In May of 2012, after reading about a friend having problems getting their insulin pump through security at a US airport, I did some research on the subject. Should you put your pump through the x-ray machine? Can you wear your CGM through a full-body scanner? There were a lot of questions in 2012 and there still are in 2018 so I reached out to a few friends in the industry to see if things have changed at all. Here is what you need to know when you are traveling with an insulin pump or CGM.
If you wear a Dexcom®
The Dexcom® G5 is cleared to take through metal detectors, be hand-wanded and be worn during flights. There are a few situations to be concerned about, however.
NEVER put your receiver or extra sensors through an x-ray machine. Ask the security personnel to do a hand-check of the items to avoid permanent damage of these devices.
According to Dexcom®, the effects of full body scanners on CGM components have not been studied. It is therefore recommended that you do not take your Dexcom® through one.
Once you are through security and on your plane waiting for takeoff, make sure to set your app to airplane mode, keeping the bluetooth on and leave your receiver turned on.
If you use FreeStyle Libre
The Dream Big Travel Far blog contacted the people at FreeStyle and asked what the guidelines were for air travel with the Libre. This is what they reported.
“We recommend the user notify security personnel when going through airport security screening. the user can go through X-ray machines while wearing a sensor. We recommend the reader be powered off during a flight and not used for scanning a sensor. However, the strip port on the reader can be used to take blood glucose or ketone readings during flight. Turning on the reader with the Home Button will activate the radio. The user must turn on the reader by inserting a test strip so as to not activate the radio.”
If you wear an Omnipod
Good news for Omnipod users! You can wear the pod through the metal detector, x-ray machines and full body scanners with no worry. The PDM can also go through the X-ray. Insulet does recommend that if you are selected for a “pat down” you disclose that you are wearing the pod.
If you wear a Medtronic® insulin pump
Medtronic® insulin pumps can be worn through metal detectors and be wanded. They should NOT be sent through x-ray machines however.
Medtronic® also notes that your sensor and transmitter must be removed if you are going through a full-body scanner. If you do not want to remove your sensor, you can ask to be pat down instead.
If you wear a Tandem® t:slim X2™ insulin pump
Tandem® t:slim X2™ can be worn through metal detectors and can be wanded. They should not be sent through x-ray machines.
Changes in air pressure cause bubbles to form in insulin, and the related expansion can cause unintentional insulin delivery. This is NOT a problem in the Tandem pump.
The pumping mechanism used in Tandem pumps isolates the insulin reservoir (bag) from the user line, so if bubbles are formed in the cartridge due to pressure changes, the internal bag will expand, but no insulin will be delivered to the user from the reservoir. The only volume in line with the user at any given time is the insulin in their infusion set and cartridge tubing, and the contents of the 0.3 unit Micro-Delivery chamber.
There is no need to turn off your t:slim X2™ during takeoff or landing. This system runs on Bluetooth which can operate during flights. If you are also using a Dexcom CGM that you are viewing with your smartphone, turn the phone on airplane mode and then turn on Bluetooth.
As I mentioned, we were privileged to be able to try using a DexCom for seven days over the Christmas holidays. I was super excited. My son however was not exactly thrilled but willing to see what all of the fuss was about.
I am pretty sure I allowed him to put down his suitcase and open his Christmas gifts, but I don’t believe I gave him time for much else before we learned how to start the DexCom process. I had been encouraged to watch the video a few times before actually inserting the device, so I had my son sit with me as we began. The video paused and allowed you to do a step before continuing. This was very user-friendly.
As we reached the insertion stage, my son suggested that we stop a bit and replay multiple times before injecting him with anything! I agreed. I was terrified that I would mess up. Not only are these sites expensive, but we only had one to try and our rep was away enjoying the holidays. I had to be perfect!
I was finally confident that I should be able to do this. My son was not exactly feeling the same level of confidence but eventually relented and allowed me to jab his body with the large contraption. It was a success! The sensor was in his body and he had not died. I asked him about the level of pain he experienced. (It didn’t look like a big needle so I never even suggested asking him if he wanted to numb the area–bad mom) He said it was close to having a site inserted–maybe a little less painful. I was psyched!
Next came putting on the transmitter. That was a challenge. I understand that it gets easier with time but I will say that figuring out how to get it to attach the first time took us a bit. Once it was on, it was time to wait our two hours before the first calibration. I was super excited to see what would happen. My son was still not as thrilled but glad to no longer have his mother poking at his belly.
Two hours later we did our first calibration and my son resumed his normal activities. One of the first thing he did after putting in the sensor was to enjoy a nice jacuzzi tub. The sensor is waterproof but I was still having a mild heart attack wondering if it really could take this. I told my son that all was fine as long as the receiver stayed dry…but I was still nervous.
Would the jacuzzi mess things up? Despite telling him that he didn’t have to test as much with the DexCom, I made him test a few times just to prove to myself that it really was as good as everyone said. The research didn’t lie. The end users didn’t lie. This little machine was awesome!
The accuracy was not perfect the first few days. I had been told that the DexCom accuracy was not as great on the high-end as it was on the low-end. We found that to be true. When it said he was high, he was often higher still. That didn’t bother me though. It showed me a trend. He was high and going higher (we had a bad site). It really didn’t matter if he was 15 or 25 (270-450). He was high and needed a correction. A finger stick gave us where to correct from but the DexCom told us if we were on the right track. For me, the combination was amazing!
During the trial period, we had extreme highs (First lesson–do not calibrate when high. Since the accuracy already isn’t great, your sensor will be off a bit more than when its calibrated at reading closer to in range). We also had lows. The first low my son had while wearing the sensor came as we arrived at our cabin. We were unpacking our gear and of course he couldn’t help. He was low.
“Really? Is it working? Did it tell you that you are low? Can you feel it? Are you actually low?” My son scarcely avoided an eye-roll and passed me his receiver. It read low! There were downward arrows! He said that yes he felt low and we treated him. The DexCom then told us that he wasn’t falling any more. He could help us get the rest of the gear out of the truck and he would be fine! Oh happy days!
Yes, I loved the DexCom. As we became more familiar with it, the accuracy also improved. I am not sure if the sensor was working better with his body or if the increased data that it had to work with through a few days of calibration improved the accuracy but it was wonderful!
At night, I would get up and take his receiver into my room so that he could have a break from diabetes care. It sat on my night side table and instead of getting up and poking him, I could roll over and watch a graph. A non-D parent will never know how soothing looking at a graph can be but let me tell you, it was AMAZING!
There were nights that my partner wanted to throw it out the window. My son was high. The DexCom told me so. We corrected. The DexCom said it didn’t work. We injected. The DexCom said he was falling. We wanted that. The constant dialogue of beeps and vibrations were sending Larry over the edge while giving me peace of mind.
Not all nights were full of alarms. The DexCom allowed me to also see my son have some of the best readings. I watched one night in amazement has he maintained a steady 4.9mmol (88mg/dL) for hours. Such a lovely number would normally have sent me into a night filled with stress. Would he drop? Would he rise? I would be testing a lot wondering or I would be pouring chocolate milk down his throat hoping to slow down a decline in blood glucose levels. With the DexCom, I was able to simply relax and watch a perfect night unfold in front of me.
The biggest gift that the DexCom brought me was pride in my son. When he moved away to live with his father, we said he would share readings with me and we would talk about his care. Well, reality was very different and with the exception of “yep, all is fine”, I have had no real information on how he was doing. When he visits with me, there are often problems due to change in activity levels and eating as much of Mom’s food as he possibly can in a short window of time.
He still ate a decent amount. He also was a little less active that he might have been at his father’s but his readings were generally quite good. The DexCom showed us a few issues–some of which he knew about but hadn’t dealt with. Together we talked about changes. He challenged me about some ideas and after a discussion, we made the adjustments that we both felt were required. I was proud to see that he had listened to what he had been told over all of these years. He was taking ownership of his disease and doing a good job of it.
I was sad to see day 7 arrive. It was the end of life with a CGM. It also meant that my son was heading on a plane back to school and his other home. The last part was the hardest but it also hurt that he would be leaving without this amazing technology.
I asked him what he had thought about the whole thing. Once again, he was not impressed with the extra site. I think he quite enjoyed being able to simply look at a graph to know what to do about his readings–he was rising, he was falling, he was nice and steady. He is not quite ready to carry a second device however nor is he ready for a second site. I see that changing in time.
Our rep kindly offered to let him use it again in the near future if he wants. I am sure we will take her up on that offer. I can see his attitude towards the DexCom changing with both use and the changes in his circumstances–moving from the classroom into the workforce.
I was always a firm believer in the benefits of this technology. This one week trial just confirmed it. Anyone living with diabetes should have access to this device. It will change their lives and improve their diabetes care. A running live-stream movie of blood glucose readings rather than snap shots throughout the day offers such incredible freedom and peace of mind. It should be a standard of care for everyone who has to live with diabetes.