New research has found that plane travel consistently causes insulin pumps to over-deliver a little over half a unit on takeoff and under-deliver a bit less on landing.
This phenomenon is due to air bubble formation and reabsorption in the insulin caused by ambient pressure changes in the airplane’s cabin. It has nothing to do with the pump itself and happens with all insulin pumps, including those in hybrid closed-loop systems.
The extent to which this affects people with diabetes who use insulin pumps depends on their dose and insulin sensitivity among other factors, but all who fly should be aware of the possibility and take precautions, particularly with children.
Specifically, for pumps with tubing, wearers can disconnect just prior to takeoff and reconnect when the plane reaches cruising altitude, about 20 minutes into the flight. The insulin will still come out, but it will not be delivered to the person. On descent, users can disconnect after landing and prime the line to remove the insulin deficit.
With the Omnipod, which cannot be disconnected, the only solution is to eat a small snack on takeoff. And on landing, users should eat another small snack, such as a banana, and give a bolus for it to overcome the blockage of insulin delivery.
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