Air Pressure and the Pump

We all know the drill once we board an airplane; the seat-belts, the inflatable vests, and those masks that drop down. We also know that cell phones must be turned off and iPods saved for later. How about your insulin pump? Did you ever think what the air pressure in the cabin and the changes in altitude are doing to the most important gizmo on you? Recent studies indicate that changes in altitude can affect your pump, messing with your blood sugar levels.

According to Dr. Johan Jendle of the Endocrine and Diabetes Center at Karlstad Hospital, Sweden, and Dr. Peter Adolfsson, member of the Department of Medicine and Health at Örebro University Hospital, Sweden, insulin pumps have failed to estimate glucose levels adequately by roughly 1-2% for each 300 meters per 1000 feet of elevation.  A decrease in pressure can cause the insulin pumps to release more than is necessary, resulting in a higher risk of hypoglycemia.

The American Diabetes Association held a study to determine the relationship between variations in air pressure and their effects on blood sugar levels in people with type 1 diabetes who are receiving insulin pump therapy. The results suggest that a decrease in air pressure may cause trapped air in the pump to change and form little bubbles that affect the delivery of insulin and the amount actually being delivered.

Jendle and Adolfsson suggest further testing is needed on the relationship between pump design, structure and exterior pressure.  Both Jendle and Adolfsson, along with those conducting the study done by the ADA, suggest removing the pump during takeoff and to check for bubbles and redraw insulin if necessary.

Sources:

1 –Chandran, Manju, MD., and Steven V. Edelman, MD. (2003). Have Insulin, Will Fly: Diabetes Management During Air Travel and Time Zone Adjustment Strategies. Clinical Diabetes (April), http://clinical.diabetesjournals.org/content/21/2/82.full (Accessed 11/29/11.)

2 - Jendle, Johan, M.D., PhD., Peter Adolfsson, M.D. 2011.Impact of High Altitudes on Glucose Control. Journal of Diabetes Science and Technology (November 3), http://www.voyagemd.com/2011/news/impact-of-high-altitudes-on-glucose-control/  (Accessed 11/29/11).

3– King, Bruce R., FRACP, PHD, Peter W. Goss, FRACP, Megan A. Paterson, CDE, Patricia A. Crock, FRACP and Donald G. Anderson, FRACP. 2011. Changes in Altitude Cause Unintended Insulin Delivery From Insulin Pumps
Mechanisms and implications. Diabetes Care (August 4), http://care.diabetesjournals.org/content/early/2011/07/26/dc11-0139#aff-2 (Accessed 11/29/11).

Reviewed by Susan Weiner, RD, MS, CDE, CDN (06/12)

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