UIAA Medical Commission Recommendations for Mountaineers, Hillwalkers, Trekkers, and Rock and Ice Climbers with Diabetes

Abstract

UIAA Medical Commission recommendations for mountaineers, hillwalkers, trekkers, and rock and ice climbers with diabetes. High Alt Med Biol 00:000-000, 2018.-The object of this advice article is not only to give the diabetic mountaineer general guidance but also to inform his or her medical team of practical aspects of care that may not be standard for nonmountaineers. The guidelines are produced in seven sections. The first is an introduction to the guidelines, and the second is an introduction to this medical problem and is designed to be read and understood by diabetic patients and their companions. The third section is for use in an emergency in mountains. The fourth is for rock, ice, and competition climbers operating in a less remote environment. These initial sections are deliberately written in simple language. The fifth and sixth sections are written for clinicians and those with skills to read more technical information, and the seventh looks at modern technology and its pros and cons in diabetes management in a remote area. Sections One and Two could be laminated and carried when in the mountains, giving practical advice.

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

“…Despite lack of robust evidence and few reported cases, experts recommend that women should consider avoiding CHC if they are to spend more than a week above 4500 m (14 764 feet) 376. Below this altitude, use of CHC is likely to be safe in a healthy, active, non-smoking woman with no personal or family history of venous thrombosis or thrombophilia.…”

Analyzing Injury Patterns in Climbing: A Comprehensive Study of Risk Factors

“…Risks are increased for advanced climbers by wearing small and strongly curved shoes [ 10 , 57 ], as such footwear increases the likelihood of injuries during landings by keeping the foot in a supinated position, thereby lengthening the peroneus longus and brevis muscles, which are important for ankle stability [ 58 ]. Wearing climbing shoes that are too small leads to chronic changes and injuries, including changes in the step and the development of transverse (and longitudinal) flat feet and in diabetics, to neuropathy [ 59 , 60 , 61 ]. It can also lead to the development of hallux valgus, which should be particularly avoided in children [ 62 ].…”

High Altitude Neurology

“…There is no evidence that previous peripheral damage can progress at altitude. Paulson et al found that Charcot Marie Tooth patients were at risk of developing dysarthria, incoordination, and difficulty walking after returning from skiing at 8000 ft in the Colorado mountains 48 .…”

“…With the abovementioned premises, screening for the presence of sleep apnoea is advisable before traveling at high altitudes and, if sleep disturbance is detected, they should travel with non-invasive ventilatory support 48 . Risk factors known to be related to altitude exposure should be assessed in PD patients (e.g., prior history of AMS, prior history of headache at HA, etc.)…”