Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Insulin pumps affected by altitude

Diabetes Care has published the results of an experiment that aimed to assess the impact of changes in ambient air pressure on insulin delivery via a pump.

This study was entirely conducted without patient involvement but as a consequence of patient reported hypoglycaemia during air travel.

It was noted that in low air pressure situations air bubbles can form or enlarge in the insulin cartridges and force additional insulin out of the cartridge. Plunger movement was only observed when the air pressure environment was made to mimic a catastrophic plane depressurisation.

The authors conclude that, "atmospheric pressure reduction causes predictable, unintended insulin delivery in pumps by bubble formation and expansion of existing bubbles".

Action: Clinicians should be aware of this recent finding. Patients who are using insulin pumps should be warned of the risk of additional insulin delivery at low air pressures.

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