Traveling is difficult enough at times, especially air travel, and if you have diabetes this can become even more daunting. Here are some things you should know about some of the TSA and ADA guidelines as well as some basic tips.
Introduction
Living with diabetes is a challenge that roughly 38.4 million Americans and 11.7 million Canadians face every day. They understand well that managing diabetes often requires strict observation of a daily routine. Individuals with diabetes must pay close attention to their diet, carefully monitoring their carbohydrate intake and opting for healthier food choices to maintain stable blood sugar levels. Regular physical activity becomes a crucial component, as exercise helps regulate blood sugar and contributes to overall well-being.
Daily blood glucose monitoring becomes second nature, involving regular checks to ensure levels are within the target range. Medication adherence is paramount, with many individuals needing to take insulin or other prescribed medications as directed by their healthcare providers. Planning and preparation are key so any change to that routine such as, say, taking a flight to Paris, can understandably cause a significant amount of trepidation.
Should you cancel that flight and just stay home? Absolutely not! Your trip just requires a little bit more planning than others might need, that's all. Let's look at how to make it happen with as little stress as possible. First off we'll check in with the TSA and see what they have to say.
TSA Guideline Bullet Points
You can bring your insulin and insulin pump with you on the flight.
The TSA website is very clear on its position about allowing insulin pens, pumps, syringes and any other such medical supplies that you might need aboard the plane. The medical equipment or supplies will need to undergo separate screening and a TSA officer may check them and conduct any necessary testing. Just make sure that you separate anything related to diabetes from your other belongings to make it an easier process. Another pointer is to make sure that your medications be labeled to facilitate the security process.
Notify the TSA agent beforehand.
When you approach the security officer you will want to alert them about your condition and supplies and in particular address any insulin pump, continuous glucose monitor or other medical device you may have attached to your body and where it is located prior to being screened. You may be asked to do a self pat down of the equipment and your hands will then be swabbed for explosives residue. I've had the swab done a couple times in past and it is nothing to worry about. Just don't travel on July 5th, i.e. the day after you have just set off a bunch of fireworks for Independence Day. Ooof, that was an awkward TSA screening.
You can request a specific type of screening depending on your situation.
If you are concerned that the Advanced Imaging Technology (AIT) will adversely affect your Insulin Pump/Continuous Glucose Monitor (CGM) you can request that you are screened using the walk-through metal detector (WTMD) as these devices are designed to withstand common electromagnetic interference. If either of these options still has you worried you can ultimately request a pat down instead. Just make sure to let the TSA officer know exactly what you want and why. Don't worry about sending insulin through the X-ray in your carry-on though, it'll be fine; but if you want to, you can request that they be manually checked as well. The TSA will accommodate you to the best of their abilities but have patience as they have an important job to do as well.
You can bring liquids in excess of 3.4 ounces (100 mL).
If your condition requires it you will be able to bring liquids such as insulin, other medications such as Smylin, Ozempic, Glucagon, glucose gels, etc. even if they exceed the usual TSA limit of 3.4 ounces but be prepared to have any such liquid undergo additional screening. There are many products, such as the Transcend Glucose Gel packs below, that are specifically designed for travel and come in handy 1.1 ounce sizes so you may not need to exceed the limit anyhow. In either case, give the officer a heads up that you have such items and make sure they are separated from everything else.
You don't need a TSA notification card but it helps.
While not necessary, you can easily obtain one of these cards which identifies your condition that you can pass to the agent to make the process a bit smoother. It is also a discreet way of informing the officer of your disability if you are reluctant to divulge such information in a pubic setting. In addition you should probably have a list of your medications and dosages with you anyhow just in case you may need it at some point in your trip. See the general travel tips below.
So that is the gist of the information on their website. You might want to also consider downloading the MyTSA mobile app as it will give additional information such as wait times, and will allow you to request assistance ahead of time as needed. In addition, you should consider applying for TSA PreCheck or Global Entry especially if you do any degree of travel as it makes it even more pain free. Check out our post on the Trusted Traveler Programs (TTP) to find out more about that process.
Continuing on we can take a quick glance at the American Diabetics Association (ADA) Website to see what kind of travel tips they have. Several have been addressed already under the TSA points so we won't go over them again but there are a few good extra pointers we can add.
ADA Guideline Bullet Points
Arrive at the airport 2-3 hours before your flight.
That is just common sense really and one that I take to heart. One that should apply to everyone who is flying IMHO. Give yourself enough time. I would much rather have an extra 40 minutes to mull around, sip coffee, or read than be rushing to make it through security, asking to cut in front of others, etc. just because I dragged my heels getting out the door or I didn't plan for the afternoon traffic around the airport.
Keep a quick-acting source of glucose to treat low blood sugar as well as an easy-to-carry snack such as a nutrition bar
Definitely good advice. You not only want to have these on hand for your flight but you should have something immediately at hand if you experience hypoglycemia while going through the security process. Depending on the airport you use, the security times may be pretty long so plan accordingly.
Medical liquids should not be placed in the quart-sized zip-top bag used for non-medical liquids.
We covered the topic of liquids already but it is important to note that the medical liquids are kept separate from any other liquids that you may be carrying.
Carry or wear medical identification and carry contact information for your physician
Can't argue with that. Not only for boarding the plane or going through security, it is just a good practice to maintain if you are traveling.
Pack extra supplies
Absolutely. You cannot anticipate delays, cancelations, or anything else that might prevent you from getting where you are going. This is especially true if you are heading back home from your trip and are expecting to be home with access to your usual supply in a few hours. Make sure you've got enough to get through an extra day or two of travel at a minimum. Best to pack for an extra week if you can. In addition to insulin/medications don't forget extra test strips, CGM, and insulin pump supplies as applicable.
ADA also provides a pretty comprehensive list of the diabetic specific equipment that is permitted on flights:
Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, epipens, infusers and preloaded syringes)
Unlimited number of unused syringes when accompanied by insulin or other injectable medication
Unlimited number of used syringes when transported in Sharps disposal container or other similar hard-surface container
Lancets, glucometer, glucose meter test strips, alcohol swabs, meter-testing solutions
Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter and needle)—insulin pumps and supplies must be accompanied by insulin
Glucagon emergency kit
Ketone test strips
Continuous blood glucose monitors
Other diabetes related medication, equipment, and supplies
So that is the basics for taking a flight, but there are some other things to consider for your trip in general as well. These last tips cover pre-trip preparations, getting there, as well as some simple recommendations to make your trip go smoothly.
General Travel Tips
Plan Ahead: Schedule a pre-travel appointment with your healthcare provider to discuss your trip and make necessary adjustments to your diabetes management plan.
Plan Your Airplane Meal: If your flight has a meal service then see if you can pre-order a diabetic meal; most major airlines offer these. You'll want to do this when you make your booking. Once aboard, don't take your insulin until your food tray is in front of you. You never know if they'll suspend service due to unexpected turbulence even if the cart is only two rows away.
Stay Hydrated: Drink plenty of water to stay hydrated, especially if you're flying or spending time in different climates. Keep a refillable water bottle with you that you can empty and refill as you pass through security. Ensure it is full before you board as you might not be able to rely on getting water on the flight.
Never Put Insulin in a Checked Bag: The same can be said for any medication or devices that you need, but with insulin it is more important. Insulin can be affected by the pressure and temperatures in cargo so you don't want to risk putting it there.
Keep Medications at the Recommended Temperature: Keeping them at room temperature is generally acceptable but keep this in mind if you are going to be somewhere that your insulin may be exposed to a very hot environment, such as left in a car for a while. Then you might want to consider a portable cooler for it.
Monitor Blood Sugar Levels: Regularly check your blood sugar levels, especially if your routine is disrupted due to travel. Make sure to use your phone to set schedules or timers and keep in mind any time zone changes you may experience and how that will affect your internal clock.
Healthy Snacks: Pack diabetes-friendly snacks to help manage blood sugar levels. Include options like nuts, seeds, and low-carb snacks. Also take a look at any airports you are using and pull up their restaurants so you can see the nutritional values on their menu. Do the same for some restaurants at your destination as well so you are armed with foreknowledge.
Exercise Regularly: Incorporate physical activity into your travel plans to help regulate blood sugar levels. Simple activities like walking can make a difference. Make use of any layovers to get in some brisk walking between flights and look ahead at your destination for walking paths or parks that might be near your accommodations.
Know Local Resources: Familiarize yourself with local healthcare facilities and pharmacies at your travel destination. Research where you can seek medical assistance if needed. Learn the basics of the language for the country that you are visiting in particular with respect to being able to ask for help. Keep some flash cards in that language in your pocket that you can hand to a local if you happen to have an emergency such as an extreme hypoglycemic episode. Also know the name of your medication in that country if it is different: your doctor might be able to help you with that information.
Conclusion
So yes, there are a few more complications added to the mix when you are traveling with diabetes but it should most certainly not deter you from taking that vacation. Plan properly and anticipate problems ahead of time so you won't get caught unprepared. Above all, savor every moment of your journey, you deserve it.
Happy Travels!
Il Digestivo
If you are going to be traveling, and are worried about losing your luggage take a glance at our post regarding tips on how to avoid lost bags and things you should always have in your carry-on. Below are a couple of products that we recommend for the diabetic travelers amongst us.
Sockwell Women's
Compression Socks
Sockwell Men's
Compression Socks
Transcend 15g
Glucose Gel Packs
Note: As an Amazon associate I earn from qualifying purchases.
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