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Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Insulin Formulations: Types and Delivery01:27

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Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
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Oral Hypoglycemic Agents: Glinides01:06

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Related Experiment Video

Updated: Jan 8, 2026

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In-flight glycaemic control using automated insulin delivery systems: A within-subject comparative pilot study.

Renald Meçani1, Silvia Basta1, Petra M Baumann1

  • 1Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Diabetes, Obesity & Metabolism
|December 22, 2025
PubMed
Summary

Automated insulin delivery (AID) systems are safe and effective for type 1 diabetes management during air travel, showing comparable glycemic control to ground conditions. These findings support the use of AID systems on flights, with no serious adverse events reported.

Keywords:
AIDCGMHCLaviationdiabetesinsulinmedicinepilotspumptechnology

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Area of Science:

  • Endocrinology
  • Medical Devices
  • Aerospace Medicine

Background:

  • Automated insulin delivery (AID) systems are vital for type 1 diabetes management.
  • In-flight functionality and safety of AID systems remain under-researched.
  • Concerns exist regarding cabin pressure effects on insulin delivery accuracy.

Purpose of the Study:

  • To assess the safety and efficacy of commercial AID systems during commercial flights.
  • To compare in-flight AID performance against ground-based conditions.
  • To evaluate glycemic control metrics and identify potential risks.

Main Methods:

  • A study involving 20 adults with type 1 diabetes using four commercial AID systems (MiniMed780G, Omnipod5, Control-IQ, CamAPS FX).
  • Comparison of in-flight performance during mid-haul flights with matched ground-based conditions.
  • Key outcomes measured: time in range (TIR), time in tight range (TITR), time above range (TAR), time below range (TBR), and insulin doses.

Main Results:

  • Overall time in range (TIR) was higher in-flight (88.2%) versus on-ground (82.1%).
  • Glycemic control metrics were comparable between in-flight and ground conditions.
  • No episodes of severe hypoglycemia, diabetic ketoacidosis, or device failure were observed; insulin delivery slightly increased in-flight.

Conclusions:

  • AID systems demonstrate robust safety and glycemic control during commercial flights.
  • Findings support the feasibility of using AID systems while flying.
  • Further multicenter studies are recommended to generalize findings and inform clinical practice.