Diabetes and Travel: How to plan, pack, and manage supplies

Whether you’re a new or seasoned traveler, planning a trip can be both fun and stressful at the same time - especially if you’re traveling with diabetes. In addition to packing the right clothes and shoes and double-checking that you have everything you need to travel, you also need to bring your diabetes therapy supplies and manage your blood glucose on the go.

While this may sound a bit overwhelming, you can manage what you need to do with some thoughtful planning and preparation. Here are some basic tips for traveling with diabetes to help you be well-prepared for your journey and time away from home.

Double up on diabetes management supplies

When traveling with insulin and other diabetes supplies, it’s important to determine how much you’ll need to bring on your trip. As a general guideline, pack double the amount of insulin and other diabetes management supplies you need for the time you’ll be away. That means one week of travel equals two weeks of diabetes supplies.

Make sure to double up on your testing supplies, medications, low blood sugar treatments (such as a glucagon kit), pump accessories, and any other essential medical items you anticipate needing. For pump users, it's wise to pack extra insulin syringes, preparing as though your pump might fail on the first day. And if you use a CGM device, be sure to bring a backup blood glucose meter to cover all bases in case something gets lost or breaks.

If you're flying, keep your supplies in your carry-on baggage so you don't have to worry about it being delayed or not arriving at all.

For road trips, use an insulated bag so your diabetes supplies won’t potentially overheat in your car. Heat can have a negative effect on the stability of insulin or the function of devices such as your pump.¹ Please also consult the manufacturer's instructions for your insulin and other devices.

Embrace your new time zone

Depending on how far you go, the direction of travel, and how long you'll be visiting, your healthcare provider may want you to alter your therapy and check your blood glucose more frequently. So before you leave, speak to a member of your healthcare team about how to manage your blood sugar as you cross time zones — especially if you use insulin.

Jet lag doesn’t only influence your sleep, it can also affect how your body uses insulin, how you eat, and how well you can interpret your blood sugar levels, so try to pay close attention to your numbers.²

Bring your own snacks

The availability of food can be inconsistent when you’re traveling. Airlines may not serve full meals or snacks without a fee, and you may experience delays. Roadside dining may not offer options that fit your diabetes diet, whereas cruise lines often have an overabundance of foods and drinks.

That’s why packing a few (or a dozen, depending on how long and far you’re traveling) snacks, nuts, or fruit bars with predictable carb counts can come in handy.

Make sure you have a fast-acting carbohydrate source to treat low blood sugar.

Pay attention to your blood sugar

Traveling can often be disruptive to your regular routine. Walking an extra 20,000 steps a day, eating meals late at night, or changing your sleep schedule can impact your blood glucose levels in unpredictable ways.

Before leaving for your trip, discuss your travel itinerary with your healthcare provider, including any changes in your blood sugar.

Be open about your diabetes diagnosis

Tell airport security, travel companions, hosts, and anyone else who needs to know that you have diabetes. Let people know what low blood sugar levels look like for you.

A note from your doctor can also be helpful to explain the extra syringes, insulin pens, infusion sets, medications, and containers of used sharp objects in your bag.

While there are a lot of considerations, traveling with diabetes is still worth the extra planning.

Global travel restrictions, varying guidelines across countries, and airline regulations can complicate the journey when flying with diabetes. From security screening rules to supplies allowances, each aspect requires careful attention.

Keep these tips in mind to help avoid any surprises at the airport or in the air. 

Diabetes and airport security

Navigating security rules can be difficult. If you're traveling by air with diabetes, you might face some challenges due to varying international travel regulations. Different countries and airlines have different guidelines for travelers with diabetes, so it's best to do some research before you fly.

Check out the diabetes management options at your destination, along with insulin availability and local healthcare systems, just to be safe.

Flying to and within the US

When traveling to or within the United States by air, the Transportation Security Administration (TSA) is a good source for the latest security regulations.³ Current guidelines state that when traveling with insulin and other diabetes-related supplies, you can bring them, along with any equipment and medications, through the security checkpoint, although they will need to be 
x-rayed or hand inspected.⁴ This includes:

• Insulin and preloaded dispensing items such as syringes or pens
• Unlimited unused syringes when accompanied by insulin or another injectable medication
• Lancets, meters, and all other testing supplies
• Insulin pump and supplies
• Glucagon kit
• Ketone test strips
• Used syringes — if they're in a hard-surface disposal container
• Juice, gel-icing tubes or other items needed to treat or prevent hypoglycemia
• Freezer or gel packs
• Any other related medication, equipment, and supplies

Explain to the security officer that you're carrying diabetes supplies so they can be properly screened. If you're wearing a pump or continuous glucose monitor (CGM), check with the manufacturer before you travel. While you may be able to go through the metal detector without disconnecting, you can always ask for a pat-down and visual inspection instead.³ The TSA website asks that you inform the officer conducting the screening about your insulin pump or CGM.

Your medically necessary liquids can be in containers larger than 3.4 ounces/100 ml, and don't have to be put in a zip-top bag, but you are asked to remove them from your carry-on bag to declare them.^3,4

Flying to and within the European Union (EU)

For flights to the European Union, regulation 2015/1998 describing common basic standards on aviation security5 specifies that liquids should be in small, clear plastic bags, with each container not exceeding 100ml. Medically-necessary liquids or special dietary requirements, including baby food, are allowed to be brought onboard inside a carry-on bag.

You should always consult the official websites of the airlines you'll be flying with and check for country-specific restrictions based on your destination. Different countries may have distinct guidelines regarding the transportation of insulin, supplies, and related equipment.

CGMs (Continuous Glucose Monitors) and Insulin Pumps

Regardless of your destination, it's crucial to check with your insulin pump and CGM manufacturer regarding airport security equipment compatibility. Inform security about these devices and request that they not be removed during screening.

By being informed and prepared, you can navigate airport security with ease.

How to manage diabetes in the air

Here are a few tips to help manage your diabetes during your flight:⁶

• Bring plenty of snacks for the airport and on the plane. You never know when a flight may be delayed. Additionally, many flights only offer in-flight beverage service. You never know when you'll need your own snacks or meals.
• Stay hydrated with non-alcoholic, caffeine-free drinks, and consider juices or soft drinks to help with hypoglycemia symptoms.
• If there is an on-board meal, wait until you see the food cart coming down the aisle before you take any pre-meal insulin.
• Keep your watch set to your home time zone until you arrive so you can stick to your regular medication schedule or the one you and your doctor agreed to before the trip.
• Let the flight attendants know you have diabetes, especially if you're traveling alone.
• Some airlines may have policies that require you to turn off Bluetooth-enabled devices, such as CGMs, during take-off and landing. Double-check with the airline beforehand to ensure you follow their specific guidelines.
• Check your blood sugar often to make sure the excitement, time zones, or changes in activity and eating aren't throwing off your levels.

There’s a good chance you already keep hard candy or fast-acting glucose in your car in case you have low blood sugar. If not, this is a great opportunity to find a safe spot for these items in your vehicle.

To prepare for longer car rides or road trips, here’s a checklist of items for your diabetes road kit that can be kept in your on-the-go bag.

• A nutritious, fairly substantial snack: Individually wrapped granola bars, dried fruit and nuts, or crackers with cheese can quickly provide much-needed carbohydrates.
• Water: Drink plenty of water or other non-alcoholic or caffeine-free drinks before, during, and after your trip to keep yourself hydrated.
• A double batch of testing supplies and medications: If you're going to be away from home, bring along double the amount of everything you need. Alcohol swabs or moist towelettes have many uses but are especially handy for cleaning up a fingertip.
• Sun, rain, and bug repellent: Diabetes can cause slower wound healing.⁷ If you're going to be outdoors, be sure to apply sunscreen and bug spray to avoid any potential complications.
• A well-charged phone and medical ID: You never know when an emergency will occur, so get in the habit of keeping your ID on you and your phone battery charged.

Now that you have done your research on how to travel with diabetes and packed your snacks, medications, and supplies, you can relax and enjoy yourself. By being well-prepared, prioritizing your needs, and communicating openly about your diabetes, you can balance taking care of your health and enjoying your trip to the fullest.

While these are helpful tips, it’s good to keep in mind that they may not cover everything you need to know. Before you go on a trip, it's always a good idea to check with your healthcare team to make sure you have everything you need. Safe travels!

Resources:

1. Heinemann L, Braune K, Carter A, Zayani A, Krämer LA. Insulin Storage: A Critical Reappraisal. J Diabetes Sci Technol. 2020;15(1):147-159. doi:10.1177/1932296819900258
2. Mason IC, Qian J, Adler GK, Scheer FAJL. Impact of circadian disruption on glucose metabolism: implications for type 2 diabetes. Diabetologia. 2020;63(3):462-472. doi:10.1007/s00125-019-05059-6
3. TSA Cares - Disabilities and Medical Conditions | Transportation Security Administration. Accessed February 9, 2024. https://www.tsa.gov/travel/tsa-cares/disabilities-and-medical-conditions
4. What Can I Bring With Me on the Plane | ADA. Accessed February 9, 2024. https://diabetes.org/tools-support/know-your-rights/what-can-i-bring-with-me-on-plane
5. The European Commision. Implementing regulation - 2015/1998 - EN - EUR-Lex. Accessed February 9, 2024. http://data.europa.eu/eli/reg_impl/2015/1998/oj
6. Pavela J, Suresh R, Blue RS, Mathers CH, Belalcazar LM. Management of Diabetes During Air Travel: A Systematic Literature Review of Current Recommendations and their Supporting Evidence. Endocr Pract. 2018;24(2):205-219. doi:10.4158/EP171954.RA
7. Spampinato SF, Caruso GI, De Pasquale R, Sortino MA, Merlo S. The Treatment of Impaired Wound Healing in Diabetes: Looking among Old Drugs. Pharmaceuticals. 2020;13(4):60. doi:10.3390/ph13040060