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Traveling with Type 1 Diabetes: The Patient's Perspective

Nov 14, 2014

By the time I boarded the plane for New Zealand, the battle to reach the other side of the world was nearly won. Like many passengers, I had to meet weight and size requirements for all of my luggage; however, my issues were a little different from everyone else's -- because I had to think about diabetes. Thankfully, diligent preparation kept my anxiety about traveling with diabetes at a minimum. I hope that sharing my experience can help others have pleasant travels, too!

1. Documentation
As I have ventured abroad before, I knew that language barriers can be an issue when it comes to traveling with diabetes. "Insulin pump" seems to be more and more universal, but it's still good to have something in writing...even if it's only in English.
I approached my diabetes healthcare provider for an official letter stating that I have Type 1 and need to have necessary items like an insulin pump, juice, and a blood glucose monitor on me at all times. It's readily available in my carry-on in case I need to show it to a TSA staff member or anyone else. I haven't had to use it so far, but it's comforting to know it's there.
By the way, going through security with an insulin pump has never been a big deal. If I get patted down, I announce that I'm wearing one, and then I get one more minute of screening. I never think of it as anything to worry about!

2. Supplies
This is by far the most painstaking part of preparing to travel. I have an insulin pump, so I need to bring enough insulin, infusion sets, cartridges, test strips, lancets, et cetera with me for the length of time I'll be traveling. I like to start the process as early as possible by talking with my doctor about what prescriptions need to be renewed as soon as I'm thinking of going abroad: Are there medications I have prescriptions for but don't use? Are my prescriptions for emergency medications (like Glucagon and KetoStrips) up to date?  Having a plan of attack before step two is a good idea so that everyone is on the same page.
Once I determine how much I need to bring with me and make sure all of my prescriptions are current, I immediately contact my health insurance about obtaining an override so I can purchase an adequate amount from the pharmacy.
It's also good idea to befriend the pharmacist in these situations, as 18 bottles of Novolog aren't always conveniently on hand.
Another challenge can be finding enough room for syringes, test strips, lancets, and pump supplies in my luggage. Some of these items can be reorganized into plastic bags so they take up less room. However, some airlines require prescription medications to be in the original packaging, so I check the policies before I fly.

3. Diabetes Jetlag
When I'm crossing many time zones to reach my destination, figuring out which basal rate and carb-to-insulin ratio to use can be confusing. I try to manage this as best I can by setting my own clock to my destination's time zone when I board the plane. That way, I'm helping myself adjust to the time I'll be living in and I can treat my diabetes accordingly.
I also monitor my blood sugar levels closely before, during, and after flying. Sitting for long periods of time can make my blood sugar fluctuate, and I've also noticed that I become easily dehydrated when I travel.
When I flew to New Zealand, I also encountered the issue of keeping my large quantity of insulin cold. I had a six-hour flight to LA, a six-hour layover, and then a 13-hour flight from LA to Auckland. I had two cold packs for my insulin: one to use and one as a backup. When I arrived in LA, I asked the attendant at the airline counter if he had any suggestions for keeping my spare freezer pack cold. He was very accommodating and put the cold pack in a freezer in the back office. A few hours later, I switched my insulin to the fresh pack before boarding my flight.
Once I found my seat, I hailed a flight attendant and asked for some ice to keep my cold packs cold. She returned with a box of dry ice wrapped in plastic bags (to keep everything from getting soaked) and my insulin stayed happily chilled until I reached Auckland.
I've found that if you ask, people are very willing to help you meet your needs!

AADE members: What are your thoughts? Is there any other piece of advice you would give to your patients preparing to travel? Do you have alternative suggestions? I would be interested in hearing your thoughts!

Katie Doyle is a writer and traveler with Type 1 who is currently living in New Zealand. She has a few tips from her recent traveling experience to share to share with diabetes educators!

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  1. Nov 19, 2014

    One very important tip is to keep insulin with you (in your carry-on) at all times. Two reasons NOT to check insulin: 1) cargo typically gets extremely cold (too cold for insulin to stay stable) and 2) 9 times out of 10 your bags don't arrive when you do (ok, that's being pessimistic, but you get the idea). Be sure to have pump supplies, syringes, and monitoring strips with you (and not in your checked bags). You may have to put some supplies (not insulin) in checked bags, but be sure to have enough to get by for at least enough time until you could get more. Don't forget extra batteries and your pump settings in writing, for example on an index card.

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