{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:59:01Z","timestamp":1785369541154,"version":"3.55.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>\n                    Hybrid closed-loop (HCL) systems remain underexplored within aviation, and as atmospheric pressure changes can independently affect insulin pumps and continuous glucose monitoring readings, this preliminary study assessed the feasibility of HCL safety evaluation, in both fasting and post-prandial states, by using hypobaric chamber to simulate flights. Participants with type 1 diabetes and on HCL were studied: Medtronic Guardian 4-Medtronic 780G-SmartGuard (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4), Dexcom G6-Omnipod DASH-Android APS (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1), and Dexcom G6-Ypsomed Pump-CamAPS (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1). Flight cabin pressures of 550 mmHg and 750 mmHg were simulated in a hypobaric chamber. Seven-hundred-50 glucose measurements were taken, with glucose levels demonstrating a stable decline to 4 mmol\/L during fasting. To maintain a tight fasting and post-prandial glucose range across the different pressure settings, the HCL administered insulin as expected. While not demonstrating any apparent issues, repeating flight simulation protocol with other systems, examining longer flights, and undertaking larger, powered randomised controlled trials can confirm their safety in aviation.\n                  <\/jats:p>","DOI":"10.1089\/dia.2024.0380","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T14:10:10Z","timestamp":1729779010000},"page":"128-133","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["The Feasibility of an Experimental Hypobaric Simulation to Evaluate the Safety of Closed-Loop Insulin Delivery Systems in Flight-Related Atmospheric Pressure Changes"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-1944","authenticated-orcid":false,"given":"Ka Siu","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom."},{"name":"CEDAR Centre, Royal Surrey County Hospital, Guildford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariba","family":"Shojaee-Moradie","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Manoli","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7665-0929","authenticated-orcid":false,"given":"Petra M.","family":"Baumann","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Koehler","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Edwards","sequence":"additional","affiliation":[{"name":"QinetiQ, Farnborough, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivienne","family":"Lee","sequence":"additional","affiliation":[{"name":"QinetiQ, Farnborough, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, KU, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4233","authenticated-orcid":false,"given":"Julia K.","family":"Mader","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Russell-Jones","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, University of Surrey, Guildford, United Kingdom."},{"name":"CEDAR Centre, Royal Surrey County Hospital, Guildford, United Kingdom."},{"name":"Civil Aviation Authority, Crawley, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EASA Diabetes Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/DS18-0091"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/193229681000400117"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30167-5"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.2272.2008"},{"key":"e_1_3_6_6_2","unstructured":"UK Civil Aviation Authority. Physiology of flight. 2023. Available from: https:\/\/www.caa.co.uk\/passengers-and-public\/before-you-fly\/am-i-fit-to-fly\/guidance-for-health-professionals\/physiology-of-flight\/#:\u223c:text=This results in a concomitant decrease in the P A O 2 is approximately 75mm Hg [Last accessed: August22 2024]."},{"issue":"5","key":"e_1_3_6_7_2","first-page":"570","article-title":"Insulin pumps and drop in pressure","volume":"144","author":"Aanderud L","year":"1994","unstructured":"Aanderud L, , Hansen E. Insulin pumps and drop in pressure. 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Diabetologia; n.d.;In Press."},{"key":"e_1_3_6_11_2","volume-title":"Performance of Fluid Infusion Systems in the Changing Atmospheric Pressures Encountered in Aviation","author":"Fan KS","unstructured":"Fan KS, , Paterson M, , Shojaee-Moradie F, et al. Performance of Fluid Infusion Systems in the Changing Atmospheric Pressures Encountered in Aviation. Aerosp Med Hum Perform; n.d."},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2024.2525.abstracts"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/193229680900300446"},{"key":"e_1_3_6_14_2","unstructured":"Federal Aviation Administration. Federal register: Special-issuance medical certification: Diabetes protocol for applicants seeking to exercise airline transport commercial or private pilot privileges. 2017."},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/152091502320798259"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.123556"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/193229681200600617"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/DIA.2011.0284"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.CCA.2013.03.021"},{"key":"e_1_3_6_20_2","unstructured":"Food and Drug Administration. Dexcom G6\u2014evaluation of automatic class iii designation for dexcom G6 continuous glucose monitoring system decision summary. n.d."},{"key":"e_1_3_6_21_2","unstructured":"Food and Drug Administration. 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