Evidence map›Paper›PMID 41424231›Full record

ArticleDiabetes, obesity & metabolism2026

In-flight glycaemic control using automated insulin delivery systems: A within-subject comparative pilot study.

Renald Meçani, Silvia Basta, Petra M Baumann, Monika Cigler, Omaima El Hakouni, Daniel A Hochfellner, Fariba Shojaee-Moradie, Ka Siu Fan, Dietrich Tews, Thomas R Pieber and 4 more

Abstract readComparative Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Renald MeçaniDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0003-2697-8544
Silvia BastaDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0009-0008-5234-7547
Petra M BaumannDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0002-7665-0929
Monika CiglerDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0001-5827-7991
Omaima El HakouniDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0009-0009-1616-6711
Daniel A HochfellnerDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0003-4872-8861
Fariba Shojaee-MoradieCEDAR Centre, Royal Surrey County Hospital, UK.ORCID 0000-0002-3514-0447
Ka Siu FanCEDAR Centre, Royal Surrey County Hospital, UK.ORCID 0000-0002-0861-1944
Dietrich TewsDiabetes Center Dr. Tews, Gelnhausen, Germany.ORCID 0000-0002-8548-1709
Thomas R PieberDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0003-3554-0405
David Russell-JonesCEDAR Centre, Royal Surrey County Hospital, UK.ORCID 0000-0002-9490-2480
Chantal MathieuDepartment of Endocrinology, KU Leuven, Leuven, Belgium.ORCID 0000-0002-4055-5233
Gerd KoehlerRehabilitation Center Aflenz, Aflenz, Austria.ORCID 0009-0008-4749-7639
Julia K MaderDivision of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0001-7854-4233

Funding

EASA - European Union Aviation Safety AssociationÖDG - Österreichische Diabetesgesellschaft
6 · The paper itself

Abstract

backgroundAutomated insulin delivery systems (AID) are increasingly used by people living with type 1 diabetes, but their functionality during air travel remains insufficiently studied. Some concerns have arisen regarding safety using AID systems under flight conditions, particularly related to potential insulin delivery errors induced by cabin pressure changes.

methodsThis study assessed the safety and efficacy commercial AIDs in 20 adults with type 1 diabetes (age: 37.9 ± 12.8 years, HbA1c: 52.3 ± 4.9 mmol/mol, TIR: 74 ± 9.8%, diabetes duration: 19.25 ± 10.6 years) during mid-haul commercial flights and matched ground-based conditions (MiniMed780G; Omnipod 5; Control-IQ; and CamAPS FX with YpsoPump, n = 5 per system). Outcomes included time in range (TIR, 3.9-10.0 mmol/L), time in tight range (TITR, 3.9-7.8 mmol/L), time above range 1 (TAR1, 10.1-13.9 mmol/L), time above range 2 (TAR2, >13.9 mmol/L), time below range 1 (TBR1, 3.0-3.8 mmol/L), time below range 2 (TBR2, <3.0 mmol/L), and total daily insulin doses.

resultsOverall TIR was 88.2 ± 13.5% in-flight versus 82.1 ± 17.7% on-ground. The mean difference in TIR was 4.6%, (95% CI: -5.0- 14.2). Other overall metrics (in-flight versus on-ground) were: TITR = 67.7 ± 19.4% vs. 64.2 ± 18.1%, TAR = 7.1 ± 10.5% vs. 12.0 ± 13.8% and TBR = 4.7 ± 7.2% vs. 5.9 ± 15.7%. Insulin delivery was slightly increased in-flight (25.4 ± 17.6 IU vs. 18.7 ± 11.6 IU), driven by bolus dosing (17.8 ± 13.3 IU vs. 11.9 ± 6.6 IU). No episodes of level 2 hypoglycaemia, diabetic ketoacidosis, or device failure occurred.

conclusionsAID systems maintained robust glycaemic control and safety during commercial flights, comparable to ground-based conditions. These data support the feasibility of in-flight AIDs use and provide a basis for future regulatory and clinical practice updates. Larger, multicenter studies are needed to generalize findings.

Indexed as

Diabetes Mellitus, Type 1Glycemic ControlHypoglycemic AgentsInsulinInsulin Infusion SystemsAdultBlood GlucoseFemaleGlycated HemoglobinHumansHypoglycemiaMaleMiddle AgedPilot ProjectsBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinAIDaviationCGMdiabetesHCLinsulinmedicinepilotspumptechnology

Identifiers

PMID41424231
PMCPMC12890751

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.