Breaking barriers in orbit: Indian astronaut Shubhanshu Shukla redefines space travel for diabetics

Indian astronaut Shubhanshu Shukla is currently taking part in a historic mission on the International Space Station (ISS) as part of Axiom Mission 4 (Ax-4). He is involved in more than 60 scientific experiments, including one that could change the way we understand and treat diabetes—not just for astronauts in space, but also for people on Earth.

For a long time, people who rely on insulin to manage diabetes were not allowed to go on space missions. This is because it’s very hard to control blood sugar levels in space, where there is no gravity. But now, the Ax-4 mission is challenging that idea and exploring new ways to make space travel possible for them too.

People with insulin-dependent diabetes are usually not allowed on the International Space Station (ISS) because space travel causes major changes in the human body. In zero gravity, food digests differently, insulin may not work the same way, and blood sugar becomes harder to control. Muscles weaken and shrink in space due to lack of gravity, which reduces physical activity—this also affects how the body uses insulin. Even healthy astronauts sometimes show signs of pre-diabetes during long missions because of these changes. Stress, disrupted sleep, and hormonal shifts in space can also push sugar levels up or down. Since there’s no full-time doctor onboard and emergency help is far away, it’s too risky to send someone who needs regular insulin—unless better ways to manage diabetes in space are developed.

The 'Suite Ride' project: A move toward greater inclusion

One of the main highlights of the Ax-4 mission is a study called "Suite Ride," which focuses on how the body handles glucose (sugar) in space.

The goal is to make it safer for people with diabetes to live and work in space one day.

Speaking to IndiaToday.in, Dr Mohammad Fityan, Clinical Lead for the Suite Ride project from Burjeel Holdings, said the study will also improve our understanding of diabetes and other conditions linked to blood sugar.

Burjeel Holdings, which is working on this research, has teamed up with Axiom Space to find out how insulin and Continuous Glucose Monitors (CGMs) work in space. These devices are already changing how diabetes is managed on Earth, and now the study wants to see if they can be safely used in space too.

Why space could change the way we study diabetes

In space, the absence of gravity gives scientists a unique chance to study how the human body works without the usual pressure from Earth's gravity. This helps them look at how the body processes sugar (glucose) in a completely new way.

Dr. Fityan explained to IndiaToday.in that in microgravity, changes in muscle size, body fluids, and sleep patterns help reveal how insulin works in the body. This could lead to discovering new signs of insulin resistance and finding better ways to manage diabetes.

By observing how healthy people’s bodies respond in space, scientists can learn how diabetes might behave in the same conditions. This is an important first step in making space travel safer for people who have long-term health conditions like diabetes.

How the study is being done on the ISS

During the two-week mission, one or more astronauts are using Continuous Glucose Monitors (CGMs) the whole time. These small devices keep track of their blood sugar levels all day and night and send the information back to scientists on Earth for study.

Dr. Fityan explained that one or more astronauts are wearing Continuous Glucose Monitors (CGMs) throughout the mission. These devices constantly check blood sugar levels, and the data is being collected for research. Although insulin pens were sent along, astronauts are not using them—they are only being tested to see if insulin remains stable and effective in space. Blood samples are also being taken during the mission to double-check glucose readings. Burjeel Holdings provided the medical tools needed, like lancets, needles, and a device called i-STAT that checks blood sugar on the spot.

Breaking Barriers for Diabetics in Space

Dr Fityan shared the main reasons why people with diabetes are not yet allowed to go to space:

Blood sugar levels can quickly change in space, and if they drop too low, it can be life-threatening—especially since there’s no quick medical help available.

Storing and using diabetes medicine in space is hard because of temperature changes, body fluid shifts, and the way medicine is absorbed in zero gravity.

Keeping blood sugar under perfect control for a long time is very difficult during space missions.
The Ax-4 mission is helping scientists learn how a healthy body handles sugar in space and whether Continuous Glucose Monitors (CGMs) can be safely used by astronauts with diabetes in the future.

Improving Diabetes Care on Earth

The Ax-4 mission isn't just about helping future astronauts—it could also bring big benefits to people living on Earth, especially those in remote or low-resource areas.

This research could lead to:

• New ways to track sugar levels from a distance in real-time.
• Better glucose monitors that work well in tough conditions.
• Smart systems using AI to help manage diabetes more personally.
• New medicines to make the body respond better to insulin.

Speaking to IndiaToday.in, Dr. Fityan said this study aims to make space travel possible for people with long-term health issues like insulin-dependent diabetes—not by lowering safety rules, but by developing the right tools and systems to support them safely.

What’s Coming Next?

After the mission ends, scientists will carefully study all the data collected to plan the next steps. Dr. Fityan shared that they hope this research will lead to more studies—possibly even sending the first astronaut with diabetes into space—and also look into other long-term health conditions.

With Indian astronaut Shubhanshu Shukla on board, the Ax-4 mission could be a turning point—showing that even people with chronic illnesses like diabetes might one day travel to space. And the knowledge gained from this mission could also improve healthcare for people back on Earth.