What you need to know when traveling with diabetes

traveling with diabetes

Life with diabetes has its ups and downs but it can feel safer to deal with when you are home.  Many of us, however, enjoy traveling whether for pleasure, to visit family or for work.  It is important that you understand what you need to do when you are bringing diabetes along for the ride. Here are some tips whether you are heading out by plane, train, or automobile!

Quick links:
General Travel Tips
How To Keep Insulin Safe
What to know when flying with diabetes
What you need to know travelling by boat
What you need to know when travelling long distance in a car
Tips for Hiking with Diabetes        
Handling Time Changes

Checklist before you travel  
Packing Checklist

General Tips for Traveling with Diabetes

1. Have a list of all of your prescription items. This can be obtained from your pharmacist before you leave.

2.  Make sure you have prescription labels on all of your supplies. The name on prescription medicine must match the name on the passenger’s ticket.

3.  Contact your doctor ahead of time and ask he/she to write you a letter of medical necessity stating that you must carry all of your diabetes supplies and/or insulin pump Security staff who may not be familiar with an insulin pump, the
note should explain why it cannot be removed. The name on the doctor’s note must match the name on the passenger’s ticket

4.  Wear Medic Alert or other medical awareness jewelry.  If you do not subscribe
to MedicAlert, you may wish to contact  Diabetes Canada and ask for an information card which will detail the type of diabetes you have and your treatment regimen.

5.  Check that your travel medical insurance covers existing conditions. If not, travel insurance can be purchased through Diabetes Canada.

6. Never pack all of your supplies in the same place. Things can be lost, stolen or somehow destroyed so make sure that you spread your supplies out in various suitcases or bags.

7. Carry extra glucose, water, and food in case you are not able to locate a store or restaurant when an emergency strikes.

8. Check carry-on regulations with individual airlines before travelling. At this time liquids or gels (including water and juices) are not permitted to be carried on board aircraft leaving Canada, so passengers must carry an alternative form of fast-acting glucose. Some airlines have additional requirements depending on the destination.

9. Bring a container of some sort for disposal of sharps.

10. If using an insulin pen, bring back up pen as well as syringes. Pens do malfunction and you are not always near a pharmacy when this happens.

11. If using an insulin pump, bring syringes in case of pump failure.

12. Set your pump to vibrate when flying. The noise of the engines may make it difficult to hear the alarms.

13. If you inject insulin while in flight, frequent travelers suggest you be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can cause the plunger to “fight you.” This can make it hard to measure insulin accurately.

14.  Keep spares of all supplies with you in a carry on.  Have twice the number of strips you would require for that period of travel. Make sure that you have extra needles as your pen may malfunction at that time. Pack spare infusion sets as your set may go bad when you least expect it. Ensure that you have extra insulin cartridges and batteries ready as they will go low at the worst times.

traveling with insulin How to keep insulin safe

1. Store insulin in insulated bag or cooled thermos.

2. Store insulin in more than one place if possible. If one vial of insulin becomes exposed to extreme heat or cold accidentally, you will still have a back up supply.

3. If you are skiing or camping, keep your insulin in an insulated back or close to your body.

flying with diabetes suppliesWhat to know when flying with Diabetes

Passengers are permitted to bring liquids, gels and aerosols through security screening at Canadian airports provided that the items are packaged in containers with a capacity of 90 ml / 90 grams (3 oz.) or less, and that the containers fit comfortably in one clear, closed and re-sealable plastic bag with a
capacity of no more than 1 litre (1 quart). One bag per passenger is permitted. Passengers must remove the closed, re-sealable plastic bag containing all permitted liquids, gels, and aerosols and place them directly into the trays provided at the beginning of the screening process.

Liquid prescription medicine and essential non-prescription liquid medicines are exempt from the container size restrictions and are not required to be placed in a plastic bag. However, passengers must declare all such items not in a bag or over 90 ml / 90 grams (3 oz.) in capacity to screening authorities. These  passengers may be subject to additional screening.

Check carry-on regulations with individual airlines before travelling.
Some airlines have additional requirements depending on the destination.

1. Insulin will lose its potency if repeatedly exposed to x-ray machines.
Do NOT allow insulin or insulin pumps to go through the x-ray at the airport. Do not disconnect at any time. If there is a problem, ask for the wand to be used. Putting the pump through such a process can damage the internal programming.

2. Carry insulin with you at all times. Insulin is sensitive to temperature changes.

3. Advise the security personnel that you have diabetes and that you are carrying your supplies on board. It is recommended that you have available a letter from your physician which indicates that you have diabetes and that you need to carry your diabetes supplies.

4. Organize your medication and supplies into one separate container in your carry-on baggage.

5. Syringes must have needle guards in place and be with your insulin. There is no limit to the number of syringes you may
carry.

6.  Make  sure insulin (vials or outer box of individual doses), jet injectors, pens, infusers, and
preloaded syringes are marked properly (professionally printed label identifying the medication or manufacturer’s name or pharmaceutical
label).  If the pharmaceutical label is on the outside of the box containing the insulin, the insulin kept in its original packaging

7. Your lancets must be capped and must be accompanied by a glucose meter that has the manufacturer’s name
imprinted on the meter

8. Notify screeners if you’re wearing an insulin pump and ask if they will visually inspect the pump since it cannot be
removed from your person.

9. Insulin pumps and supplies must be accompanied by insulin with professionally printed labels described above.

10. If possible, advise screeners when/if you are experiencing low blood sugar and are in need of medical assistance.

11. If you have any difficulty throughout the screening process, you can request to speak to the screening supervisor.
If you are traveling outside of Canada, you should consult with your airline for applicable international regulations.

12. Carry extra food and water in case of hyper- or hypoglycemia as airline food service has seen a dramatic cutback over
the years.

13. You may request a visual inspection of your supplies. You have the option of requesting a visual inspection of your
insulin and diabetes associated supplies. Keep in mind that:

  • You must request a visual inspection before the screening process begins otherwise your medications and supplies will undergo x-ray inspection.
  • You should separate your medication and associated supplies from your other property in a pouch or bag.
  • Medications should be labelled so they are identifiable.
  • In order to prevent contamination or damage to medication and associated supplies and/or fragile medical materials, you will be asked at the security checkpoint to display, handle and repack your own medication and associated
    supplies during the visual inspection process.
  • Any medication and/or associated supplies that cannot be cleared visually must be submitted for x-ray screening.  If you refuse, you will not be permitted to carry your medications and related supplies into the sterile area.

For more information on airport security screening and your pump,
you may wish to read “Your Pump and Airport Security…What you need to know.

You can also learn more about travelling with your CGM or flash meter by reading How to manage airport security with an insulin pump and CGM

driving with diabetes How to Travel Long Distance in a Car with Diabetes.

1. Check you blood glucose levels before you leave and at least every four hours when traveling.

2. Stop every few hours to stretch and do some physical activity.

3. Try to limit your driving to a maximum of 12 hours and go no more than 6 hours between any two meals.

4. Be sure to have snacks and glucose sources in the vehicle with you as you may not be able to reach a restaurant or store on time.

5. Make sure that you have spare supplies in the car with you. Murphy’s Law says that if you don’t, you will find that you need more strips than are in your canister, your site will fail for the first time, or your insulin cartridge will suddenly be empty.

travel by seaHow to Navigate Sea Travel with Diabetes

1. Keep active to compensate for the added food you will probably eat while onboard.

2. It’s a good idea to make ship staff aware of your condition in case any problems arise.

3. Have all of your medication well documented.

hiking with diabetesTips for Hiking with Diabetes

1. Avoid going alone.

2. Make sure someone knows where you are and when you will be back.

3. Bring along a first aid kit and if you use insulin, a Glucagon Emergency Kit

4. Make sure that your traveling companion knows how and when to use Glucagon.

time changesHandling Time Changes

1. Test often.

2. When traveling east, your travel day will be shorter. Remember that if you lose more than two hours, you may need to take fewer units of intermediate or long-acting insulin.

3. When traveling west, your travel day will be longer. Remember that if you gain more than two hours, you may need to take extra units of short-acting insulin and more food.

4.You can change the time of your injections and meals by up to two hours in a day without adjusting your insulin dose or your meal plan.

*Always check with your diabetes team before making any changes.  They will be able to match your insulin needs to your travel arrangements.

Checklist of things to do before you leave…

Here is a handy checklist to help you to ensure that you have a wonderful trip and that diabetes won’t be too much of a bother.

checklist for travel with diabetes

Download your copy of the travel checklist here.

List of Diabetes Related Items to Pack

We don’t want you to forget anything when packing to travel with diabetes. That’s why we created this great checklist to help you out.

 

References:

http://www.childrenwithdiabetes.com/pumps/life.htm
http://www.childrenwithdiabetes.com/d_0j_211.htm
http://www.diabetes.org/advocacy-and-legalresources/discrimination/public_accommodation/travel.jsp