An observation that has attracted the attention of scientists for years has received a new explanation: people living at high altitudes, where oxygen is scarcer, are less likely to develop diabetes. Data from epidemiological studies in regions such as the Andes and the Himalayas show a lower incidence of the disease compared to populations at sea level, even with a similar lifestyle.
For a long time, the reason for this relationship remained unclear. A new study, published in the journal Cell Metabolism and conducted by a team from the Gladstone Institutes, proposes a mechanism that puts an unexpected “player” -red blood cells- at the center of the process.
Traditionally, these cells are considered to be a transport mechanism for oxygen. However, new data show that in a state of Hypoxia they change their function and begin to actively participate in the regulation of blood sugar. At low oxygen levels, red blood cells increase their ability to absorb glucose from the blood, acting as a kind of “buffer“ for excess sugar.
The effect was established in experiments with animal models, in which after a meal, a significantly faster decrease in blood glucose was observed. Initially, researchers sought an explanation in classic metabolic organs such as the liver, muscles and brain, but did not find sufficient data. The analysis shows that it is red blood cells that absorb a large part of the glucose, and in hypoxia both their number and metabolic activity increase.
Additional biochemical studies indicate that the absorbed glucose supports the synthesis of molecules that optimize the release and delivery of oxygen to the tissues. Thus, the body simultaneously compensates for the lack of oxygen and improves glycemic control – a mechanism that could explain the observed lower rates of diabetes in people living at high altitudes.
As part of the same study, scientists are testing an experimental compound known as HypoxyStat, which mimics the effects of hypoxia at the cellular level. In laboratory models of diabetes, the drug led to significant reductions in blood sugar, in some cases comparable to or better than standard therapies. Such approaches fit into a broader trend in modern medicine to develop therapies that target metabolic processes outside of classic organs such as the pancreas.
Experts emphasize that the results should be interpreted with caution. The data are mainly obtained from preclinical models, and the effects in humans have yet to be confirmed through clinical trials. Furthermore, prolonged exposure to hypoxia can have adverse effects, including on the cardiovascular and pulmonary systems, which limits the direct application of such an approach.
Nevertheless, the discovery expands the understanding of metabolic regulation and places red blood cells as a potential new therapeutic target. In the context of the global increase in diabetes - according to the World Health Organization, more than 400 million people worldwide live with the disease - such mechanisms may open the way to new strategies for control and treatment.