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In individuals with Type 2 Diabetes (T2D), there is an observed increase in Gram-negative Enterobacteriaceae and a concurrent decrease in acetic acid-producing bacteria, such as Bifidobacteria

Thus, it occurs when you're in a transitional phase

(4) quantified and showed the durability of this phenomenon in chronic obstructive pulmonary disease (COPD) patients who relocated for 3 weeks from Jerusalem (altitude 800 m, 2500 ft, 13.4 psi, 0.91 ATA) to the Dead Sea (altitude 402 m of air below sea level 15.4 psi, 1.05 ATA)

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Ive seen it mostly on tv news stories with personal testimony