Insulin Pumps and Private Pilot

Anyone here a private pilot with a pump? I started a pump during training because my doctors got tired of navigating all the rules for Type 2 medicine and the FAA. But now I am seeing that I might have to disconnect my pump during flight? I tried to google it, but its all about flying commercial, not flying private in an unpressurized cabin. Any help is appreciated.

I was part of a beta group a few decades ago and the best I could hold on to then was Commercial/Instrument Class 2 physical on an FAA waiver and flight compliance was not an issue. Keeping up with the waiver requirements after a few years got to be such a pain that I finally totally ditched the left seat. I am MDI so as restrictions keep loosening up, I am periodically tempted to start up again, but then realize I no longer have the flying fire in the belly.

My husband is the pilot and not home right now for me to ask yet… In the meantime, though, I’m going to suggest you add quotation marks to your Google search. That tells Google your search results MUST contain the word(s) inside the quote marks.

You’ll have a different medical class certificate than commercial passenger pilots, so I’d start by including whatever your specific medical is called inside of quote marks, along with “insulin pump”. Does a part number apply to your situation? Part 91, 121, 135, etc… Because “part 91” or something would also set your search results apart from all the commercial passenger pilot results.

You didn’t mention if there were passengers in your plane or not. From what I understand, there are few regulations at all if you’re flying private and without passengers. I doubt there are any regs at all regarding how you’re dosing insulin in this case.

We go through our own brand of FAA medical misery. He’s asthmatic and color blind… and flies contract gigs in business jets. He just called into the FAA the other day for clarification about a breathing test result, sh that’s always an option, too.

I apologize in advance if I missed the mark completely. "Private"is a broad spectrum, and I don’t if we’re talking little planes/little regulations, or the other end of the spectrum.

I am 99% sure from regulatory standpoint that you don’t need to disconnect during flight, but is that the question?

It has been recommended to disconnect certain pumps during takeoff and landing due to the pressure changes, because even the tiniest little air bubble can expand and push out an unregistered bolus because … physics. (I am also 100% sure that this explained why for YEARS I went low at almost every layover, because I live in AK and to get anywhere is at least a 3.5hr flight, so with a 3-4hr insulin absorption time that meant if the pressure burp happened on the way up, it would become problematic about the time we were landing. I didn’t know why for the longest time, I just knew I needed to eat a package of fruit snacks when we started descending or Id be so low when we got off the plane that I couldn’t navigate to the next flight.)

I have only had a couple flights in a small unpressurized plane, so Im not sure it would definitely be either the same or different, but there must be an altitude at which the pressure causes the potential problem… I wonder what it is though!

The Juicebox podcast episode #332 The Wright Stuff: The Wright Stuff talks about flying with diabetes and the FAA hurdles involved
And I think DiabetesMine (now part of Healthline) published a well-researched article years ago that explained and measured some of the effects of pressure on (an) insulin pump(s) and how to mitigate. If I can find the article again Ill post the link here!
Found it! Article from DiabetesMine re pressure changes here Dosing Insulin on a Plane | Ask D'Mine

The FAA released a new guideline last year for insulin treated diabetes (types I &II) and CGM, which allows you to get a class 1, 2 or 3 medical. Nothing about disconnecting your pump but your pump and cgm must be able to auto suspend if readings are approaching a hypo.

If you’re just looking for class 3 and without cgm, that guidence is here. This one requires in flight testing, but nothing about disconnecting from what I recall.

I apologize for not being clear. For some reason, I thought I was clear, but that’s on me. I know all about the FAA and diabetes. That’s not the question. I am working with doctors and an AME.

The issue is that buried deep in the Tandem documentation is a recommendation to disconnect the pump in unpressurized aircraft. I don’t know if this is CYA / Untested or a genuine concern that during altitude maneuvers, I would get myself in trouble leaving the pump on.

That’s why I put it in Insulin Pumps. This is a technical question, not a regulation / FAA question. I’ve been researching the FAA situation for years now. I know what I am dealing with there. I still feel the FAA discriminates a lot and I don’t think it is fair, but that’s a rant for another day.

So yeah, this is about pumps and unpressurized cabins. The idea is to have a CGM and a pump as a means to satisfy some FAA requirements, but now I am concerned and wondering if I may have to MDI on flight days.

The tandem pump uses internal pressure of the cartridge to determine how much insulin is in the cartridge. Not sure it effects the delivery.
That’s why they don’t want you flying in a non pressurized cabin with it. Maybe it could deliver more than expected, or more likely they just don’t know.

The Medtronic pumps used a displacement method of determining the insulin and delivery is regulated by micro steps of a motor. So would not be an issue or at least not obvouisly an issue.


I know that one! I used to fly in my neighbors’ Cessna all the time, pre-covid. It’s 95% to cover their butts, and 5% a problem with the pressure sensors not liking the air pressure inside the pump being different than the air pressure outside the pump.

The micro-delivery feature with the isolated chamber of insulin was specifically designed to not “leak”, like the syringe-style reservoir pumps which keep you directly in line with the pump can. There is absolutely no way for any insulin to get out of the reservoir accidentally. There is a small risk associated with the tubing, though. Unless you’re facing some exteme temps, it’s unlikely the volume of your insulin will change any, but any air bubbles in the tubing will probably expand, forcing some insulin at the end of the line out of the tubing. If we’re talking a few champagne bubbles, that amount of insulin is probably negligible. However, if there are sizable air gaps in the line, the amount of insulin forced out could actually be problematic. So definitely make a point to check the tubing, just to make you don’t see any obvious air bubbles.

You may occasionally get an altitude alarm if the air pressure inside the pump is significantly different than outside the pump. This is easily remedied. All you have to do is eject the cartridge and re-seat it again. Then clear the alarm. No need to go through the load process or anything. Popping the cartridge out just let’s the pressure equalize, and makes the pump happy again. Funny thing is, I see that altitude alarm more while skiing than flying, no idea why.

Basically, the most responsible thing you can do is disconnect during ascent/descent, but you won’t damage your pump or make it otherwise unsafe if you’re cruising at a relatively stable altitude.

Well, but if you are practicing stalls or doing touch and goes, I wonder if that is where things get sketchy. I fly starting at 5500 feet (Utah), so we start thin, but flying to 8000 feet is what has me wondering.

Commercial airliners are pressurized to the equivalent of 8000’. So if your ceiling is 8000’, then you aren’t getting any lower pressure than you would flying in a commercial airliner.