Humans living at a higher altitude are less prone to suffer from impaired
glucose homeostasis and
type 2 diabetes mellitus (T2DM), which might at least partly be explained by lower
oxygen availability at higher altitudes. The present systematic review aimed to provide an overview of the current literature on the effects of
hypoxia exposure on
glucose homeostasis in metabolically compromised humans. Several databases were searched up to August 10th, 2020. The search strategy identified 368 unique records. Following assessment for eligibility based on the selection criteria, 16 studies were included in this review. Six studies (2 controlled studies; 4 uncontrolled studies) demonstrated beneficial effects of
hypoxia exposure on
glucose homeostasis, while 10 studies (8 controlled studies; 2 uncontrolled studies) reported no improvement in
glucose homeostasis following
hypoxia exposure. Notably, passive
hypoxia exposure seemed to improve
glucose homeostasis, whereas hypoxic exercise training (2-8 weeks) appeared to have no additional/synergistic effects on
glucose homeostasis compared to normoxia exposure. Due to the heterogeneity in study populations and intervention duration (acute studies / 2-8 wks training), it is difficult to indicate which factors may explain conflicting study outcomes. Moreover, these results should be interpreted with some caution, as several studies did not include a control group. Taken together,
hypoxia exposure under resting and exercise conditions might provide a novel therapeutic strategy to improve
glucose homeostasis in metabolically compromised individuals, but more randomized controlled trials are warranted before strong conclusions on the effects of
hypoxia exposure on
glucose homeostasis can be drawn.