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From the flight deck: diabetics, watch your insulin

To prevent any danger to flyers, the researchers set out a list of recommendations, including that insulin cartridges should only contain 1.5 milliliters of insulin.

Diabetics should disconnect the pump before takeoff, remove air bubbles and reconnect at cruising altitude, then disconnect again and prime the line with 2 insulin units after landing before reconnecting for good. They should also disconnect the pump during flight emergencies when there's a big drop in cabin pressure, King and colleagues wrote.

"I believe most people would rather know exactly how much insulin their pumps were giving. Following the recommendations means that they know and are in control of what is happening with their pump," King said.

Cohen added that it's important patients know how to carry out these recommendations safely, if they're going to follow them. Otherwise, he said, "their solution may be worse than the underlying problem if somebody doesn't really understand how to carry it out."

Patients can talk to their doctors to see if this concern applies to them, and if so, learn how to safely disconnect and reconnect their insulin pumps while flying, he said.

The researchers added that it's possible other big changes in pressure could cause insulin pumps to deliver too much or too little of the drug -- such as ski lifts, or even a trip up the Empire State Building for very young kids, King said.

"There aren't very many other major pressure changes that we experience," Cohen said. Still, he added, "I don't know how to advise people about what they should do with their pumps if they're going parachute jumping."

SOURCE: http://bit.ly/q9NdpQ Diabetes Care, online August 4, 2011.