{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:56:24Z","timestamp":1782917784234,"version":"3.54.5"},"reference-count":30,"publisher":"Aerospace Medical Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> There is increasing interest in the screening and evaluation of individuals with underlying medical conditions for participation in commercial spaceflight, including those with diabetes mellitus. Diabetes risks incapacitation through hypoglycemic or hyperglycemic events. Limited analog data exist regarding tolerance of spaceflight in diabetics; here we evaluated diabetic tolerance of centrifuge-simulated spaceflight.<\/jats:p>\n<jats:p><jats:bold>METHODS:<\/jats:bold> Aggregated data from diabetic volunteers in prior studies of centrifuge-simulated spaceflight were compared to nondiabetic subjects. There were 20 (3 women) diabetic volunteers, with glycemic control methods including diet, oral medications, and insulin, who met screening criteria for inclusion and participated in up to 7 centrifuge profiles. Heart rate data collected prior to and during centrifuge spins and subjective postspin symptom questionnaires were analyzed.<\/jats:p>\n<jats:p><jats:bold>RESULTS:<\/jats:bold> Diabetic layperson subjects demonstrated similar hypergravity tolerance compared to nondiabetic laypersons. Two diabetic subjects did not complete all available profiles: one for nausea and one for scheduling constraints. Glycemic control methods (insulin vs. noninsulin) were not associated with differences in tolerance. There were no statistical differences in vital signs or symptoms. One subject had transient symptoms possibly related to hypoglycemia in the setting of decreased oral intake.<\/jats:p>\n<jats:p><jats:bold>DISCUSSION:<\/jats:bold> Diabetes poses a risk of incapacitation in high performance environments. Even so, these data suggest that, with appropriate screening and stratification, diabetic individuals can successfully tolerate spaceflight hypergravity exposures. Further research may allow for inclusion of diabetic individuals in future spaceflight.<\/jats:p>\n<jats:p><jats:bold>King SA, Blue RS. <jats:italic>Tolerance of centrifuge-simulated spaceflight in individuals with diabetes mellitus<\/jats:italic>. Aerosp Med Hum Perform. 2025; 96(2):101\u2013110.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6490.2025","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:30:46Z","timestamp":1738629046000},"page":"101-110","source":"Crossref","is-referenced-by-count":1,"title":["Tolerance of Centrifuge-Simulated Spaceflight in Individuals with Diabetes Mellitus"],"prefix":"10.3357","volume":"96","author":[{"given":"Samantha A.","family":"King","sequence":"first","affiliation":[{"name":"From the University of Texas Medical Branch at Galveston, Galveston, TX, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Blue","sequence":"additional","affiliation":[{"name":"From the University of Texas Medical Branch at Galveston, Galveston, TX, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"key":"B1","year":"2024","unstructured":"Center for Disease Control and Prevention. National Diabetes Statistics Report: estimates of diabetes and its burden in the United States. 2024. [Accessed 31 July 2024]. Available from https:\/\/www.cdc.gov\/diabetes\/php\/data-research\/index.html."},{"key":"B2","year":"2024","unstructured":"American Diabetes Association Professional Practice Committee. American Diabetes Association Professional Practice Committee. Pharmacologic approaches to glycemic treatment: standards of care in diabetes\u20142024. Diabetes Care 2024; 47(Suppl. 1):S158\u2013S178. [Accessed 31 July 2024]. Available from https:\/\/diabetesjournals.org\/care\/article\/47\/Supplement_1\/S158\/153955\/9-Pharmacologic-Approaches-to-Glycemic-Treatment."},{"issue":"11","key":"B3","series-title":"J Strength Cond Res.","first-page":"3193","article-title":"Physical fitness and blood glucose influence performance in IndyCar racing","volume":"32","author":"Ferguson DP","year":"2018","unstructured":"Ferguson DP, Myers ND. Physical fitness and blood glucose influence performance in IndyCar racing. J Strength Cond Res. 2018; 32(11):3193\u20133206. 10.1519\/JSC.0000000000002879"},{"issue":"11","key":"B4","series-title":"Diabet Med.","first-page":"1425","article-title":"Diabetes, trekking and high altitude: recognizing and preparing for the risks","volume":"32","author":"Mohajeri S","year":"2015","unstructured":"Mohajeri S, Perkins BA, Brubaker PL, Riddell MC. Diabetes, trekking and high altitude: recognizing and preparing for the risks. Diabet Med. 2015; 32(11):1425\u20131437. 10.1111\/dme.12795"},{"issue":"11\u201312","key":"B5","series-title":"Mil Med.","first-page":"e603","article-title":"Effect of military deployment on diabetes mellitus in Air Force personnel","volume":"183","author":"Folaron I","year":"2018","unstructured":"Folaron I, True MW, Wardian JL, Sauerwein TJ, Sim A,  Effect of military deployment on diabetes mellitus in Air Force personnel. Mil Med. 2018; 183(11\u201312):e603\u2013e609. 10.1093\/milmed\/usy050"},{"key":"B6","year":"2023","unstructured":"Federal Aviation Administration. Federal Aviation Administration guide for medical examiners: protocol for diabetes mellitus treated with any medication other than insulin. 2023; [Accessed 27 September 2023]. Available from https:\/\/www.faa.gov\/ame_guide\/dec_cons\/disease_prot\/diabetes_med."},{"issue":"12","key":"B7","series-title":"World J Diabetes.","first-page":"2036","article-title":"Hypoglycemia in diabetes: an update on pathophysiology, treatment, and prevention","volume":"12","author":"Nakhleh A","year":"2021","unstructured":"Nakhleh A, Shehadeh N. Hypoglycemia in diabetes: an update on pathophysiology, treatment, and prevention. World J Diabetes. 2021; 12(12):2036\u20132049. 10.4239\/wjd.v12.i12.2036"},{"issue":"10","key":"B8","series-title":"Diabetes Care.","first-page":"2127","article-title":"Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study","volume":"41","author":"Critchley JA","year":"2018","unstructured":"Critchley JA, Carey IM, Harris T, DeWilde S, Hosking FJ, Cook DG. Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study. Diabetes Care. 2018; 41(10):2127\u20132135. 10.2337\/dc18-0287"},{"issue":"7","key":"B9","series-title":"Aviat Space Environ Med.","first-page":"721","article-title":"Tolerance of centrifuge-simulated suborbital spaceflight by medical condition","volume":"85","author":"Blue RS","year":"2014","unstructured":"Blue RS, Pattarini JM, Reyes DP, Mulcahy RA, Garbino A,  Tolerance of centrifuge-simulated suborbital spaceflight by medical condition. Aviat Space Environ Med. 2014; 85(7):721\u2013729. 10.3357\/ASEM.3956.2014"},{"issue":"12","key":"B10","series-title":"Aerosp Med Hum Perform.","first-page":"830","article-title":"Physiological effects of centrifuge-simulated suborbital spaceflight","volume":"93","author":"Smith TG","year":"2022","unstructured":"Smith TG, Pollock RD, Britton JK, Green NDC, Hodkinson PD,  Physiological effects of centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2022; 93(12):830\u2013839. 10.3357\/AMHP.6153.2022"},{"issue":"10","key":"B11","series-title":"Aviat Space Environ Med.","first-page":"929","article-title":"Commercial spaceflight participant G-force tolerance during centrifuge-simulated suborbital flight","volume":"83","author":"Blue RS","year":"2012","unstructured":"Blue RS, Riccitello JM, Tizard J, Hamilton RJ, Vanderploeg JM. Commercial spaceflight participant G-force tolerance during centrifuge-simulated suborbital flight. Aviat Space Environ Med. 2012; 83(10):929\u2013934. 10.3357\/ASEM.3351.2012"},{"issue":"11","key":"B12","series-title":"Aerosp Med Hum Perform.","first-page":"1008","article-title":"Dysrhythmias in laypersons during centrifuge-simulated suborbital spaceflight","volume":"88","author":"Suresh R","year":"2017","unstructured":"Suresh R, Blue R, Mathers C, Castleberry T, Vanderploeg J. Dysrhythmias in laypersons during centrifuge-simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017; 88(11):1008\u20131015. 10.3357\/AMHP.4910.2017"},{"issue":"7","key":"B13","series-title":"Aerosp Med Hum Perform.","first-page":"641","article-title":"The effects of training on anxiety and task performance in simulated suborbital spaceflight","volume":"88","author":"Blue RS","year":"2017","unstructured":"Blue RS, Bonato F, Seaton K, Bubka A, Vardiman JL,  The effects of training on anxiety and task performance in simulated suborbital spaceflight. Aerosp Med Hum Perform. 2017; 88(7):641\u2013650. 10.3357\/AMHP.4807.2017"},{"issue":"8","key":"B14","series-title":"Aerosp Med Hum Perform.","first-page":"584","article-title":"Layperson physiological tolerance and operational performance in centrifuge-simulated spaceflight","volume":"94","author":"Blue RS","year":"2023","unstructured":"Blue RS, Ong KM, Ray K, Menon A, Mateus J,  Layperson physiological tolerance and operational performance in centrifuge-simulated spaceflight. Aerosp Med Hum Perform. 2023; 94(8):584\u2013595. 10.3357\/AMHP.6237.2023"},{"issue":"12","key":"B15","series-title":"Aviat Space Environ Med.","first-page":"1217","article-title":"Preflight screening techniques for centrifuge-simulated suborbital spaceflight","volume":"85","author":"Pattarini JM","year":"2014","unstructured":"Pattarini JM, Blue RS, Castleberry TL, Vanderploeg JM. Preflight screening techniques for centrifuge-simulated suborbital spaceflight. Aviat Space Environ Med. 2014; 85(12):1217\u20131221. 10.3357\/ASEM.4114.2014"},{"key":"B16","series-title":"Aerosp Med Hum Perform.","first-page":"688","article-title":"Blood glucose alterations and continuous glucose monitoring in centrifuge-simulated spaceflight","volume":"93","author":"Ong KM","year":"2022","unstructured":"Ong KM, Rossitto JJ, Ray K, Dufurrena QA, Blue RS. Blood glucose alterations and continuous glucose monitoring in centrifuge-simulated spaceflight. Aerosp Med Hum Perform. 2022; 93:688\u2013695. 10.3357\/AMHP.6110.2022"},{"issue":"4","key":"B17","series-title":"Diabetes Obes Metab.","first-page":"473","article-title":"Understanding and overcoming metformin gastrointestinal intolerance","volume":"19","author":"Bonnet F","year":"2017","unstructured":"Bonnet F, Scheen A. Understanding and overcoming metformin gastrointestinal intolerance. Diabetes Obes Metab. 2017; 19(4):473\u2013481. 10.1111\/dom.12854"},{"issue":"4","key":"B18","series-title":"Br J Pharmacol.","first-page":"542","article-title":"Glucagon\u2010like peptide\u20101 in diabetes care: can glycaemic control be achieved without nausea and vomiting?","volume":"179","author":"Borner T","year":"2022","unstructured":"Borner T, Tinsley IC, Doyle RP, Hayes MR, De Jonghe BC. Glucagon\u2010like peptide\u20101 in diabetes care: can glycaemic control be achieved without nausea and vomiting? Br J Pharmacol. 2022; 179(4):542\u2013556. 10.1111\/bph.15647"},{"issue":"12","key":"B19","series-title":"Neurogastroenterol Motil.","first-page":"951","article-title":"Diabetes and the enteric nervous system","volume":"19","author":"Chandrasekharan B","year":"2007","unstructured":"Chandrasekharan B, Srinivasan S. Diabetes and the enteric nervous system. Neurogastroenterol Motil. 2007; 19(12):951\u2013960. 10.1111\/j.1365-2982.2007.01023.x"},{"key":"B20","year":"2024","unstructured":"American Diabetes Association Professional Practice Committee. Glycemic goals and hypoglycemia: standards of care in diabetes\u20142024. Diabetes Care 2024; 47(Suppl. 1):S111\u2013S125. [Accessed 31 July 2024]. Available from https:\/\/diabetesjournals.org\/care\/article\/47\/Supplement_1\/S111\/153951\/6-Glycemic-Goals-and-Hypoglycemia-Standards-of."},{"key":"B21","series-title":"Am J Case Rep.","first-page":"e931311","article-title":"Symptomatic hypoglycemia during treatment with a therapeutic dose of metformin","volume":"22","author":"Joseph CMC.","year":"2021","unstructured":"Joseph CMC. Symptomatic hypoglycemia during treatment with a therapeutic dose of metformin. Am J Case Rep. 2021; 22:e931311. 10.12659\/AJCR.931311"},{"issue":"2","key":"B22","series-title":"Endocr Pract.","first-page":"205","article-title":"Management of diabetes during air travel: a systematic literature review of current recommendations and their supporting evidence","volume":"24","author":"Pavela J","year":"2018","unstructured":"Pavela J, Suresh R, Blue RS, Mathers CH, Belalcazar LM. Management of diabetes during air travel: a systematic literature review of current recommendations and their supporting evidence. Endocr Pract. 2018; 24(2):205\u2013219. 10.4158\/EP171954.RA"},{"key":"B23","series-title":"Cureus.","first-page":"e22447","article-title":"Considerations in the care of athletes with type 1 diabetes mellitus","volume":"14","author":"Pujalte G","year":"2022","unstructured":"Pujalte G, Alhumaidi HM, Ligaray KPL, Vomer RP, Israni K,  Considerations in the care of athletes with type 1 diabetes mellitus. Cureus. 2022; 14(2):e22447. 10.7759\/cureus.22447"},{"issue":"9","key":"B24","series-title":"Lancet Diabetes Endocrinol.","first-page":"677","article-title":"A UK Civil Aviation Authority protocol to allow pilots with insulin-treated diabetes to fly commercial aircraft","volume":"5","author":"Mitchell SJ","year":"2017","unstructured":"Mitchell SJ, Hine J, Vening J, Montague J, Evans S,  A UK Civil Aviation Authority protocol to allow pilots with insulin-treated diabetes to fly commercial aircraft. Lancet Diabetes Endocrinol. 2017; 5(9):677\u2013679. 10.1016\/S2213-8587(17)30264-4"},{"issue":"12","key":"B25","series-title":"Diabetes Care.","first-page":"2923","article-title":"An evaluation of the safety of pilots with insulin-treated diabetes in Europe flying commercial and noncommercial aircraft","volume":"43","author":"Garden GL","year":"2020","unstructured":"Garden GL, Hine JL, Mitchell SJ, Hutchison EJ, Gaffney TP,  An evaluation of the safety of pilots with insulin-treated diabetes in Europe flying commercial and noncommercial aircraft. Diabetes Care. 2020; 43(12):2923\u20132929. 10.2337\/dc20-0277"},{"key":"B26","year":"2023","unstructured":"Federal Aviation Administration. Guide for Medical Examiners: decision considerations - diabetes mellitus type i or type ii - insulin treated - CGM option. 2023; [Accessed 8 April 2024]. Available from https:\/\/www.faa.gov\/ame_guide\/dec_cons\/disease_prot\/itdm."},{"key":"B27","year":"2023","unstructured":"European Aviation Safety Agency. EU aircrew regulation: medical assessment protocol for pilots with diabetes treated with insulin and\/or potentially hypoglycaemic medication. 2023; [Accessed 4 April 2024]. Available from https:\/\/www.easa.europa.eu\/en\/document-library\/easy-access-rules\/easy-access-rules-aircrew-regulation-eu-no-11782011#page=117."},{"issue":"7","key":"B28","series-title":"Diabetes Obes Metab.","first-page":"1439","article-title":"Pilots flying with insulin\u2010treated diabetes","volume":"23","author":"Russell\u2010Jones DL","year":"2021","unstructured":"Russell\u2010Jones DL, Hutchison EJ, Roberts GA. Pilots flying with insulin\u2010treated diabetes. Diabetes Obes Metab. 2021; 23(7):1439\u20131444. 10.1111\/dom.14375"},{"key":"B29","series-title":"Life Sci Space Res.","first-page":"3","article-title":"Biomedical results of the Skylab Program","volume":"14","author":"Michel EL","year":"1976","unstructured":"Michel EL, Johnston RS, Dietlein LF. Biomedical results of the Skylab Program. Life Sci Space Res. 1976; 14:3\u201318."},{"issue":"1, Pt. 1","key":"B30","series-title":"Am J Physiol.","first-page":"E155","article-title":"Endocrine relationships during human spaceflight","volume":"276","author":"Stein TP","year":"1999","unstructured":"Stein TP, Schluter MD, Moldawer LL. Endocrine relationships during human spaceflight. Am J Physiol. 1999; 276(1, Pt. 1):E155\u2013E162. 10.1152\/ajpendo.1999.276.1.E155"}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/2\/article-p101.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/2\/article-p101.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/2\/article-p101.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T00:01:23Z","timestamp":1739577683000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/2\/article-p101.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6490.2025","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}