“The study demonstrates how vital the role of red blood cells is in diabetes management,” Isha Jain, who conducted the study and is a biochemist at the Gladstone Institutes and the University of California, San Francisco, told the Live Science website. “That’s the concept to be targeted in the future.”

Experiments that revealed the link

To understand what was happening, scientists exposed mice to air containing just 8 per cent oxygen, similar to high-altitude conditions, while another group remained in normal air with 21 per cent oxygen.

After several weeks, both groups received glucose injections. The findings were dramatic. Animals from the low-oxygen environment exhibited considerably lower glucose peaks, indicating that their bodies processed the sugar much faster. This trend persisted even when the mice returned to regular oxygen conditions, implying metabolic changes.

Upon examining the data in detail, the scientists observed an anomaly. The decrease in glucose was not fully accounted for by its absorption in organs such as the liver or muscles. As a result, the researchers suspected that blood cells played a role in the phenomenon.

Red blood cells in the spotlight

Subsequent experiments supported this hypothesis. Researchers found that lowering red blood cell counts in oxygen-starved mice eliminated the glucose-lowering effect. Conversely, enhancing the red blood cell concentration in regular mice resulted in reduced blood sugar.

Tracking glucose inside the body revealed that red blood cells in low-oxygen conditions absorbed far more sugar than usual, about three times more. These cells also contained higher levels of a protein called GLUT1, which helps glucose enter the cell.

The absorbed glucose was then converted into a compound that binds to haemoglobin, the protein responsible for carrying oxygen. This development assists in facilitating the release of oxygen from haemoglobin, which is critical during oxygen deficiency.

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Experts rationalise the process by stating that increased erythrocyte production leads to increased glucose utilisation, which reduces blood glucose levels.

Approach to diabetes treatment

The results can pave the way for novel approaches in diabetes treatment. Researchers conducted studies on HypoxyStat, an experimental drug that replicates the condition of oxygen deficiency through the interaction of haemoglobin with oxygen.

However, researchers caution that much more work is needed before such treatments can be tested in humans.

Still, the study points to a new way of thinking about diabetes, not just as a problem of insulin, but as something that could also be influenced by how red blood cells manage oxygen and glucose.