Deliveries by aerial drone are difficult in urban areas, and safety and regulatory concerns have delayed their use in suburbs. However, in certain instances, drone delivery is becoming the best option for transporting urgent, high-value items. An international team conducted what it described as the world’s first documented drone delivery of insulin for a patient living in a remote community.

The 16-minute test flight from Galway, Ireland, to the Aran Islands, about 12 miles off the west coast of Ireland, occurred last September. After severe storms disrupted healthcare access in Ireland in recent years, the researchers wanted to find a solution for future disasters when people with diabetes in remote regions might be stranded for days without their life-saving diabetes medicines, said the project’s principal investigator, Derek O’Keeffe, M.D., Ph.D., a consultant endocrinologist at National University of Ireland Galway.

“We now have the drone technology and protocols in place to deliver diabetes medications and supplies in an actual disaster if needed,” he said. “This is a milestone in improving patient care.”

A large autonomous drone flew beyond visual line of sight (BVLOS) during commercial flight operations in regulated airspace, O’Keeffe said. The project team’s year-long planning required approvals from aviation, pharmaceutical and clinical regulatory agencies.

Getting a prescription for drone delivery

In addition to delivering medicine with an unmanned aircraft operating in a 4G cellular network and using GPS waypoints, the team had to address several challenges unique to healthcare, recalled endocrinologist Spyridoula Maraka, M.D., M.S., of the University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock.

“Insulin can be outside the fridge for hours, but it can’t be exposed to extreme heat, so we put it in an insulated parcel with temperature monitoring en route,” Maraka said. “We also put a security lock on the parcel in case the drone did not arrive at the right place.”

Local laws specify that a pharmacist must dispense prescription drugs, so Maraka arranged for a pharmacist to dispense the insulin and glucagon, another diabetes medication, before loading them to the drone for delivery.

Another unique aspect of the project, according to Maraka, is that the drone returned with a blood sample collected from the patient for monitoring blood glucose control (HbA1c).

“We wanted to find a way to monitor glycemic control remotely,” she said. “It was the full circle of care, which has not been done by drone before.”

Maraka stressed that this ability for remote diagnostics could save lives. “A patient with Type 1 diabetes could develop life-threatening diabetic ketoacidosis after more than one day without insulin,” she said. “A blood specimen would allow us to properly diagnose and treat the condition.”

Drone delivery an Endocrine Society milestone

For this project, Wingcopter provided the drone, Novo Nordisk supplied the insulin and glucagon, and Vodafone Ireland allowed use of its 4G network.

The Endocrine Society, which is part of the U.S.-based Diabetes Disaster Response Coalition, offers tips on managing diabetes in an emergency. It has more than 18,000 members, including scientists, physicians, educators, nurses, and students in 122 countries.

The Endocrine Society canceled its annual meeting, ENDO 2020, amid concerns about COVID-19. It now plans to publish accepted abstracts, such as one describing the drone delivery project, in a special supplemental section of the Journal of the Endocrine Society.