I first "met" Douglas Cairns (via phone) when I interviewed him in college for a teen diabetes website. Douglas has an incredible story and I'm excited to hear he's off on another adventure!

After getting kicked out of the Royal Air Force when he was diagnosed with type 1 diabetes at age 25, Douglas didn't give up on his passion for flying. Living in Taiwan, he began flying with the Thai Flying Club, and later learned that it was legal to privately fly in the United States with diabetes. In 2003, Douglas launched the Diabetes World Flight (DWF), the first round-the-world flight by a licensed pilot with type 1 diabetes. The journey covered 26,300 nautical miles through 22 countries over five months in a twin-engine aircraft, and raised $26,000 for JDRF.

Today, Douglas is launching a new attempt to set a speed record to the North Pole. When we spoke recently, Douglas shared how he'll do it and why he does it. To follow his trip at home, you can visit Diabetes Polar Flight.

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DM) The last time we spoke was in the mid or early 2000s, and I hear you've been breaking records since then?

I think we spoke after the around the world tour, [so around 2005 or 2006]. Since then I came back to the UK from the US in November 2007, back to London, and back to the asset management industry... I've  decided to make the flying with diabetes my focus in my spare time. I've ended up doing some really exciting projects because of this. I think when we last spoke, I had probably set 5 speed records in the US and two transcontinental records.

I've broken two very, very interesting records in the US using a twin engine Beech Baron. I broke an existing record to land in all 48 continuous states in the US which, was a race against time. The last record was five and half days and we managed to break it in 4.5 days. I was really delighted with that. I had two pilots with diabetes, myself and a friend with type 2 but he's on insulin, so he has the same protocol to meet when flying.

Last year, I also broke the old record to land in all 50 states. The last record was over 15 days, and I did it in 5 days and 15 hours, so I really smashed that. I had to install extra fuel intakes to allow for a 14.5 hour flight between Hawaii and Los Angeles. I also had an official observer to record all the landings, and a technical crew member to look over all the systems.

I bet the Air Force is regretting losing you, now that you're a celebrated pilot.

I was delighted last month to receive an award for that flight from the National Aeronautic Association. They basically recognized it as one of the most memorable aviation records of 2010. It was a real honor and a pleasure. It was great to stand up for about 5 minutes and explain why I'm doing all these record flights... showing what you can do with diabetes, rather than be told what you cannot do when it comes to flying. Only five countries will allow private flying for pilots with type 1, and the US is the only country that has unrestricted pilots privileges for people with type 1 diabetes.

I'm really trying to get out positive messages. Showing what you can do and also really highlighting a key message that diabetes need not limit the scope of people's dreams and ambitions.

Tell us about the flight you're launching on April 18 (today!) to the North Pole.

I've been planning a flight to the North Pole in the Beech Baron in 2005, and nearly did it in 2006 but funding fell through. One of the benefits of going back to work was that I can help finance these trips myself now. I do have some sponsorship, but the aim is to have all the flying costs funded by private funds and sponsorships, so any donations made go directly to JDRF.

This particular project has two aims. First, to set a world speed record from Barrow, Alaska and the North Pole, and the second is to make the first-ever landing at the North Pole in a light twin engine piston parrot aircraft. We cannot find anyone who's done it before, so we're trying to register this as another unique aspect of this record flight.

But really the key aim that it comes back to is flying solo with diabetes. It'll be an endurance flight, taking 16 hours to complete. The aircraft has extra fuel tanks to allow me 20 hours of cruising time. There's also the added challenge that you're in an extremely cold, isolated environment. So we're really highlighting what you can do with diabetes when it comes to flying.

Sounds pretty dangerous / crazy...?

It's a pretty extreme project, but we've made a huge amount of preparation going into this. And I'm working very closely with an arctic aviator called Ron Sheardon. I'm hoping very much that he will have a single engine plane to fly up to the North Pole. If he does, he'll fly up ahead of me [with another person] in a single engine plane with skis on and he'll find a suitable piece of ice. That will allow me to land on a 2,000 foot strip of ice and it will be cold enough to use the breaks effectively. I've done the training in Alaska and I'm feeling comfortable enough to do it with two people on the ice, having prepared a strip beforehand. And after the training, because there are no trees getting in the way (it's the North Pole!), it should be a relatively straightforward experience. But if Ron cannot get a hold of an aircraft and prepare the ice, I'm going to do this flight solo, flying over magnetic north pole and the geographic north pole, but I won't land because the risk is just too great not having a strip prepared for me.

So how do you manage diabetes while flying for 16 hours straight, with no stops?

In fact, it's very straightforward. I'll have a supply of water, sweet drinks if my sugar's trending a bit lower, sandwiches and snack bars. The protocol is to test 15 minutes before take off, every hour while flying and 30 minutes before landing. Your blood sugar range needs to fall between 100 to 300 mg/dl. It's a very wide, workable range. If you're above 300, you need to land as soon as practical. In over 10 years of flying, not once have I gone above 300 and I have no intention of doing so. If you're under 100, you don't need to land, but you do need to ingest 20 grams of carbs.

The flying issue is really interesting, because when you're flying you can fly straight and level for quite a number of seconds with your hands off the controls. Similar to sailing, you can "trim" the controls so the plane can carry on flying straight and level. It might begin to gradually wander off, and if you're in turbulent air, that will happen. I also have an auto-pilot on the aircraft, so you can sit back and relax and just monitor your settings. It's like sitting at a kitchen table and testing your blood sugar then.

What diabetes tools do you use?

I'm delighted to have support from Roche's Accu-chek Mobile meter. It's all self-contained. A little test strip is rolled out, and the finger pricker is attached to the meter. But even if you're using a more old-fashioned meter, where you have to insert strip and have a separate finger stick, you can do it step by step. You can take your hands off the controls and do one step, and then put your hands back on the wheel.

Although it's not required, I also use a continuous glucose monitor. I'm very happy to work with DexCom and use one of their Seven Plus CGMs. The beauty of that is that I have a velcro strip on the back of that monitor and I attach it to the instrument panel so I can just press a button as often as I like to see my blood sugar levels and trends. By combining CGM and blood testing every hour, I can absolutely guarantee that I will not go low.  It really works terrifically well.

Isn't the BG testing distracting?

When you're flying for a long period of time, there are certain cockpit checks and procedures you need to go through to monitor everything. The diabetes management and testing just becomes part of your cockpit test regime.

What kind of advocacy have you done on behalf of other pilots? Have any other countries begun allowing pilots with diabetes to fly?

In terms of advocacy, my main aims are to get awareness out and show what we do with diabetes, through the aviation magazines and other channels.

We have a group in the UK called Pilots with Diabetes. The aim is to really help open doors for the British Aviation Authority to become more flexible. We have been proposing ideas for commercial flying. We've attended meetings to highlight what we're doing and how we can do this. So we're quietly working away here, and anyone anywhere else can get in touch with us.

I did act as a witness for a gentleman in Australia, who was getting a consideration to fly solo in Australia. This was a number of years ago, about 2005. Funny enough, I phoned up the tribunal hearing in Melbourne or Canberra, Australia. I was just standing by my aircraft, about to hop in it, at night time by myself, over the Rocky mountains flying back to Denver. I was able to relay all this and I was delighted that the review panel decreed that that gentleman could then also fly solo.

Australia has since then amended their policies, though I don't know the exact details, but I understand they are a bit more flexible now.

In which countries are PWDs allowed to fly solo?

Now it is the US, Canada, the UK, Australia and we understand Israel as well.  All the other countries outside the US have some restrictions we're aware of. In the UK, you can only fly alone in a single engine plane below a certain weight and it needs to be during daylight. Canada has similar restrictions, although you may be allowed to have one passenger. In America, there are no restrictions. You can fly what you like, where you like, whatever you like, and in whatever conditions you like as long as they're safe. In Australia, we understand that you're only allowed to fly with a safety pilot, which of course takes the freedom away to fly, and they're telling you that you're not safe unless you have a chaperone. Of course, we know this is not the case because in America, we have over 1,000 pilots flying on the system with Pilots with Diabetes, and they've been doing this safely and effectively since 1997.

Once you're done with the trip to the North Pole - which I just think is really cool, say hi to Santa for me - what are you planning on doing after that? What's the next big thing?

The next big thing is: I would like to break a record here in the UK, specifically the existing record to fly around the coast of the UK. So that's 3,500 km. I'd like to do that this summer, in a single engine aircraft. I do have other goals in mind, but I'm going to keep them quiet because I don't want anyone to get the same idea. There are more endurance records I would like to break in the US. The North Pole flight I'm doing now is setting a brand new record, since that one doesn't exist yet!

What is it about setting about world records that changes the game for people with diabetes?

For all those aviation authorities that prevent people like me from flying, setting and breaking world speed records is kind of an official way to showcase what we can do — because in their countries they wouldn't even allow a person with diabetes to sit in the plane and fly it. Setting and breaking records is a very nice way of getting recognition. It's a nice challenging project that has a nice achievement attached to it.

That's putting it mildly, Douglas! You rock.  Readers: don't forget to follow Douglas at Diabetes Polar Flight.

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