As the countdown to the Axiom-4 mission proceeds, a rather groundbreaking experiment led by Burjeel Holdings in collaboration with Axiom Space is taking off — quite literally. Among the astronauts heading to the International Space Station (ISS) is Indian astronaut Shubhanshu Shukla, and while his voyage marks a historic leap for India, it also opens new frontiers in diabetes research. This mission aims to address a critical question that has long limited the pool of astronaut candidates: can insulin-dependent diabetics safely travel and live in space?Tracking Glucose in MicrogravityFor the first time, astronauts on the Axiom-4 mission will take part in the "Suite Ride" experiment, which involves the use of Continuous Glucose Monitors (CGMs) to track real-time blood sugar levels in microgravity. Although it's not publicly disclosed which astronaut will wear the CGMs, the implications of this experiment are universal. These astronauts will also collect blood samples in-flight to validate the CGM data, ensuring the findings are accurate and clinically useful.Dr. Mohammad Fityan, Chief Medical Officer at Burjeel Holdings, explains the motivation behind the research, "We are trying just to see if there is any change or fluctuation to the blood-sugar levels while they are in space." The focus is on understanding how microgravity impacts glucose metabolism, insulin absorption, and hormonal responses — factors crucial to diabetes management.Refrigerated vs. Ambient Insulin: Will It Hold Up in Space?In addition to wearing CGMs, astronauts on the Axiom-4 mission will carry two types of insulin pens: one stored in refrigeration and the other kept at ambient temperature. These are not just symbolic inclusions but scientific test subjects. Researchers aim to observe whether the molecular integrity of insulin can be maintained in space, a challenge given the temperature fluctuations and radiation exposure on the ISS.This is a significant development in light of current restrictions. NASA presently does not allow insulin-dependent diabetics to become astronauts, and although there is no official exclusion for non-insulin-dependent individuals, no person with diabetes has ever ventured into space. This mission could set the stage for a major policy shift.Why Microgravity Matters for Diabetes Research and Treatment?Life in microgravity is vastly different from life on Earth. Reduced gravitational force alters fluid dynamics, muscle mass, bone density, and cellular signaling. These changes can impact how insulin is absorbed, how glucose is metabolized, and how the body reacts to both.Dr. Fityan notes, "We hope that if we learn something about metabolism or its effects, we can use that knowledge to help our patients on Earth." Indeed, what is discovered in orbit could lead to more effective and targeted therapies for those living with diabetes on the ground — especially those who are bedridden, paralyzed, or in otherwise low-activity environments.What's Next? Wearables, AI Models, and New Drug TargetsBeyond space exploration, the Suite Ride study is poised to have ripple effects in terrestrial healthcare. The data collected will help:Design wearable tech for patients with limited mobilityDevelop AI-powered predictive models to forecast insulin needsCreate new drugs that enhance insulin sensitivity or mimic exercise in sedentary individualsRemote monitoring platforms that can capture continuous metabolic data from space may one day become the gold standard in diabetes management for underserved communities and telehealth systems.Although this isn’t the first diabetes-related experiment in space, Axiom-4 takes the research further. Astronauts on Polaris Dawn and Galactic 07 missions wore CGMs or tested insulin pens, but Axiom-4 integrates both real-time monitoring and pharmacological testing — a first.The Polaris Dawn mission, which lasted five days in September last year, involved CGM usage but lacked molecular testing of insulin. The Galactic 07 sub-orbital mission by Virgin Galactic proved that commercially available insulin pens could be used in space, but it was a brief encounter with microgravity.Axiom-4’s two-week long mission, therefore, is uniquely poised to yield longitudinal data critical for comprehensive understanding.Should the Axiom-4 study succeed, it could dismantle one of space exploration’s last great medical barriers. Diabetics, particularly those reliant on insulin, have historically been excluded from astronaut programs due to the unpredictability of insulin behavior in microgravity. Proving that it is safe and manageable could redefine who gets to go to space.Moreover, this could lead to rethinking diabetes care on Earth. As Dr. Fityan says, "It has the potential to transform the future of space travel for astronauts with insulin-dependent diabetes mellitus (IDDM), a condition historically considered disqualifying for space missions."Even after the astronauts return, the impact of their journey will continue. Data from CGMs, blood samples, and insulin tests will be analyzed in ground-based labs. If trends or anomalies are found, they could spark development in precision medicine — tailoring diabetes care not just for astronauts but also for aging populations, patients in intensive care, or individuals living in remote areas with limited access to healthcare.The fusion of space tech and medicine, driven by private and public partnerships, is making personalized and planetary health one and the same.