How Tobias Steinberger conquers the 82 four-thousanders as a diabetic – Challenges, strategies and medical pioneering work at extreme altitudes
To be the first diabetic worldwide to independently climb all 82 four-thousanders – a medical and mountaineering pioneering achievement
"Whether at the waterfall in front of the Matterhorn or at -15°C and thin air - the diabetes technology must function"
Type 1 diabetes for over 35 years – what would mean the end of extreme sporting ambitions for many, became the driving force for Tobias's greatest challenge.
"When I received the diagnosis 35 years ago, the doctor told me: 'Forget extreme sports.' Today I prove the opposite every day. Every summit is a victory over this prognosis."
- Tobias Steinberger
💪 "Diabetes is not an obstacle – it's an additional variable that can be mastered."
🔧 Modern Technology: Tubeless insulin pump + CGM with loop system for optimal control
World Record Attempt – To be the first diabetic to conquer all 82 four-thousanders without a mountain guide and prove that diabetes is no limit for extraordinary achievements.
⚠️ No diabetic has yet mastered this challenge
🏔️ Technical Challenge: Pump & CGM only approved up to 3000m - individual tests required above
Extreme cold slows insulin action and can impair blood glucose meters. Special storage required.
Oxygen deficiency can affect blood sugar levels and mask symptoms of hypo-/hyperglycemia.
Extreme calorie consumption requires constant adjustment of insulin-carbohydrate ratio during long tours.
Mountain air and exertion lead to rapid dehydration, which can destabilize blood sugar levels.
Early starts and poor sleep at altitude significantly affect insulin resistance.
Insulin pump between shoulder blades (only place without equipment). Protect insulin, CGM and backup equipment from cold below -20°C.
"At -20°C at 4200m altitude, batteries can drain extremely quickly due to the cold. I systematically carry all electronic devices directly on my body. The insulin pump between the shoulder blades is the only place where it cannot be torn off by the climbing harness or backpack."
"Once my pump failed due to the altitude. Without the backup syringe and the insulin carried on my body, the tour would have been over. I always carry double equipment - the weight is worth it."
"The automatic system adapts my insulin to the exertion while I focus on climbing. But above 3000m the devices are officially not approved and I have to be doubly vigilant."
Detailed Planning
Set blood sugar target values for different activity phases
Redundancy System
Backup for everything: Syringe + insulin in addition to pump, manual blood glucose meter, batteries
Medical Consultation
Adjust basal rate and discuss emergency protocols
Frequent Measurements
Check blood sugar every 30-60 minutes
Continuous Carbohydrates
Small, regular portions instead of large meals
Temperature Management
Insulin & electronics on body at -20°C, loop system for automatic adjustment
"Pump change at 4 AM in a winter room at 4,550m altitude at 5 degrees room temperature."
Blood sugar below 70 mg/dl
Immediate tour stop
15g fast carbohydrates (glucose)
Wait 15 minutes, measure again
Initiate descent if necessary
Blood sugar above 250 mg/dl
Perform ketone body test
Correction insulin according to scheme
Drink plenty (sugar-free liquid)
If ketones > 1.5: Immediate descent
⚠️ Danger: Hyperglycemia symptoms resemble ketoacidosis - regular ketone tests essential!
"Diabetes is not the end of your dreams – it's the beginning of a new way to realize them. Every summit I reach is proof that limits only exist in our minds."
"Millions of diabetics worldwide hear daily: 'That's not possible.' I want to prove that with proper preparation and technology, almost anything is possible. Every summit is a signal to all affected: Keep dreaming!"
"The emails from diabetics who start exercising again after my tours. The children who don't give up despite diagnosis. That's worth more than any summit. This challenge is for all of them."
Regular consultation and therapy adjustment for extreme exertion at different altitudes.
Specialist for the effects of altitude and extreme exertion on diabetic metabolism.
Continuous monitoring of blood sugar levels via CGM system with alarm function for emergencies.
Accompany the first diabetic on his way to all 82 four-thousanders. Every tour is a medical experiment and an inspiration for millions of diabetics worldwide.
⚠️ Important Note: This information does not replace medical advice. Diabetics should always discuss extreme activities with their doctor.
