Tolerance of Centrifuge-Simulated Spaceflight in Individuals with Diabetes Mellitus
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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. King SA, Blue RS. Tolerance of centrifuge-simulated spaceflight in individuals with diabetes mellitus. Aerosp Med Hum Perform. 2025; 96(2):101–110.

Inclusion and exclusion criteria for diabetic subjects participating in prior human centrifuge studies aggregated for the current analysis.

Combined spaceflight profiles. A) Fixed-wing suborbital spaceflight profile with passengers seated upright during launch and supine during re-entry, resulting in sequential +Gz and +Gx acceleration vector exposures. B) Combined fixed-wing suborbital spaceflight profile for vehicle with upright, seated passengers during launch and re-entry, resulting in a combined +Gx/+Gz acceleration vector exposure during simulated reentry.

Diabetic cohort heart rates during winged vehicle profiles, including sequential-vector fixed wing suborbital spaceflight profile (top panel; corresponding to Fig. 1A); and combined-vector fixed-wing suborbital spaceflight profile (bottom panel; corresponding to Fig. 1B), compared to nondiabetic subjects experiencing these profiles. Heart rate values are presented at rest before and after the profile as well as during predetermined dynamic profile events. Diabetic subject average heart rate is indicated by the dark black line, with standard deviation as indicated by darker vertical bars; nondiabetic cohort average is indicated by the light gray line, with standard deviation as indicated by lighter vertical bars. Dotted black lines represent minimum and maximum diabetic heart rate ranges. Light gray shaded area represents minimum and maximum nondiabetic heart rate ranges.
Contributor Notes