800-P: Sleep Quality for Adults with Type 1 Diabetes Using Multiple Daily Injections (MDI) of Insulin Flying across Multiple Time Zones: A Pilot Study

Long-haul travel (flights >6 hours) can be disruptive for people living with type 1 diabetes (T1D). As part of a study comparing insulin Degludec U100 (DEG) with insulin Glargine U100 (GLA) during long-haul travel (ClinicalTrials.gov Identifier: NCT03668808), we evaluated the impact of direction of travel on sleep quality and glucose control. The study began, after randomization to GLA or DEG, in Honolulu (HI) with a non-stop flight to New York (NY). After 72 hours, subjects returned non-stop to HI. Six weeks later subjects repeated travel using the other basal insulin. Sleep was monitored with ActiGraph wGT3x worn on the non-dominant wrist for 24 hours at the destination and blinded continuous glucose monitoring (CGM) using the Abbott Freestyle Libre Pro. Usual care was used for glucose monitoring. Jet lag was assessed by a validated questionnaire. Twenty-one subjects (13 women) mean (SD) age 34.2 (15.2) years and HbA1c 7.5 (1.2) % completed travel (Table). TST, SE, and median glucose were significantly different between NY and HI. Sleep also differed subjectively with “ease of going to sleep” and “sleep quality” better in NY vs. HI; “alertness on waking” and “jet lag” were not different. We found that traveling across multiple time zones from East to West was more disruptive to sleep and associated with higher average glucose levels for adults with T1D using MDI.