- βDespite small pressure-related insulin delivery changes at altitude, real-world pilots using insulin pumps had better in-flight blood sugar control than those on multiple daily injections β with no hypoglycemia recorded.
| Journal | Diabetologia |
| Year | 2025 |
| Authors | Garden, Fan, Paterson |
| PMID | 39496965 |
| DOI | 10.1007/s00125-024-06295-1 |
What This Study Found
When an airplane climbs or descends, the air pressure inside the cabin changes. Researchers wanted to know if those pressure changes could cause insulin pumps to accidentally deliver too much or too little insulin. In lab testing, pumps did deliver slightly more insulin during ascent and slightly less during descent β but when researchers looked at real pilots flying real flights, none of them experienced low blood sugar (hypoglycemia) as a result.
Why This Matters
People with type 1 diabetes who want to fly β whether as passengers or licensed pilots β often worry about how their insulin pump will behave at altitude. Until now, there has been limited evidence to either reassure or caution pump users about flying. This study is one of the most thorough looks at this question to date, combining both controlled lab experiments and over seven years of real-world flight data.
What the Researchers Did
The study had two parts:
- Lab simulation: Insulin pumps were placed in a pressure chamber that mimicked the cabin pressure of a commercial airliner. Researchers measured how much insulin was delivered during a simulated climb and descent.
- Real-world data: Seven pilots with insulin-treated diabetes who were cleared to fly under European aviation rules recorded their blood sugar levels across 1,081 flights and more than 2,300 hours in the air.
What They Found
In the lab, pressure changes during a normal flight caused pumps to deliver about 0.60 units of extra insulin during ascent and withhold about 0.51 units during descent. In a rare emergency rapid decompression scenario, as much as 5.6 extra units could theoretically be released β a more significant amount.
However, in the real world, the results were reassuring. Of 4,656 blood sugar readings taken during flights:
- 99.3% of readings from pump users were within the acceptable safe range
- Not a single reading fell into the hypoglycemic range (below 72 mg/dL)
- Pump users actually had better blood sugar control than pilots using multiple daily injections (MDI)
Should You Worry About Flying With a Pump?
The researchers concluded that insulin pumps can be safely used during flight. The small pressure-related delivery changes seen in the lab did not translate into dangerous blood sugar drops in real pilots. Pump users also checked their blood sugar more often and stayed in range more consistently than injection users β which likely helped them stay safe.
That said, it is always a good idea to monitor your blood sugar more closely during flights, carry fast-acting glucose for emergencies, and talk with your diabetes care team before traveling.
β Key Takeaway
Real-world pilots using insulin pumps had zero in-flight hypoglycemia episodes and better overall blood sugar control than those on injections β giving travelers and aviators more confidence in flying with a pump.
Staying Prepared at Any Altitude
Whether you are a licensed pilot or a frequent flyer managing diabetes, having the right supplies on hand is essential. MDS Diabetes carries a wide range of insulin pump accessories, blood glucose monitoring supplies, and travel-ready diabetes management tools to help you stay in control β on the ground or in the air. Explore your options at mdsdiabetes.com.
Citation: Garden, Fan, Paterson (2025). Effects of atmospheric pressure change during flight on insulin pump delivery and glycaemic control of pilots with insulin-treated diabetes: an in vitro simulation and a retrospective observational real-world study. Diabetologia. PMID: 39496965. DOI: 10.1007/s00125-024-06295-1