Air travel may affect insulin pump delivery in people with type 1 diabetes

Altitude adjustments throughout industrial flights could have an effect on the blood glucose ranges of individuals with sort 1 diabetes who’re handled with insulin pump remedy, in accordance with new analysis to be offered at this 12 months’s Annual Assembly of The European Affiliation for the Research of Diabetes (EASD), Madrid (9-13 Sept).

“We investigated the impact atmospheric stress adjustments throughout flight can have on insulin pumps following considerations that glucose ranges could drop under the traditional ranges throughout or instantly after flights,” defined lead writer Dr. Ka Siu Fan from the Royal Surry County Hospital and College of Surrey, UK.

Within the examine, insulin supply from 26 insulin pumps was examined in Europe’s largest hypobaric chamber to imitate the atmospheric adjustments throughout a traditional industrial flight.

The hypobaric chamber was depressurized to 550 mmHg over a 20-minute ascent, maintained at a 30-minute cruise (mimicking an airline pressurized cabin altitude of 8,000 ft), adopted by a 20-minute descent to the bottom (with an ambient stress enhance to 750 mmHg).

Throughout the simulated flights, insulin infusion was set at 0.60 items per hour to characterize a charge utilized in grownup and pediatric apply and to permit correct measurements on a number of flights.

Insulin supply charges and bubble formation (attributable to air popping out of an answer and forming bubbles when stress decreases) have been recorded by attaching infusion units to open-ended 100 microliter capillary tubes towards 1mm grid paper.

Insulin infusion units with out pumps have been additionally examined underneath a separate stress protocol to simulate speedy decompression. This mimics the sudden lack of cabin stress, which happens in emergencies.

The researchers discovered that full insulin cartridges over-delivered 0.60 items of insulin over a 20-minute ascent (ambient stress lower) in comparison with ground-level efficiency. Whereas this will barely cut back blood glucose, the authors don’t anticipate that this might result in clinically vital or symptomatic hypoglycemia.

Throughout descent (ambient stress enhance), cartridges under-delivered 0.51 items of insulin. This may occasionally result in blood glucose being greater than common however doesn’t pose the identical concern because the hypoglycemic results of an excessive amount of insulin.

Strikingly, speedy decompression resulted in fluid supply equal to five.6 items of extra insulin. Within the uncommon occasion of a sudden decompression of the cabin at altitude, an insulin overdose might trigger blood sugar ranges to fall to such an extent that it might trigger vital hypoglycemia. Nevertheless, in such emergencies—for example when an plane loses a door mid-flight—there can be time to ingest further short-acting carbohydrates to counter this.

As Dr. Fan defined, “People who use insulin pumps ought to concentrate on the potential influence of adjustments within the cabin air stress on insulin supply. The drop in cabin stress throughout ascent could result in a slight enhance in insulin supply because of the formation of air bubbles which displace extra insulin out of the cartridge.

“A slight discount in insulin supply can also be doable throughout descent because the rising air stress dissolves the air bubbles, sucking insulin again into the pump. Whether or not these abnormalities in insulin supply throughout flights trigger scientific results will rely on a number of components, together with a person’s insulin sensitivity, meals consumption, and glycemic management.”

He cautioned, “To forestall any unintended metabolic penalties, we advocate that people who use insulin pumps think about quickly disconnecting their pumps earlier than takeoff, and eradicating air bubbles earlier than reconnecting them at cruising altitude.”