I don’t fly very often but I have had that “baggage claim” low often. And early on in my pumping experience, there was talk about the pressure changes as the problem. So one time I did disconnect my pump and just watched to see if indeed insulin came out. And I think I saw it only once but there was drops of insulin being infused. It didn’t look like much but for me a .5 of a unit is enough to handle most highs. Now this was back with my first MiniMed pump and I haven’t tested it since. But I do find I am lower heading to baggage claim and have tablets on the way. Could just be I am excited about the trip or excited I am heading home. But I am one of those who gets those darn baggage claim lows!
The more I think about it, I suspect that there is no real “mobilization” of my meal bolus, or the follow-up “frustration boluses” so nothing much happens for those few hours sitting on the airplane.
Then when you get off, the burst of activity is combined with simultaneous insulin release from the area around the pump infusion site which drives me low.
This has happened to me while driving for long periods as well.
And of course the food is also suspect, possibly higher glycemic index but then drops off glucose raising effect?
If the site was working before and after the flight, it’s possible that a change in altitude of a few thousand feet while driving across high hills could have a tempory effect on the pump until it equalized but commercial aircraft take off and descend rapidly enough that altitude change would trigger equalization quickly.
I’m guessing that the rate of diffusion from venous to interstitial fluid is effected by the lower pressure during flight. I know that digestion is, a simple example being that you can get drunk faster with less alcohol at 30,000 feet than at sea level.
I remember that there are special warnings in my pump’s manual about thingts todo during and after a flight. I didn’t pay much attention to what they were because I don’t fly, but do remember that BGM tests were involved.
I’m thinking that the CGM may be the weakest link since air that normally is present in blood and body fluids at 1 ATM would be outgassing. I’d also expect the opposite to happen after landing.
There re other explanations if you are new to traveling with a pump.
I just got back from an extended driving trip where I crossed the Smoky Mountains. My normally tightly controlled BG was all over the place starting right after I left. I attribute it mostly to driving stress, only a small part to the time zone change and the temporary change to wake very early early to leave.
My glucose levels drop too if I stay in the shower too long with it running hot. I get out and start drying my hair and get an alarm that its dropping. I usually stop and check it with a fingerstick and usually it just levels out.
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If my glucose is in the 80-90 range before a shower, I quickly fall into the 60’s and have to eat glucose. I am glad that your level evens out for you.
Knowing that the heat drops me, I never get into the shower unless I’m over 100. I am terrified of lows, so just play it safe.
Interesting that heat drops your glucose levels too. I have had very few bad insulin reactions in my life, so I probably don’t worry about them enough.
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