014]

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

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

8. England pubmed.ncbi.nlm.nih.gov

The effect of altitude hypoxia on glucose homeostasis in men. [2019]

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

Glucose-induced insulin release during acute and chronic hypoxia. [2018]