Further directives from the TSA and Federal Aviation Administration (FAA) state that syringes and insulin delivery systems (pens, jet injectors, pumps, etc.) can be carried onto a plane only when accompanied by insulin, and that glucagon kits should be kept intact in their original, preprinted pharmaceutically labeled containers.
When I have called international carriers before trips abroad, they have suggested carrying a doctor’s letter and list of supplies and medicines. It is perhaps because I have always had the letter ready with my passport at the security station that I have never been asked to produce insulin boxes or actual pharmacy labels. But being prepared to show all of the above forms of medicine identification is the best way to ensure a trouble-free security check.
Carrying diabetes supplies
When flying, I carry all of my diabetes supplies in my carry-on luggage. They all fit well inside a wheeled backpack, which is easy to carry or pull along. It is also convenient for security officers to examine if they choose to do so, and it stays with me in case of delays or cancellations. When going through security, I have also learned to mention beforehand that I wear an insulin pump so that the personnel do not attempt to pull on it when they feel the pump in my pocket.
Insulin should never be placed in checked baggage since the baggage compartments of airplanes, buses, and other forms of transportation can get very hot or cold, and either extreme will degrade the insulin. Likewise, you should never leave insulin in the trunk or glove compartment of a car or leave a bag containing insulin out in direct sunlight. Be careful at hotels without a refrigerator; don’t, for example, set your diabetes supply case on a sunny window sill. If you put your insulin in the ice bucket overnight, you may want to remove it in the morning (mine was tossed out by housekeeping on one trip).
Many frequent travelers invest in an insulated insulin carrying case to keep their insulin cool. For a list of such cases, see “Carrying Cases.” Homemade insulin carriers using thermoses and ice, for example, will also work to keep insulin cool but are not much less expensive than a modest commercial case and may be bulkier and less convenient.
Some travel guides recommend taking twice the amount of supplies that you would normally need for the time span of the trip to allow for unexpected problems and delays. I have found that taking what I would normally use plus enough for a few more days (and enough pump supplies to allow for two extra infusion set changes) suffices for most trips, and usually I have surplus to bring home. When carrying oral medicines, it is often easiest to carry the original prescription bottle rather than count out pills just for your trip. You may also want to bring extra batteries for your blood glucose meter, particularly if you are traveling to a remote area.
One thing that I do routinely is set aside two days’ worth of medicines and supplies in a separate place (such as in my checked luggage or in my purse) just in case my carry-on luggage is lost or stolen. That way, I know that I will have enough to last until I can get to a pharmacy and get my prescriptions refilled. When I travel to a developing country where pharmacies may not be easily accessible, I tend to split my emergency stores among a couple of different locations, including my travel partner’s carry-on, and to pack a bit more than my usual extra amounts. The same practice would work well for a boat trip or cruise, especially if your itinerary calls for days at a time at sea between ports of call.
Maintaining blood glucose control
Now we’re on our way! The excitement of travel alone can affect your blood glucose control, and so can time zone differences and variations in activity level. Evaluating how each of these affects your blood glucose levels requires frequent monitoring and accurate record keeping. A walk that would seem easy and relaxed at home often seems more intense when it is combined with sightseeing and the joyful stress of being someplace new and different. Checking blood glucose levels before and after walking tours and other physical activities can help you notice changes and patterns you might not see at home. Always carry a source of glucose such as hard candy, glucose tablets, regular soda, or fruit juice in case of an unexpected drop in blood glucose levels. Small cans of juice are available at just about any supermarket.