Unintended insulin delivery using Omnipod DASH during a high-altitude flight

Area of Science:

• Endocrinology
• Aerospace Medicine
• Medical Devices

Background:

• Type 1 diabetes mellitus (T1DM) management often involves continuous insulin delivery via insulin pumps.
• The Omnipod DASH is a tubeless insulin pump system offering customizable basal and bolus insulin delivery.
• The impact of high-altitude atmospheric pressure changes on insulin pump function is not well-documented.

Observation:

• A case report details a 55-year-old woman experiencing symptomatic hypoglycemia during flight.
• The patient was utilizing an Omnipod DASH insulin pump in a non-pressurized aircraft cabin.
• This event occurred despite adherence to programmed insulin delivery settings.

Findings:

• The Omnipod DASH insulin pump system may be susceptible to alterations in atmospheric pressure during high-altitude flights.
• Symptomatic hypoglycemia was observed, suggesting potential over-delivery of insulin under reduced atmospheric pressure.
• This case highlights a potential risk associated with insulin pump therapy in aviation environments.

Implications:

• Insulin pump users, particularly those with T1DM, should exercise caution when flying in non-pressurized aircraft.
• Rapid cabin depressurization events could precipitate severe hypoglycemia, posing a significant flight safety risk.
• Consideration of temporary cessation of insulin pump therapy and reliance on manual insulin administration during flights is recommended.