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Navigating a Diabetes Tech Disaster at 30,000 Feet: A True Story of Insulin Pump Failure on a Plane
- Jul 29
- 6 min read
Would I have died? Probably not. Ended up in the ICU? That was definitely a possibility if I didn’t act quickly. I’d accidentally ripped out my last insulin pump infusion set and the plane was about to take off.
This is a true story of how diabetes education and preparing for the unexpected helped me avoid a diabetes disaster at 30,000 feet after an insulin pump failure.
A Vacation That Lasted a Little Too Long
I was in my early 20s and had been living with Type 1 diabetes for about 6 years. By then, I was in a groove with my diabetes care and had become accustomed to life with an insulin pump. Traveling with diabetes technology was still relatively new for me, but I’d done my research on what to expect at the airport, and things went smoothly for my departure to Mississippi.
The trip to visit my extended family was supposed to last five days. That’s two infusion set changes. I’d packed one extra set for good measure.
What I hadn’t planned for was the extension of my vacation by 2 extra days.
I was having fun and happily accepted my mom's offer to push back my flight home. Before leaving, I put on my last infusion set.
Then Everything Went Wrong: Insulin Pump Site Failure.
Vacation over, my uncle drove me to the Vicksburg Municipal Airport. I said my goodbyes and headed inside.
The airport was tiny.
Hot.
Crowded.
Getting through security was uneventful. Once I found my gate, I pulled out a book to pass the time. Eventually, boarding began. I stepped onto the plane. It was packed full of people. I made myself as small as possible while inching down the aisle toward the back.
I spotted my seat.
Slid my backpack off one shoulder.
Tossed my purse to the floor.
Felt a sharp tug.
Adhesive ripping from my skin.
I looked down.
My insulin pump was resting on top of my purse.
The Teflon cannula from my infusion set was staring back at me from the floor.
Education Saved Me
I quickly pieced together what had happened.
I’d been wearing my pump clipped to the front pocket of my jeans. Over years of use, the clip had gradually lost some of its gripping power. With each step forward down the aisle, my thigh had pushed the pump upward until it slipped off my pocket. It landed on my purse, but not far enough away to tug on the tubing with a gentle warning. That happened more than I cared to admit, and I’d blown off buying a new pump clip. When I tossed my heavy purse to the floor, it carried enough momentum to forcefully rip out the infusion set.
Without a new infusion set, the only way to get insulin into my body was with a syringe.
Before anyone starts using an insulin pump, they receive education on what to do if insulin delivery is interrupted. This could be a mechanical malfunction (rare, but they do happen), or more commonly a pump site issue, spoiled insulin, air bubbles, loose connections... The list goes on.
This was one of those moments.
Becoming My Own Insulin Pump
I stowed my backpack, sat down, and pulled out my glucometer for a fingerstick. I didn’t have a continuous glucose monitor, and even if I'd had one, CGM technology wasn't accurate enough back then to dose insulin from. Disconnected from insulin delivery, I knew my blood sugar would rise gradually 30-60 minutes from now.
I grabbed my ‘what if’ supplies from my purse.
Vial of fast acting insulin.
Alcohol wipes.
Syringes.
I checked my blood sugar, calculated the amount of basal insulin my pump would have delivered over the next hour, added a small correction dose to bring my glucose closer to target, rounded the number, and drew up the insulin.
No time to feel self-conscious, I injected the insulin it for survival, not caring if anyone was watching me.
An hour later, I repeated the process. And then again. I was careful not to stack correction doses, well aware of the action time for my insulin. Hour by hour, I acted in place of my insulin pump.
Throughout the flight, I delivered enough insulin to prevent diabetic ketoacidosis (DKA), offset the stress hormones trying to push my glucose higher, and kept my blood sugar in a safe range.
No severe highs.
No low blood sugar either.
Honestly, I was pretty proud of myself.
When I finally got home, I inserted a new infusion set and re-connected my pump.
Crisis over.
The Takeaway
Diabetes technology is incredible.
But technology can fail.
Batteries die.
Sensors fall off.
Infusion sets kink.
Pumps break.
That’s why diabetes education matters just as much as the device itself.
I didn’t avoid disaster because I got lucky.
I avoided it because someone taught me what to do before I ever needed it.
That's the real power of diabetes education.
Why Pump Users Can’t Just Wait.
I have type 1 diabetes, an autoimmune condition where the body's immune system destroys the insulin-producing cells of the pancreas. People with type 1 diabetes no longer make insulin and depend on replacement insulin to stay alive. Without insulin, the body can only survive for a few days, two weeks at most.
Insulin pumps use programmed settings to deliver only rapid-acting insulin. They give tiny amounts over each hour plus known as a basal rate and the user can request larger doses called a bolus to cover the impact of food or correct high blood sugar. Because there is no long acting insulin being used, there is very little safety net for when insulin delivery suddenly stops.
Diabetic Ketoacidosis (DKA) is a serious, life-threatening diabetes emergency caused by a severe lack of insulin. For someone using an insulin pump, DKA can begin developing in as little as two to four hours after insulin delivery stops completely.
When insulin is present in the body, it opens the door to our cells letting sugar enter to be used as energy. Without insulin, the body switches to burning fat for energy. This process creates acidic byproducts called ketones. As ketones build up, the blood stream becomes more and more acidic, leading to toxic levels. At the same time, the liver recognizes the body needs more energy and tries to help. Loads of sugar are added to the blood, making a dangerous situation even worse.
Early DKA Warning Sings
High blood sugar
Low energy
Intense thirst
Frequent urination
Nausea
Fruity smelling breath (from ketones)
As DKA Progresses
Worsening fatigue
Abdominal pain
Persistent vomiting
Significant dehydration
Low blood pressure
Deep, rapid breathing
Confusion or delirium
Untreated, The Final Stages of DKA
Organ failure
Coma
Death
Did you know?
Whether you make it or you take it, every person you know has insulin in their body. All mammals do, including dogs, cats, horses, mice, and so on. The first successfully isolated insulin came from pancreatic tissue of dogs in 1921.
Researchers used this extracted insulin to reverse diabetes symptoms in dogs. They managed to keep the dogs alive for 70 days, when they ran out of insulin.
Before this breakthrough, diabetes was a death sentence. In 1922, 14-year-old Leonard Thompson became the first human to receive a life saving injection of insulin extracted from a cow [source https://diabetes.org/blog/history-wonderful-thing-we-call-insulin].
What Is an Insulin Infusion Set?
For anyone unfamiliar with insulin pumps, an infusion set is the small device that delivers insulin beneath the skin. It consists of a soft plastic cannula (or a tiny steel needle) secured with an adhesive patch. Think of it as a very small IV, except it sits in the fatty tissue instead of a vein.
Most infusion sets are changed every two to three days.
Why Change an Infusion Set Every Few Days?
The biggest reason is insulin absorption.
Imagine the infusion set as a faucet dripping insulin slowly and steadily into a sink. At the bottom of the sink sits a dry sponge, this represents a fresh patch of tissue under the skin. At first the sponge absorbs the insulin easily, blood sugar levels are more predictable. Eventually the sponge becomes saturated. Even if you try adding more insulin, the sponge is full and less effective than it was before.
A fresh infusion site absorbs insulin more predictably. As the days go by, inflammation develops, the tissue becomes less responsive, and blood sugars often become harder to manage. Other reasons infusion sets need regular changes include:
The Body Fights Back: The immune system naturally tries to wall off the foreign cannula, gradually causing inflammation that reduces insulin absorption.
Scar Tissue: Repeated and frequent use of the same area can lead to lipohypertrophy, rubbery lumps beneath the skin that cause unpredictable insulin absorption.
Microscopic Clogs: Body heat and movement leads to tiny insulin crystals that form over time, occasionally blocking insulin flow.
Infection Risk: Sweat, moisture, and bacteria collect beneath the adhesive. The longer a site stays in place, the greater the chance of skin irritation and infection.
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Author's Note
This story was written by me, Katlyn Agosta, MSN, APRN, FNP-C, CDCES, nurse practitioner, certified diabetes care and education specialist, and proud Valrico local. I started Papaya Primary Care to make healthcare more personal, accessible, and prevention focused again. My specialty is diabetes care, education, and empowerment from the lens of my own type 1 diabetes experiences.
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