For a long time, it has been observed that people living at high altitudes with lower oxygen levels have a lower incidence of diabetes compared to those living at sea level. Despite well-documented statistics, the biological reasons for this phenomenon remained unclear.

Recent studies have shown that under low oxygen conditions, red blood cells begin to absorb glucose from the bloodstream more actively. In such environments, these cells act as reservoirs for sugar, a trait typical of people living in mountainous regions. Data published in Cell Metabolism demonstrated that red blood cells can alter their metabolism when oxygen levels drop, which helps deliver oxygen to tissues more efficiently while simultaneously lowering blood sugar levels. This may explain the reduced risk of developing diabetes at higher altitudes.

Experiments on mice revealed that exposure to low-oxygen air led to a sharp decrease in blood glucose levels, and the removal of sugar from the blood after eating occurred more rapidly—an effect usually associated with a lower risk of diabetes. However, analysis of major organs did not clarify exactly where the glucose was being used.

Using visualization techniques, researchers discovered that red blood cells absorb and utilize a significant amount of glucose from the bloodstream, a fact previously overlooked since these cells were traditionally considered only as oxygen carriers.

Further experiments confirmed that in low-oxygen conditions, animals produce more red blood cells, and each cell absorbs more glucose compared to those formed under normal oxygen levels.

To uncover the molecular mechanisms behind this process, scientists specializing in red blood cell biology collaborated and found that under oxygen deficiency, red blood cells use glucose to form molecules that promote the release of oxygen into tissues—a process especially important when oxygen is scarce.

It was also found that the metabolic benefits of prolonged hypoxia persist in mice for weeks and months after returning to normal oxygen levels.

In subsequent studies, the drug HypoxyStat, which mimics the effects of low oxygen, was tested. Taken as a tablet, this drug increases the binding of oxygen to hemoglobin in red blood cells, limiting its delivery to tissues. In mouse models of diabetes, HypoxyStat completely eliminated high blood sugar and outperformed existing treatment methods.

The results obtained may be relevant not only for diabetes. Changes in the production and metabolism of red blood cells can affect glucose availability and muscle performance, which is important for physical activity and in cases of pathological hypoxia after injury.

Research in this area is ongoing, and it remains to be seen how the body adapts to changes in oxygen levels and how these mechanisms can be used to treat various diseases.