Episode Overview

Podcast: Taking Control Of Your Diabetes® – The Podcast!
Episode: Travel Tips From a T1D Commercial Pilot
Date: February 12, 2026
Hosts: Dr. Jeremy Pettus & Dr. Steve Edelman
Guest: Quentin Weiskettle (Commercial Airline Pilot living with Type 1 Diabetes)

In this enlightening and uplifting episode, Drs. Pettus and Edelman sit down with Quentin Weiskettle, one of the few commercial airline pilots in the U.S. licensed to fly with Type 1 Diabetes (T1D). Quentin shares his personal journey, the challenges he overcame to return to the cockpit, and practical, real-world strategies for managing T1D at 35,000 feet—through time zones, turbulence, and ever-shifting travel routines. The conversation mixes important guidance for travelers with diabetes, a window into regulatory changes, and candid discussion about overcoming stereotypes in the medical and aviation communities.

Key Discussion Points & Insights

Quentin’s Diagnosis & Early Impact (02:14–08:10)

• Late-Onset Diagnosis: Quentin was diagnosed with T1D at 37, having already established his commercial airline career.
• Symptoms Misattributed: Early symptoms (fatigue, extreme thirst) were initially dismissed as due to having a newborn at home.
  • Memorable detail: Had to request extra bathroom breaks on flights due to excessive drinking.
• Quick Medical Response: Diagnosed correctly without delay, unlike many adults who are misclassified as T2D.

“They immediately listened to my story. The minute I said, you know, yeah, I'm drinking like crazy... For instance, I’d be going from Boston down to Raleigh Durham, and I’d be asking the flight attendants to set up for a bathroom break, like, twice.” — Quentin (04:01)

Career Setback and Industry Barriers (05:15–11:08)

• Immediate Threat to Career: Upon diagnosis, Quentin believed he’d taken his last flight as a commercial airline pilot under existing U.S. FAA regulations.
• Advance of International Standards: Canada, the UK, and Australia already allowed insulin-dependent pilots, highlighting the U.S. lag.
• Legal and Regulatory Change: Lawsuits and advocacy (notably Eric Friedman’s case) pressured the FAA, which began reissuing medical certificates to T1D pilots in 2021.
• Seven-Year Hiatus: Quentin was grounded for seven years, during which he became a stay-at-home parent while his wife started her medical residency.

“When I went to go see the doctor, that was it. I knew that that was my last flight as a commercial airline pilot.” — Quentin (05:20)

Life During the Hiatus (08:29–11:24)

• Embracing Change: Quentin reframed adversity, relishing time as “Mr. Mom” for his daughter during formative years.
• Aviation Ties Remain: Continued work tangentially in aviation, including participation in a famous Discovery Channel crash-test experiment involving a 727 (see “DB Cooper Door” anecdote, 09:15–11:14).

Getting Back in the Air: Medical Requirements & Management (11:31–14:18)

• FAA Medical Standards: To regain his license, Quentin needed a first-class FAA medical, which mandates:
  • Continuous CGM use (e.g., Dexcom G7)
  • 12 months of stable CGM data showing good “time in range”
  • Quarterly endocrinology visits; annual cardiology and ophthalmology exams
• No Pump Required: Pumps are not required, and Quentin remains on multiple daily injections for personal and safety reasons (see below).
• Ongoing Monitoring: After initial certification, Quentin submits CGM data and medical reports every 6 months for license renewal.

“They’re going to want your CGM data separated out into months... The bare minimum, they want to see like, a time in range of 70% between 70 and 180 [mg/dL]. They don’t want more than 1% excursions above 250, and very few excursions below 50.” — Quentin (12:10)

In-Flight Diabetes Strategies (14:18–19:06)

• Diet and Insulin Dosing: Quentin adjusts his diet (low-carb, measured intake) and raises his target blood glucose slightly (140–150 mg/dL) to reduce hypoglycemia risk while flying.
• Routine and Tools: Always preps with orange juice as a ready hypo treatment; sets low CGM alerts at 100 mg/dL for advance warning.
• Professionalism in Cockpit: Notifies co-pilots about his CGM and injections in advance (sometimes necessary to avoid startling needle-phobic colleagues).
• Colleague Reactions: Has not encountered discrimination from pilots; some frustration with non-endocrine physicians attributing every health issue to diabetes.

“Part of my flow, I add... I grab my phone, I pull it up, I check my CGM, because that’s my last chance... if something’s really off, that’s my last chance to say, ‘Hey, I need to return to the gate, I can't fly today.’” — Quentin (18:00)

Technology in Aviation: Pump or Not? (23:17–25:36)

• Pump Concerns: A catastrophic cabin depressurization could force air through pump tubing, risking insulin overdose if any air remains.
• Pilot Preferences: Many T1D pilots prefer MDI for maximal manual control; a few use pumps successfully.
• Peer Support: While joking about a “T1D Pilots Facebook Group,” there appears to be informal networking and information sharing.

“If there’s a pump that has any sort of air in it... I’m not sure... but if the path of least resistance is going into the injection site, then that’s a really big problem.” — Quentin (23:40)

Military, Regulatory, and Systemic Barriers (27:29–29:50)

• Military Exclusion: U.S. armed forces still do not allow pilots (or often anyone) with T1D or autoimmune diseases like Hashimoto's.
• Veteran Impact: Many VA patients with T1D developed it after military service, leading to unique late diagnoses.
• Dr. Edelman’s Frustration: Host laments changing regulations and arbitrary exclusions, given treatability and capabilities of many with T1D.

Practical Travel Tips for People with Diabetes (30:28–33:59)

Staying Prepared Before and During Travel

• Anticipate Blood Sugar Fluctuations

  • Airport rush can prompt lows; long, sedentary flights typically lead to highs.
  • Slightly higher target (140–150 mg/dL) during travel for safety.

• Bring Supplies and Redundancy

  • Always carry backups: multiple insulin pens and CGMs, stored in separate bags.
  • Use a stainless steel water bottle (e.g., Klean Kanteen) with ice to keep insulin cool during transit.

• Keep Insulin Safe but Not Excessively Cold

  • Room temperature is fine for insulin being used; don't overdo chilling, which can waste space and effort (host advice).

“Ideally I want them in separate bags, so if something happens and I lose my bag, I don’t lose my insulin.” — Quentin (32:29)

Insights on Security and Device Use

• Quick Security Processing for Pilots: But still manages typical travel routines, including TSA screening.
• Consider an Apple Watch: Hosts suggest checking blood glucose on a smartwatch to avoid suspicion (and the appearance of texting during pre-flight checks).
• Use the CGM Receiver: Reduces risk if phone/Bluetooth fails; easy cockpit access.

Memorable Quotes & Moments

• On diagnosis and sudden career disruption:
  “I knew that that was, like, my last flight as a commercial airline pilot.” — Quentin (05:20)

• On overcoming medical bias:
  “I had an endocrinologist who just looked me in the eye and said, ‘I wouldn't want a diabetic flying my plane.’ And obviously that wasn’t going to work.” — Quentin (35:18)

• On practical professional adaptation:
  “I come into the cockpit, I start setting up... I immediately set an orange juice over in the cup holder... When I’m flying, I’m perfectly fine with [BG] being like 140 or 150... it gives me that much of a buffer.” — Quentin (16:00)

• Dr. Steve Edelman on hybrid closed loops:
  “It just reminds me how effective these hybrid closed loop systems are... It'll turn off the insulin to prevent lows... increase the basal rate...” — Dr. Edelman (31:45)

• On advocacy and medical partnerships:
  “Find endocrinologists you can work closely with... There’s a lot of paperwork, you’re going to need someone who gets back to you in a timely manner and is willing to put in that extra effort.” — Quentin (35:00)

Notable Timestamps

• Quentin’s T1D diagnosis and initial career shock: 05:15–07:11
• Legal battles and regulation change: 05:45–07:04
• Details on FAA and medical certification for T1D pilots: 11:31–14:18
• In-flight diabetes management strategies: 14:18–16:58
• Cockpit routines and co-pilot communications: 17:49–19:06
• Debate on pumps vs. MDI for pilots: 23:17–25:36
• Traveling with T1D—practical travel tips: 30:28–33:59
• Advice on working with supportive medical professionals: 35:00–36:41

Takeaways for Listeners

• Commercial pilots with T1D face rigorous, data-driven medical oversight but CAN pursue or reclaim their dreams thanks to recent regulatory progress.
• Smart preparation, dietary strategies, and tech like CGMs allow for safe flying—even across time zones and in unpredictable work environments.
• Supportive, agile medical teams—not just great gadgets—make all the difference for people with T1D pursuing demanding careers.
• Advocacy works—regulations restricting T1Ds from certain professions CAN be changed.
• Practical tips (e.g., always carry backup insulin, accept a slightly higher BG during travel, and key uses for a decent smartwatch) benefit all travelers with diabetes.

For more “edutaining” conversation and firsthand expertise, check out more episodes from Taking Control Of Your Diabetes®.