About this Research Topic
Diabetes is major problem in public health. Diabetes is linked to severe chronic complications and is one of the leading causes of death. Recent reports have estimated that diabetes affects nearly 420 million adult individuals worldwide. Thus, more studies are needed to understand the cause of diabetes and ultimately prevent or cure this disease. An interesting observation is that populations living at high altitude (defined arbitrarily as an elevation ≥1,500 m above sea level), particularly in the Andes and high elevations of North America, have lower prevalence of diabetes and obesity (a major risk factor for diabetes) compared with populations living at low altitude. Possible biological mechanisms underlying this inverse association come from in vitro studies showing that hypoxia stimulates glucose uptake in the skeletal muscle, an important biological event that not only provides fuel to the living organism but also prevents persistent elevation of blood glucose levels, a pre-condition for the development of diabetes. Rodent and small clinical studies have also reported improved insulin sensitivity (in vivo glucose uptake) under hypoxic conditions. However, several questions remain unanswered. Is the inverse association between altitude and diabetes/obesity ethnicity-specific? For example, do Ethiopian populations living at high altitude have lower prevalence of diabetes than those living at low altitude? Is the inverse association between altitude and diabetes related to the effect of altitude per se or does this represent differences in lifestyle (or other modifiable beneficial factors) between low-and high-altitude populations? Is hypoxia the only altitude-related factor involved in the potential lower risk of diabetes when living at high altitude?
The aim of the present Research Topic is to bring together rigorous scientific papers about diabetes/obesity and high altitude. Specifically, we encourage the submission of manuscripts on basic, translational and clinical research to provide 1) further evidence or refutation of the inverse association between altitude and diabetes/obesity prevalence in populations of different ethnicities around the globe; 2) further experimental evidence (in vitro and in vivo) of the effects of altitude-related factors, namely mainly hypoxia, hypobaria, and cold temperature, on glucose homeostasis, including but not limited to fasting glycemia, glucose tolerance, insulin resistance, insulin secretion, estrogens, inflammation; 3) further evidence of the effect of relatively short-term exposure to high altitude on individuals with diabetes (type 1 or type 2) and its repercussion on diabetes management. 4) new insights into the cellular and molecular mechanisms of the effect of hypoxia on glucose and fat metabolism.
In summary, this Research Topic ambitions to serve as a bridge between basic and clinical studies to advance the knowledge of the relationship between diabetes/obesity and high altitude. A better understanding of this relationship and the cellular and molecular mechanisms will provide, we hope, insights and stimulate the identification of new potential targets for prevention or cure of diabetes.
Keywords: Hypoxia, Mechanisms, Glucose, Fat, Metabolism
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