Shubhanshu Shukla's space mission could rewrite the rules of diabetes care. Here's how

India Today

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Indian astronaut Shubhanshu Shukla is currently part of a historic mission aboard the International Space Station (ISS), participating in over 60 scientific experiments as part of the Axiom Mission 4 (Ax-4). Among them is a study that could reshape how we understand and manage diabetes: not just in space, but also on Earth.For years, people with insulin-dependent diabetes have been excluded from space missions because of the challenges of managing blood sugar levels in a zero-gravity environment. The Ax-4 mission is now rethinking that rule.advertisementTHE 'SUITE RIDE' PROJECT: A STEP TOWARD INCLUSION
A major highlight of the Ax-4 mission is a research project called Suite Ride, designed to study how glucose metabolism is affected by microgravity.The ultimate goal is to make it safe for people with diabetes to live and work in space."Suite Ride is investigating how the space environment affects glucose metabolism in the human body. This can enhance our understanding of diabetes and other metabolic diseases that impact blood sugar regulation," Dr. Mohammad Fityan, Clinical Lead for the Suite Ride project (Ax-4) from Burjeel Holdings, Chief Medical Officer, Burjeel Medical City, told IndiaToday.in.
Dr. Mohammad Fityan (right), Clinical Lead of the Burjeel–Ax-4 Space Health Research, with Gavin D'Elia (L), Global Head Of Pharma at Axiom Space and Dr. Lucie Low, Chief Scientist for Axiom Space at Kennedy Space Center.
advertisementBurjeel Holdings, the research collaborator behind the project, partnered with Axiom Space to explore how Continuous Glucose Monitors (CGMs) and insulin fare in space. These tools are already revolutionising diabetes care on Earth.WHY SPACE IS A GAME-CHANGER FOR DIABETES RESEARCHMicrogravity provides an environment that allows scientists to study the body without the usual gravitational pressures. This makes it possible to observe glucose metabolism in an entirely new light."Microgravity allows us to study metabolism without the influence of gravity. Changes in muscle mass, fluid distribution, and circadian rhythm offer new insights into glucose metabolism and insulin sensitivity. This may lead to the identification of novel pathways and early biomarkers for insulin resistance," said Dr. Fityan.By studying healthy individuals in space, scientists can create a foundation for understanding how diabetes behaves in such conditions, an essential step toward future space travel for those with chronic conditions.HOW THE STUDY WORKS ABOARD ISSDuring the two-week mission, one or more astronauts are wearing CGMs for the entire duration. These devices continuously monitor blood glucose levels and send data back to Earth.
The Ax-4 crew members aboard the International Space Station. (Photo: Nasa)
"One or more astronauts are wearing CGMs for the entire duration of the mission. Readings are continuously monitored, and data is being collected. Insulin pens were sent on the flight, but astronauts are not using them. We are testing the viability and stability of insulin in the space environment. Point-of-care blood samples are also being taken during the mission to validate glucose levels. Lancets, needles, and blood glucose analyzers (i-STAT) were provided by Burjeel Holdings," said Dr. Fityan.OVERCOMING BARRIERS FOR DIABETICS IN SPACEDr. Fityan explained the current barriers that keep people with diabetes from going to space:Glucose variability and hypoglycemia can be life-threatening in space, where immediate medical help isn't available.Medication challenges due to storage temperatures, fluid shifts, and inconsistent absorption in microgravity.The need for extremely accurate glucose control, which is hard to maintain on long missions.The Ax-4 mission is helping scientists understand how healthy metabolism behaves in microgravity and whether CGMs can be safely used by astronauts with diabetes in future missions.TRANSFORMING CARE ON EARTHThe findings from Ax-4 are not just for future astronauts. They could also benefit people on Earth, especially in remote or underserved areas. advertisementThis study could lead to:Remote monitoring platforms for real-time metabolic tracking.Advanced glucose monitors for extreme or low-resource environments.AI-based predictive models for personal diabetes care.New drug targets to improve insulin sensitivity."This research helps expand eligibility for spaceflight, not by lowering standards, but by creating technologies and protocols that enable safe participation for individuals with chronic conditions, such as insulin-dependent diabetes," Dr. Fityan told IndiaToday.in.WHAT'S NEXT?Once the mission returns, researchers will analyse the data to determine the next steps."We hope this research opens the door to future studies, including sending the first astronaut with diabetes into space and exploring other metabolic and chronic conditions," said Dr. Fityan.The Ax-4 mission, with Shubhanshu Shukla on board, could mark a historic event, one where space is accessible even for those managing chronic conditions like diabetes, and where the lessons from above help save lives back on Earth.- EndsTune InMust Watch