Flying with an Insulin Pump: What Your Doctor Forgot to Tell You

Having an insulin pump has been a life-saver for me. It really has.  But flying within it has been an absolute nightmare that I had little warning about. Hopefully my experiences can help others have a more pleasant experience. And though I use an Omnipod, which has no tubing, this may also help others using a tubed insulin pump.

I fly probably 6-12 times/year. I’m actually flying as I write this. My blood sugar is also 50 at the moment. I’m eating maybe my 6th glucose tab, and I have already had at the least 60g of carbohydrate before eating these glucose tabs. I’ll admit I’m about on the verge of an anxiety attack and focusing on writing this is keeping me a little more calm. Oh and my ESA dog on my lap.

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Tucker looks out the window while I down some more glucose tabs.

 

Anywho, if that doesn’t tell you what a mess my blood sugar is, I don’t know what will.  I was 153 when we took off.  No insulin on board. I bought a snack pack with 42g carb at the airport, and ate the applesauce before we took off, and the crackers/meat/cheese after we were in the air, without any insulin.  Mostly because my Dexcom was resetting so I couldn’t see my blood sugar and knew sometimes I go low on flights.  I figured worst case, I’ll just take insulin if I go high.

The stewardess came around and gave us honey peanuts and Wheat Thins.  I ate those too.  Hey, I hadn’t eaten all day in my last-minute-getting-ready frenzy! And that did not attribute to the lows because I frequently skip meals with no issues. FYI.

Now my Dexcom just says LOW. WTF. Ugh. Turn around Dex, turn around!!!! I’m absolutely positive I’ll go really high after this. And I’m not talking about the airplane altitude.  Hardy har har.

I’ve had this issue before.  I have a normal or even high blood sugar as the flight starts, and mid flight I’m clammy, eating all my snacks, and asking the stewardess for more.  For absolutely no reason.  It took a few times before I finally decided to Google the issue.

The Low Down on Flying With a Pump

Apparently with insulin pumps, the change in pressure in the cabin of the aircraft can push extra insulin out of your tubing due to any air bubbles.  I know, and Omnipod has no tubing, but it can still push out extra insulin from any tiny air bubble in the device (obviously, it’s doing it to me). From my research, Omnipodders have commented on the discussion threads saying they don’t have this issue as often, but I am one of the lucky bunch.  And apparently if you are using a tubed insulin pump, you’re even more likely to be lucky.  BUT if you have a tubed pump, it is way easier to avoid the issues.

For anyone flying with diabetes, PACK EXTRA SNACKS. Pack all the snacks.  All of them.  As a chronic over packer, I hate packing things I deem unnecessary (like a bunch of food) but THESE ARE NECESSARY. Glucose tabs and your favorite candy bar. Seriously, this is your chance to possibly consume, take it.

So for the easy part, if you have a tubed pump, while flying, disconnect upon ascent and descent. This will for the most part prevent the air bubble issue and your pump should function as normal.

Oh I’m finally 45 and not LOW! Yay! Oh the little victories.

With an Omnipod, this is much much more tricky. You literally have to take your pod off to disconnect.  Doing that twice is tedious and nor practical. So what can you do? Once you board the plane, suspend your delivery. Even if it’s 30 minutes until you leave, suspend.  Then wait until you’re about 30 minutes in the air to resume. That’s about an hour without insulin delivery, but it should compensate for the extra insulin. Granted, I am not your doctor and these are SUGGESTIONS only, but this is what has worked when I’ve done it.  I just thought my carb consumption would make up for it today. Clearly not. But it will be way easier to correct a potential high than deal with a potential low (in my mind). Also, if your blood sugar is relatively high ahead of time, you may not need to.  It’s a learning game and it’s pretty much never the same to be honest.  But awareness is key.

Oh! 77! We are on the upwards (and likely seeing something super high way too soon).

So once I started noticing the issue and Googled it, I asked my doctor, who also was the person that came to my home and trained me on my pump.  She had no clue. Had never heard of the issue. REALLY? Blew my mind. How could I be the only person with this issue? But like I said, I’m super lucky, sooooooo.

And now the rise alert from my Dexcom, because I’m rising faster than I should be, and the plane is about 15 minutes from landing. Looks like I’m about to ride the diabetes rollercoaster that is my life. Luckily I have some Afrezza with me to hopefully blunt the rise/precent me from going too high. I’m going to need a nap after this and it’s not because I had a drink on the flight…

Update: I started to rise but then dropped almost low (see Dexcom photo), likely from the descent. Of course expecting to drop further, had some juice and then spiked. Flying home I am going to turn off my Omnipod and see what happens!

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