Some of Brynn Lansford’s best memories as a young boy were listening to his pilot family members share tales from the cockpit. Always drawn to the big skies and bright stars above his South Park home, he dreamed of the day he would wear the “wings.”
That dream was crushed in middle school when his dad broke the news: Because of the type 1 diabetes he was diagnosed with at age 2, Lansford could never become a commercial pilot.
“It was tough,” recalled Lansford, whose family – which boasts several Air Force alumni, including his commercial-pilot father – had just moved to Colorado Springs. “I’d always looked up to my family, and my role models were from the Air Force and aviation. It was something I really, really, really wanted to do.”
A decade later, Lansford’s extinguished dream was unexpectedly reignited with the help of Halis Akturk, MD, an endocrinologist at the Barbara Davis Center for Diabetes (BDC) at CU Anschutz, where Lansford has gone since age 8 for diabetes treatments. Collaborating with the Federal Aviation Administration (FAA), Akturk helped pioneer putting insulin-dependent pilots on the path toward medical clearance.
"As a teenager growing up in South Park, we had a hot tub where I would go out at night, turn off all the lights and stare at the stars. Now when I fly at night I stare at the same stars and can't believe where I am."
– Brynn Lansford, first officer, Republic Airways
Years in the making, the transition culminated in late 2019 when the FAA at last ceded to advancements in continuous glucose monitors (CGM) and diabetes treatments. Until then, the agency deemed that anyone with type 1 diabetes posed too great of a safety risk as a commercial pilot.
The inaugural group of insulin-dependent pilots cleared its first-class medical certificates in April 2020.
Akturk said it was a steep learning curve to fully understand the FAA’s rigorous requirements for each patient – months of CGM data linked to flight logs and breakdowns of A1C (average blood sugar) tests and other metabolic information. “We learned what the FAA needs, and we created a template specific to pilots,” he said. “We have to write our notes in a certain way. We have to document things in a certain way.”
The experience of helping the early groups of pilots secure their first-class medicals led to more patients, including Lansford, and the launch of the BDC’s Flying with Type 1 Diabetes program, one of few of its kind in the nation. About 10 pilots are now flying for major carriers through the BDC program.
Nationally, it’s a small group of insulin-dependent pilots flying commercially, and Lansford has a connection to Bob Halicky, one of the inaugural pilots who in April 2020 cleared his medicals.
Halicky resumed flying for Southwest that spring after he’d flown for the airline up until being diagnosed with type 1 diabetes in 2011. Early in his revived captaining career, Halicky bumped into Lansford’s father, who excitedly shared the news of the new program with his son. Having shelved his hopes of becoming a commercial pilot, Lansford had studied medicine and was applying to radiology school.
“It was such a shock,” Lansford said. “It’s like being told you don’t have legs and all of a sudden you can grow a new pair and run. After 24 hours I told my dad that 100 percent this is what I want to do. I was in an airplane the next day.”
Word about the BDC program has literally flown across the nation and globe, with inquiries even coming from Europe, where countries have varying rules for pilots with type 1 diabetes. Akturk said he regularly hears pediatric diabetes patients saying they want to become a pilot.
When starting as a clinical endocrinologist a decade ago, Akturk said, he would tell young insulin-dependent patients, “You can still do whatever you want – other than being a pilot.” Fortunately, he doesn’t have to say that anymore.
Helping future pilots with type 1 diabetes reach their dreams
Brynn Lansford is in the process of launching a social media page as a resource for aspiring pilots who have type 1 diabetes. “My goal is to create a platform for people to exchange information, to talk, to spread that message of hope and inspiration that things are changing. If you’d asked me five years ago if it was going to be possible, I would’ve told you never.”
Now, he tells patients with aviation aspirations to pay attention to three things: For the best health outcomes, use a smart insulin pump connected to a CGM; maintain their hemoglobin A1C in the safety ranges required by aviation authorities; and lastly, study the aviation medical certificate requirements for their region and country.
Hypoglycemia, or potentially dangerous low blood sugar, is a risk for pilots with type 1 diabetes because the condition can decrease their ability to make decisions. “It’s a situation where it may change your level of consciousness,” Akturk said. “In recent years, with the advancements in diabetes treatment technologies, we can minimize hypoglycemia significantly in our patients.”
For Lansford, the switch from sticking his finger for blood draws to the automated wearable CGM – and now an integrated Garmin watch that shows, at a glance, his blood-sugar level – has made all the difference.
Low blood sugar is obviously problematic for a pilot, but high blood sugar is also “fairly uncomfortable,” he said. “So, I try to eat fairly light in the beginning of the day, minimize the carbs, but once you are in the plane or at the airport, you’ve got all the food options you need” to manage blood-sugar levels. Apple juice and gummy bears are his go-to snacks in the cockpit.
Every six months, his first-class medicals must be renewed. Lansford makes quarterly visits to an endocrinologist, annual trips to the ophthalmologist and appointments with a cardiologist every two years.
He is currently based in Columbus, Ohio, wrapping up his first year as a commercial pilot for Republic Airways. He flies to Barbara Davis Center to have a visit with Akturk every quarter.
Lansford’s dreams are just beginning. He envisions a day when he spearheads a nonprofit that takes children with diabetes to a smaller airport, possibly Centennial in suburban Denver, to stoke their own flying passions.
He loves that avenues to captaining the airways are now open to children with type 1 diabetes – among the next generation of aviators.
Frequently, in the quiet of the night while behind the controls, he revels in the surrealness of his journey. He gets to enjoy “the best view in the world” while working.
“As a teenager growing up in South Park, we had a hot tub where I would go out at night, turn off all the lights and stare at the stars,” Lansford said. “Now when I fly at night I stare at the same stars and can’t believe where I am. I’d be lying if I said it doesn’t make me emotional. A feeling of accomplishment, being grateful that I’m alive at this time, that I get the opportunity to do something I was told my whole life wasn’t possible because of my diabetes.”
Photo at top: Brynn Lansford stands beside a Piper Archer PA-28 aircraft. “It holds a special place in my heart,” he said. “More than 1,000 hours of my flight time were in that model of plane.”