Pilots flying with insulin-treated diabetes

Abstract

People with diabetes treated with insulin have often faced blanket bans from safety-critical occupations largely because of fear of incapacitation due to hypoglycaemia. Recent advances in insulin therapies, modes of administration, monitoring, and non-invasive monitoring techniques have allowed stereotypical views to be challenged. The aviation sector has led the way in allowing pilots to fly on insulin. Recently countries that have traditionally been opposed have changed their minds largely due to the increasing evidence of safety. The purpose of this review was to gather all available information to update clinicans. The physiology and pathophysiology underpinning glucose regulation and the management of diabetes in the air allowing certain insulin-treated pilots to fly are discussed.