# Rebreathing‐induced hypoxemia improves glucose tolerance in adults with type 2 diabetes

## TL;DR

Breathing techniques that cause low oxygen levels may help improve blood sugar control in people with type 2 diabetes and obesity.

## Contribution

Rebreathing-induced hypoxia is proposed as a novel, non-invasive strategy to improve glucose tolerance in type 2 diabetes.

## Key findings

- Participants achieving hypoxemia during rebreathing had significantly lower glucose concentrations and AUC.
- Body weight was strongly correlated with oxygen desaturation and glucose AUC during rebreathing.
- Rebreathing-induced hypoxia may be a promising strategy for glycemic control in type 2 diabetes with obesity.

## Abstract

Hypoxia stimulates glucose uptake in isolated skeletal muscle through an insulin‐independent pathway. Intermittent hypoxia can lower glucose concentration in adults with type 2 diabetes, but its application remains limited by the use of gas tanks to induce hypoxia. The aim of this study was to examine the effect of rebreathing‐induced hypoxia on glucose and insulin responses to an oral glucose tolerance test in adults with type 2 diabetes. Ten adults with type 2 diabetes performed an oral glucose tolerance test during either rebreathing‐induced hypoxia or spontaneous breathing. The glucose and insulin responses to the oral glucose tolerance test did not differ between rebreathing‐induced hypoxia and spontaneous breathing. However, participants who achieved hypoxemia, defined as an oxygen saturation nadir below 90%, during rebreathing‐induced hypoxia (n = 5) showed lower glucose concentrations and glucose area under the curve (AUC) (20,376 ± 553 vs. 24,346 ± 639, p < 0.01) than participants who achieved an oxygen saturation nadir above 90% (n = 5). Interestingly, body weight was strongly correlated with oxygen desaturation (r = −0.87, p < 0.01) and glucose AUC (r = −0.81, p < 0.01) during rebreathing‐induced hypoxia. Rebreathing‐induced hypoxia may represent a promising strategy to improve glycemic control in adults with type 2 diabetes and coexisting obesity.