Joint Medtronic and Animas Statement about effect of cabin pressure on insulin pumps

Diabetes Technology Insulin Pumps
1

A few days ago, Reuters Health published this:
http://www.reuters.com/article/2011/08/19/us-flight-diabetics-idUSTRE77I6EU20110819

(Reuters Health) - Changes in cabin pressure during flights may cause insulin pumps to deliver too much or too little of the medication -- possibly putting sensitive diabetics at risk, researchers report.

(the abstract of the study referenced in the article can be read here:
http://care.diabetesjournals.org/content/early/2011/07/26/dc11-0139)

We reached out to pump manufacturers to ask them to comment on this. Below is a joint statement signed by the Chief Medical Officers from Medtronic and Animas:

We are aware of Dr. King’s experiments showing that the air pressure changes that occur with air travel can affect insulin delivery rates from pumps. Specifically, he reported that the decrease in air pressure that occurs with take-off can result in 0.7-1.4 units of extra insulin, and the increase in air pressure that occurs with landing can result in 0.6-0.9 units of missed insulin.

Many factors affect blood glucose during travel and the effect of small dose variations over the course of a plane flight is unlikely to be clinically significant. However, we are both continuing to further explore this subject.

In the meantime, we’re continuing to advise our customers to follow standard travel guidelines for diabetes management. As always, consult your healthcare team before taking a trip, always be prepared with extra supplies and sources of glucose, and test your blood sugar frequently. With so many variables that can affect glucose levels while traveling – such as stress and time zone changes as well as atypical schedules, activity levels and meals – it’s important to be extra vigilant.

  • Dr. Francine Kaufman, Chief Medical Officer and VP of Global Clinical, Medical and Health affairs at Medtronic Diabetes
  • Henry Anhalt, DO, Chief Medical Officer, Medical Director Artificial Pancreas Program at Animas
2

Interesting …I have flown with my Medtronic pump many times, overseas flights and continental and have done what has been advised …be vigilant !

3

Very interesting Manny, thank you.

4

Hum, an extra 0.7 IU/hour would double my basal rate, and the fall in pressure occurs over a time period when access to food is reduced. Still, I’ve just started using the OmniPod (which cannot be disconnected) and I’m very careful not to inject air into it (fortunately my insurance company pays for the insulin, so squirting 10 units into the air to be sure is not an issue for me.)

Omnipod is also approved to 25 feet of water for 60 minutes, that’s close to the same pressure change. (Cabin pressure is about half that at sea level, 25 feet of water is about 1.7 times that at sea level, if I got the calculations right.)

5

It’s only at take off and landing, when pressure changes.
It’s not 0,7U per hour, just per take off.

6

Thanks for posting this Manny. I hope they both have plans to note this on their sites.

7

Interesting. The one thing I've done a lot of? Travel, both domestic and international, and I've not seen anything significant with either of my pumps: initially a Medtronic 508 and now a Revel.

I'll just have to watch this thread and the news for updates. I'll also see what my endo has heard about this. (Glad he's at a top teaching hospital.) Maybe I just didn't notice and attributed a low or high to travel turmoil. :-S

8

Just recently travelled and noticed no issues with going low or high in relation to take off or landing.