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

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.