Flight in light aircraft

[Redkite]

My son is lucky enough to be getting a free flight in a small light aircraft on Friday evening at the local RAF base. Someone (another parent of a cwd) has said that he ought to remove his pump for the flight due to pressure changes (it's only 20-30 mins in the air, but probably plenty of faffing about beforehand, so pump could potentially be off for quite a while). Has anyone done this activity and could advise whether removing the pump would be necessary? I doubt they'll be doing any aerobatics!

 

[Northerner]

I've posed your question on the 'Flying with Diabetes' Facebook group page to see if anyone can help 🙂

 

[Northerner]

I've had this response:

He will experience less pressure change than he would if he was flying on a commercial passenger jet. If it is safe for that then it's safe for a light aircraft. Hope he has fun. It could turn out very expensive!

 

[Redkite]

Thankyou Northie! 🙂 One less thing to worry about then! I'm not on Facebook but interesting to know that there exists such a specialist group as "flying with diabetes". I'm sure it would be VERY expensive to do flying lessons, but this is strictly a one-off treat.....I think!

 

[Northerner]

It's a very reliable resource as it is run by Douglas Cairns who has campaigned for diabetics to be allowed to fly as qualified pilots (successfully!) for years 🙂

 

[Redkite]

Oh fab! We met him and heard him speak at a JDRF event at Duxford museum - he's really inspirational! 🙂

P.S. One of these days I will have to join Facebook - I just hate the thought of being publicly visible.

 

[HOBIE]

I have flow to the Isle of Man TT in a 4 seater, & Grand Canyon in a 6 seater loved every minute. Tell your son to have a good time 😉

 

[Redkite]

Thankyou Hobie 🙂. Did you have your pump at that time, and if so, did it work ok during the flight?

 

[Redkite]

I had asked our DSNs, and they contacted Medtronic, who came back with a wishy-washy response about the limits of pressure, temperature and humidity that the pump can withstand - surely small aircraft don't fly high enough to be affected by low temps and low pressure....?

Anyway, I've decided the pump is staying on!

 

[Northerner]

Another response (from Karl Beetson, who you may also have met 🙂):

I've flown with my pump attached flying normally at heights from 0ft to 16000ft also have done aerobatics with my pump and it is fine.

He follows that up with:

Of course wearing my other hat, if there is a doubt maybe suspend pump & disconnect set for the flight if it's a SHORT flight. But generally from my own personal experience my animas vibe has been ok with a few positive G

Facebook is good for groups and pages of information, links etc. I find, and pictures of cats of course! I joined chiefly to find out what family are up to 🙂 If you just use it for that, and maybe a small group of trusted friends, it's fine really, no-one else really needs to know you're there.

 

[Redkite]

Thanks, that's reassuring 🙂

 

[Northerner]

Another response 🙂

Some research undertaken here in Australia and published in 2011 showed that pumps will deliver a slight excess of insulin during the climb phase of a commercial flight due to dissolved gasses coming out of solution and forming bubbles. Conversely, on descent, not enough insulin is delivered due to the bubbles dissolving again. The pressure change on a commercial flight is similar to flying a light plane from sea level to 7000 feet.

In this study, the amount of excess insulin delivered on climb was proportional to the amount of insulin remaining in the cartridge, and averaged about 0.6% or a bit over 1 unit of insulin. The effect of this on subjects blood sugar level of course varied due to their insulin sensitivity. (If it was me it'd lower my BSL by 3mmol/L). The deficit of insulin delivered on descent was about 0.7 of a unit, leaving a net excess of 0.3 units.

The recommendations made by the authors, and widely adopted by endocrinologists and diabetes educators here now is:

1) The cartridge should only contain 1.5 mL of insulin.
2) Disconnect the pump before takeoff.
3) At cruising altitude, take the cartridge out of the pump and remove any air bubbles before reconnecting.
4) After the airplane lands, disconnect the pump and prime the line with 2 units. Then reconnect the pump.
5) During flight emergencies involving cabin decompression, disconnect the insulin pump.

In your son's case I think the effect will be minimal. If the flight is up and down in 20 minutes, and the maximum altitude is 3-4000 feet, any bubbles will be very small and short lived. If you're worried, just keep a closer eye on his BSLs in the one to two hours after the flight, as this is when a hypo will occur due to any excess insulin delivery. The benefits of keeping the pump connected probably outweigh the very small risk of a hypo.

Here's the paper:

https://attachment.fbsbx.com/file_d...inline=1&ext=1403178520&hash=ASsykFROqkhnz-Fo

(if you have trouble viewing the document, PM me your email and I'll send it to you 🙂)

 

[Redkite]

Thankyou. Specialist stuff indeed! Our experience of normal holiday flights is that he always ends up high! I'm sure all will be ok with the pump left on, but I might worry if it was a longer duration of flight.

 

[HOBIE]

Light aircraft don't have air tight doors. I remember it is just like being in a old transit van with wings. You breath the air through the gaps in the door & can fly for days if you had enough petrol. Let us know how much he enjoys the trip pls I couldn't believe when I got to the TT. It was just like the movie when he dips the oil with a dip stick. Just like a car but they use a bit oil. So a half tin of STP & back to normal 🙂

 

[Pumper_Sue]

Hope your son enjoys his flight, I had the pleasure and privilege to fly with navy pilots in their jet streams when a member of the ROC. 🙂

 

[Sally71]

I'd read all that stuff about air pressure changes on planes affecting the rate of delivery on pumps, and what to do about it etc, but when I did pump training last year and asked the Roche rep about it she looked at me as if I'd gone completely round the bend and said she'd never heard anything like that at all!

Wasn't brave enough to attempt flying anywhere with pump last year, might have given it a go this year but husband and daughter have decided we're staying in the UK for our holidays this year. So I've yet to find out what it's like!

Hope your son has a fab time, Redkite!

 

[Redkite]

Thanks everyone 🙂

 

[Hanmillmum]

Interesting post Redkite, hope your son enjoys himself 🙂 Good source of info thanks Northerner, will have to keep that somewhere handy for next hols.

Only experience here is one holiday via commercial flight approx, 4 hrs and trouble with bubbles in the tubing after the take off - a suprising amount IMO, glad I checked 😉, other than that no great effect on BG's during & after the flight.

 

[Redkite]

Well, he had a fabulous time - the pilots were brilliant with the kids, can't praise them enough for their generosity in laying on this event!

He flew in a bulldog (used to be a trainer aircraft for RAF pilots) and sat side by side with the pilot, handling the controls and at times actually flying the plane! Weather was perfect - clear and sunny - and they went up to 1500ft and did a circuit (avoiding the Heathrow and Luton airspace 😱). He was buzzing afterwards 🙂

Diabetes behaved itself too. 😎

 

[PattiEvans]

At cruising altitude, take the cartridge out of the pump and remove any air bubbles before reconnecting.

Eh? I only have experience of the Roche pump, but I'd say that manoeuvre is pretty much impossible without a full set change and I'd not like to do that at altitude!

Just flew home from holiday on Friday last, can't honestly say that my BGs were affected at all since I was 4.9 before the flight and 5.3 after the flight and I didn't do anything at all other than change the time on the pump after we landed (Corfu is 2 hours ahead).

So glad to hear your son enjoyed himself Redkite 🙂