It seems that the insulin I gave to cover my meal around 5pm vanished. Didn’t absorb. Whatever. It had basically zero effect. I was sitting on an airplane and couldn’t really move. So I gave myself a couple extra doses, more and more insulin, at 0.75 to 1 u at a time and nothing!!
Until I arrived at my destination. Then big time double arrow down.
I think sometimes insulin is infused and sits there stealthily biding it’s time. And later when it gets mobilized it can get you all at once. Initial dose was about 5 units and another 3 over the next couple hours. IOB was listed at around 2. Just before the freefall from the stealth insulin. You better believe I snacked.
There are well-documented insulin delivery anomalies that occur in insulin pumps during airplane flights. They are caused by the external air pressure changes felt during the ascent and descent and related cabin pressure changes experienced during a typical flight.
Many people report low blood sugars often occur in the immediate aftermath of a flight – like an unexpected hypo at the bag claim.
I haven’t been on an airplane in about ten years but I do regularly go over a couple of mountain passes and when ever I go down the mountain I often get a sudden drop in BG. This happens with my Tandem pump but it also used to happen on MDI.
I don’t see how this can happen at all. Because even with increased pressure in the cartridge there is a valve that prevents any insulin moving beyond the swing of the pump valve. In a syringe pump like Medtronic it’s even less likely because the piston is locked in position and only turns tiny steps. Extra pressure has no where to go.
Even lower pressure wouldn’t make any difference. When I swim with my pump it doesn’t effect insulin delivery and there is a huge difference in pressure between air and water. Even more than what you experience in an airplane.
Pumps are designed with this in mind.
Unless pressure acting on the insulin already in your skin matters. Where maybe it can get absorbed faster.
I don’t know. I know hot showers drop my sugar. I think it speeds up absorption.
I really don’t think that more insulin is delivered tho.
Indeed, and I read in the manual if there is a significant pressure change, a pump alert is expected. So I don’t know if it’s a “flying” thing or a “sitting on your ■■■ and doing nothing” thing. Followed by a burst of activity . . Releasing all that pent up insulin.
I’ve had it from long car rides as well.
But not motorcycle rides; there, I need the whole time to set it on exercise / activity profile!!
Many of us have seen “fake pressure hypos” when lying down on a CGM sensor.
I wonder if the reverse can happen, that when flying and cabin pressure is low, the CGM gives fake high readings.
Also, I know from experience, that sitting in one place can yield “stale” CGM readings that rapidly change when I finally get to stand up and move around.
Many of us have seen the “shower bump” which is a fake high that, my theory is, is caused by changes in interstitial fluid circulation due to warm water on the skin.
Good point! Next time it happens, I’ll check with finger prick testing (if I can remember how, LOL, it’s been a while!! Every time I have checked or to calibrate, the numbers have been nearly identical, so I stopped checking)
My levels really drop too. There is something about the heat that does it. It also happens in the rare times I take a bath.
Swimming in cold water doesn’t seem to matter though
@Timothy A few weeks ago, a Tandem tech rep, not the usual rep but from their real Tech dept, told me when I complained about the bag vs the Medtronic type insulin pump hard cylinder, told me that the bag was safer than the Medtronic one. She told me that diabetics had died and she had just heard of a 6 yo on a plane whose entire pump cylinder (blocking on word) was injected into body due to this cabin pressure thing. Now, I don’t know if this is true and I don’t know how a great amount of insulin could even be absorbed quickly. But she told me that the syringe type device was not safe.
I don’t know if that was PR hype but if it was it was unethical if it was false.
Of course, even 20 units could be dangerous for a child if not caught in time or treated in time.
More recently, I saw elsewhere a MD arguing that planes should stock glucose and I did not know they didn’t. Of course, they have sugar but the doc may have meant injectable glucagon.
I do not fly but if this is a problem, it should be addressed in diabetes education programs.
