Ashhar Alam/New Delhi

For years, scientists have noticed a curious trend: people living at high altitudes appear less likely to develop diabetes. Now, new research has uncovered a biological explanation that could reshape the way the disease is treated.

A team at the Gladstone Institutes has found that when oxygen levels drop a condition known as hypoxia, red blood cells dramatically change the way they function. Instead of acting solely as oxygen carriers, they begin absorbing large amounts of glucose from the bloodstream, effectively lowering blood sugar levels.

The findings, published in Cell Metabolism, suggest that under low-oxygen conditions, red blood cells switch into a different metabolic mode. This shift helps the body cope with thin air by improving oxygen delivery to tissues. At the same time, it reduces circulating glucose offering a potential explanation for lower diabetes rates at higher elevations.

Senior author Isha Jain, a professor of biochemistry at University of California San Francisco, said the discovery highlights an overlooked aspect of human metabolism. According to her, red blood cells represent a previously underappreciated “glucose sink” that could be harnessed to control blood sugar.

The breakthrough came after researchers observed that mice exposed to low-oxygen air cleared glucose from their bloodstream at an unusually fast rate. Surprisingly, traditional glucose-consuming organs such as the liver, muscles, and brain did not account for the rapid drop. Advanced imaging techniques revealed that red blood cells were absorbing and utilizing the excess sugar.

Further experiments showed that hypoxia not only increased the number of red blood cells but also enhanced each cell’s capacity to take up glucose. Collaborating with experts from the University of Colorado Anschutz Medical Campus and the University of Maryland, the team identified the molecular process behind the change. Under oxygen scarcity, red blood cells use glucose to produce molecules that facilitate oxygen release to tissues, a crucial adaptation in low-oxygen environments.

In a promising development, researchers also tested an experimental pill called HypoxyStat, designed to mimic the effects of low oxygen. In diabetic mouse models, the drug significantly reduced high blood sugar levels and even outperformed some existing treatments.

The study’s implications extend beyond diabetes. Experts believe the findings could influence exercise science and trauma care, where oxygen availability plays a critical role in recovery and metabolic balance.

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While more human studies are needed, the research opens a new frontier in diabetes therapy, one that focuses not on traditional organs like the pancreas or liver, but on red blood cells themselves.

As Jain notes, understanding how the body adapts to oxygen changes may unlock innovative strategies to tackle metabolic diseases and beyond.