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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different breathing techniques might affect glucose levels in the body. Participants will either breathe normally or use a rebreathing method that temporarily lowers oxygen levels (rebreathing-induced hypoxia). The researchers aim to determine how these methods impact glucose uptake in healthy individuals, those with prediabetes, and people with type 2 diabetes. Individuals with type 2 diabetes or prediabetes may qualify if they do not have serious heart or lung issues and are not on certain medications. As an unphased trial, this study provides a unique opportunity to contribute to groundbreaking research on non-drug interventions for glucose 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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that breathing air with lower oxygen levels for short periods, known as rebreathing-induced hypoxia, affects blood sugar levels. Studies have found that this method can reduce blood sugar in people with type 2 diabetes and prediabetes. Importantly, no serious side effects have been reported, indicating that the treatment is generally safe.

In earlier research, participants experienced a drop in blood sugar without harmful effects on their oxygen levels. Careful control of the duration and amount of low-oxygen air ensures safety. Overall, evidence suggests that rebreathing-induced hypoxia can be safely used, under supervision, to study its effects on blood sugar levels. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about this trial because it explores how rebreathing-induced hypoxia affects glucose levels, a novel approach to understanding metabolic responses. Unlike standard methods that focus on medications or lifestyle changes to manage glucose levels, this technique involves a simple, non-invasive method of rebreating room air in a controlled manner. This could uncover new insights into how short-term oxygen deprivation impacts glucose metabolism, potentially leading to innovative strategies for managing glucose-related conditions.

What evidence suggests that this trial's treatments could be effective for glucose uptake in individuals with prediabetes and type 2 diabetes?

Research has shown that rebreathing-induced hypoxia, which participants in this trial may experience, can improve how the body processes sugar, particularly in adults with type 2 diabetes. This method involves inhaling a reduced amount of air, temporarily lowering oxygen levels in the body. Studies have found that this low-oxygen state can help muscles absorb sugar without insulin. In some cases, it has also lowered sugar levels in people with diabetes. These findings suggest that rebreathing-induced hypoxia might effectively manage sugar levels. Meanwhile, another group in this trial will undergo a spontaneous breathing trial as a comparator. ^{1 2 6 7 8}

Who Is on the Research Team?

Sophie Lalande

Principal Investigator

UT Austin

Are You a Good Fit for This Trial?

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.

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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 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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2681331/

Effects of acute intermittent hypoxia on glucose metabolism in ... It was hypothesized that, in healthy volunteers, exposure to short-term intermittent hypoxia would decrease insulin sensitivity, glucose effectiveness, and ...

2. trialx.com trialx.com/clinical-trials/listings/230769/rebreathing-induced-hypoxia-and-glucose-levels/

Rebreathing-induced Hypoxia and Glucose Levels Thus, the aim of this research project is to determine the effect of few bouts of rebreathing-induced hypoxia on glucose uptake during an oral glucose tolerance ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12527985/

Rebreathing‐induced hypoxemia improves glucose ... However, rebreathing‐induced hypoxemia improved glucose tolerance in adults with type 2 diabetes.

4. withpower.com withpower.com/trial/phase-hypoxia-9-2021-08c4b

Rebreathing for Hypoxia Effects on Glucose Levels Studies on intermittent hypoxia, which is similar to rebreathing-induced hypoxia, show that it can affect glucose levels and increase sympathetic nervous system ...

5. researchgate.net researchgate.net/publication/396520377_Rebreathing-induced_hypoxemia_improves_glucose_tolerance_in_adults_with_type_2_diabetes/download

(PDF) Rebreathing‐induced hypoxemia improves glucose ... Hypoxia stimulates glucose uptake in isolated skeletal muscle through an insulin‐independent pathway. Intermittent hypoxia can lower glucose ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5648288/

Intermittent hypoxia training in prediabetes patients: Beneficial ... We found that IHT afforded beneficial effects on glucose homeostasis in patients with prediabetes reducing fasting glucose and during standard ...

7. diabetesjournals.org diabetesjournals.org/care/article/36/8/2183/33071/Effects-of-a-Single-Bout-of-Interval-Hypoxia-on

Effects of a Single Bout of Interval Hypoxia on ... Blood glucose significantly decreased after IH. No such changes were observed during the placebo day, except an increase in oxygen saturation.

8. researchgate.net researchgate.net/publication/360364872_Effect_of_Intermittent_Hypoxia_on_Plasma_Glucose_Levels_during_an_Oral_Glucose_Tolerance_Test

Effect of Intermittent Hypoxia on Plasma Glucose Levels ... The aim of this study was to examine the acute effect of rebreathing-induced hypoxia on plasma glucose and insulin levels in adults with type 2 ...