Clinical research

Two weeks of moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes


We previously showed that nightly exposure to moderate hypoxia reduces fasting glucose levels and improves both whole-body skeletal muscle and hepatic insulin sensitivity in individuals with obesity. The goal of this study was to extend this observation in an “at home” setting and determine if nightly exposure to moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Eight adults, ages 20–65 years with type 2 diabetes enrolled in our study and slept for 14 consecutive nights at home in a hypoxic tent maintained at 15% O2 (~2400 m). The primary endpoint was insulin sensitivity (Matsuda Index) calculated from a 75-g oral glucose tolerance test. Secondary endpoints included calculations of insulin secretion and beta-cell function, including the area-under-the-curve (AUC) for glucose and insulin, the Insulinogenic Index, and the Disposition Index. We observed the Matsuda Index trended towards a 29% increase following 14 nights of moderate hypoxia (from 1.7 ± 0.7 to 2.2 ± 1.7; p = 0.06). Two-hour glucose AUC was significantly reduced from 501 ± 99 to 439 ± 65 mg/dL × h (p = 0.01). We conclude that 14 nights of moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Future studies should confirm whether exposure to moderate hypoxia consistently improves glucose homeostasis in larger sample sizes.

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Fig. 1

Data availability

The dataset pertaining to the current study is available from the corresponding authors in accordance with appropriate data use agreements and IRB approvals for secondary analyses.


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The authors thank Robbie A. Beyl, PhD, of PBRC for his assistance in the statistical analysis.


This research was internally funded through the Louisiana State University’s Leveraging Innovation for Technology Transfer (LIFT2) Grant (#LIFT-14B-14). This research is also partially supported by the NIDDK sponsored Ruth L Kirschstein National Research Service T32 Research Training Grant (T32-DK064584 to KLM) and a NORC Center Grant (P30DK072476 to ER).

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KLM conducted research, interpreted data, and drafted most of the manuscript; FLG provided medical oversight for data collection, interpreted data, and edited the manuscript; JKS conducted research, interpreted data, and edited the manuscript; ER designed study, conducted research, interpreted data, edited the manuscript, and has primary responsibility for final content. All authors approved the final manuscript before submission.

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Correspondence to Eric Ravussin.

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Conflict of interest

ER is the inventor of the used technology and is seeking patent protection. FLG has a patent application that is pending for an insulin sensitizer. The remaining authors declare that they have no conflict of interest.

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Marlatt, K.L., Greenway, F.L., Kyle Schwab, J. et al. Two weeks of moderate hypoxia improves glucose tolerance in individuals with type 2 diabetes. Int J Obes 44, 744–747 (2020).

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