Islets of Hope  care tips for persons with diabetes

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Article disclaimer

Article by Lahle Wolfe.

Sources
American Diabetes Assn.
Transportation Security 
Administration (TSA)
Diabetic Drugstore: Travel tips
MiniMed - Travel tips

We recommend that you vist the following links for up-to-date travel information:

American Diabetes Assn.

Transportation Security 
Administration (TSA)


When Traveling to Another Country
Different Countries Use Different Units of Measurement

Different Measurements for Blood Glucose Testing

Different Insulin Strengths

Carry an "I have diabetes" Placard in Your Car, Wallet, or Purse

I Have Diabetes - Translated into Other Languages

Links to More Information About Traveling to Other Countries

What should insulin look like?

How long does insulin (bottled in vials) last? (What is the "shelf-life" of insulin?)

How long does insulin stay "good" in an insulin pump cartridge?

How long does insulin stay "good" in insulin pen cartridges and prefilled pens?

Chart for Insulin Storage and Expiration


getting the most out of diabetes camps
American Diabetes Assn.
Getting the Most out of Diabetes Camp:
 A Guide for Parents ahd Kids.  Along with anecdotes and stories from campers, Getting the Most Out of Diabetes Camp covers topics such as why go to a diabetes camp, is your child ready, which camp is best for your child, what to expect, what not to expect, how to evaluate your child's experience, and more.


BD Diabetes:  Injecting while traveling

According to BD Diabetes, insulin can safely be scanned by X-ray machines in airport terminals.  However, they also state that prolonged or repeated exposure can affect the stability of insulin.  BD Diabetes suggests that when traveling, you inspect your insulin each time before using it.

You have the right to ask for your medications, including insulin, be visually screened.  See our Traveling with Diabetes: Laws and Policies section for more information.


Did you know?

... that you should not inject air into insulin bottles when in the air on a plane? The cabin is already pressurized and injecting air will cause too much pressure inside the insulin bottle.

...that most insulin pump companies will rent or loan you a spare insulin pump to take with you when you travel?  Pumps can fail so it may be worthwhile to contact your pump company and ask about spare pumps for traveling.


Site Links for Information About Traveling with Diabetes

American Diabetes Association

Diabetes Prevention and Control Program - Traveling with Diabetes: General & Safety Information Needed for A Healthy Trip (including laws regulating traveling with diabetes supplies).

Traveling with Insulin

Have Diabetes, Will Travel

Traveling with Diabetes

Traveling With Diabetes (Tips)

Traveling with Diabetes: Make Adventure the Destination, Not Health Management

Your Traveling Medical Record

Diabetes UK offers valuable tips for traveling abroad with diabetes

Traveling With Diabetes

diabetes care tips                    

Tips on Traveling with Diabetes
General Travel Tips f
or All Travelers with Diabetes


Mini Site Index
Travel Tips for a Safe Trip
Your Insulin Requirements will Probably Change
Insulin Storage and Handling Tips
Diabetes Care Supplies:  What You Need to Take
Coping with Travel Illness, Diarrhea, and Vomiting
Make Sure Your Insurance will Cover Emergency Medical Care
Changing Time Zones
High Altitude Areas and Airplanes Affect Pumps, Pens and Insulin Vials

For more information see
Traveling with Diabetes: Laws and Policies
How can I travel safely with insulin?
Traveling to Another Country


Travel Tips for a Safe Trip

  • If you are traveling alone, be sure to tell the flight attendant that you have diabetes and where you will be keeping your glucagon kit and fast sugars.  In case of an emergency this is important information for the flight crew.  
     
  • Carry printed instructions on how to give a glucagon shot, and complete, detailed medical information including insurance information, emergency contacts, your physician's contact information, insurance card, your insulin schedule and dose (write down your basal rates if you are using an insulin pump), allergies, any other medications that you are on, and your diabetes daily care log information.
     
  • Carry twice the amount of supplies, including insulin, that you think you will need for the trip.  In addition to what you place in your stored luggage, carry 1-day's worth of supplies with you on the plane (do not store insulin in the overhead compartment.).  Always carry all your insulin with you in your onboard luggage as it can freeze (or get lost) in the baggage compartment below.
     
  • Ask for an aisle seat.  This will make restroom trips more convenient, give you more space for injections, and in the event that you experience hypoglycemia and require assistance, it will be easier for airline personnel to get to you promptly.


Your Insulin Requirements will Probably Change

While traveling, it is important that you check your blood glucose more often than you would at home.  Your insulin requirements will probably be different while traveling for many reasons, including:

  • Airplanes are notorious for causing dehydration -- this can cause hyperglycemia.  Be sure to drink plenty of water while on the plane.  
     
  • When flying, insulin requirements usually change temporarily while in the air.  This can be due to stress, changes in air pressure, which affect insulin, pumps, pens, and insulin action.
     
  • Stress (even vacation "stress") can  increase blood glucose levels causing hyperglycemia.
     
  • Excitement, especially in young children, can lead to hypoglycemia.
     
  • Hot weather, hot tubs, and saunas, as well as increased activity can speed up the action of insulin and lead to hypoglycemia.
     
  • Changes in eating habits and times.  For those on shot therapy, it is often hard to maintain a tight schedule of shots and eating -- especially when changing time zones.  Be extra vigilant about changes in your child's behavior and mood and check blood glucose levels frequently and carry extra snacks.
     
  • Changes in sleep schedule.  When time zones change, so does bedtime.  Your body may take a few days to transition to a new time zone and this can lead to blood glucose problems, especially at night.  When changing time zones be sure to check your blood glucose at least twice during the night until the time zone transition is complete.


Insulin Storage and Handling Tips

  • Insulin should be kept out of direct sunlight and kept cool.  If you unhook your insulin pump at the beach or pool, never leave it in direct heat or sunlight!
     
  • Insulin can freeze if stored in the cargo baggage area.  If insulin freezes it is no good and should always be discarded.  When traveling by airplane always bring your insulin with you in your hand luggage on the plane.
     
  • A cooling device to keep your insulin cool while traveling.  Read Islets of Hope's review of Frio pouches and why we gave them a low rating.
     
  • Most hotels will have, or can put in your room, a small refrigerator to store your insulin.  Call the hotel and ask about having a refrigerator in your room before you travel.
     
  • Insulin can be absorbed faster in warmer temperatures and with increased activity.  Be sure to check your blood glucose levels more often while traveling.


Diabetes Care Supplies:  What You Need To Take

  • Take twice as much insulin, syringes, pens, needles, medications, ketone test strips, lancets, glucose tablets, insulin pump supplies are would normally be used.  Also, bring along a spare meter, batteries for the meter (and your insulin pump), and an extra lancing device.
     
  • At least two glucagon injection kits along with instructions (in case someone else needs to perform the injection).
     
  • If traveling with someone else, split the amount of extra supplies between each passenger's hand luggage just in case one of the bags is lost.
     
  • Two cooling bags for storing insulin (in case one is lost, fails, or needs to be "recharged."
     
  • High altitude, pressurized airplane cabins, heat, and humidity can sometimes affect meters and test strips. This can cause false readings.  If you are not feeling good, retest your blood glucose levels.  Also, at least while on the plane, do not use "alternate" testing sites like your forearm.  This is especially important for children as alternate sight testing is not as accurate and does not always reflect rapid changes in blood glucose levels.  Read more about alternative site testing and meter accuracy.
     
  • Sharps containers - this can be a small, portable sharps container, or even an empty instant coffee tin.  Some countries allow any clear, plastic container to be used as a sharps disposal container.  In a pinch, you can place used syringes in empty soda cans and crush the can.  You can also purchase snippers to remove the needle tips from syringes, making disposal easier -- the needle tips can be stored and carried in small, plastic empty film cases.
     
  • A diabetes identity card or jewellery.  Be sure to include emergency contact information and it is advisable to have written down medications you are on, insulin dose, timing, type, basal rates, correction factors, etc.  Also, include any other medical conditions or allergies and who to contact in an emergency -- family and physicians..
     
  • Fast-acting carbohydrates, and healthy snacks in your hand luggage to cover any traveling delays.
     
  • Do not order a special "diabetic" meal on the plane.  Often, they will contain too little carbohydrate (and frankly, taste nasty because "diabetic" meals contain no fat and no salt). Sometimes, airlines fail to have the requested food anyhow and some airlines (i.e., Jet Blue) no longer even provide meals.  Instead, bring extra carbohydrates in the form of sandwiches, fruit, cereal bars, etc. And bring juice or other sugary drinks -- the best fast acting carbs that will also provide you fluids if your stomach is upset.
     
  • A letter from your doctor with a contact telephone number and address confirming the need to carry needles and syringes.
     
  • A list of all current medication - e.g. a copy of up to date repeat prescription request.
     
  • You might also wish to carry a basic first aid box.
     
  • If you have an insulin pump, call your pump company about renting or borrowing a spare pump for the trip.  Animas offers free spare loaner pumps to persons traveling who already use an Animas pump.  (When in Virginia, the night before our flight back home, my daughter's pump "drowned" in a swimming pool.  It was a challenge to get on the plane the next morning and we would have missed our flight had Animas not come to our rescue).


Coping with Travel Diarrhea, Vomiting and Illness

  • If you become sick while traveling with vomiting or diarrhea, do not stop taking insulin or your diabetes medications even if solid foods cannot be tolerated.   This is especially important for those on insulin pumps.  You need to maintain circulating insulin in order to prevent hyperglycemia and diabetic ketoacidosis.
  • Take fast-acting sugars to raise blood glucose, sugary drinks are the better then glucose tablets.
  • Check your blood glucose levels frequently.
  • Test your urine should be tested for ketones and seek medical help if they are in the moderate range or higher.
  • If you are unable to maintain a safe blood glucose range seek medical help as soon as possible.


Make Sure Your Insurance will Cover Emergency Medical Care

If you do not have insurance that would cover the costs of emergency medical care purchase travel insurance. Inform the insurance company that you have diabetes to make sure that the insurance package provides adequate cover. This should include cover for emergency transport home and recovery of charges for replacement of insulin or equipment.

Free or reduced cost emergency treatment is available in countries in the European Union.  The Form EIII for treatment is available at the post office (in the UK).


Changing Time Zones

Changing time zones can cause problems with your insulin schedule.  Be sure to check with your doctor before traveling for advice on how to make changes in your insulin schedule.  It is helpful to keep a watch that reflects the time zone you are traveling from until you have made a complete transition into the new time zone.  A copy of your flight plans and itinerary will help your doctor know how to make insulin adjustment suggestions.

Be aware that changing time zones, therefore, sleeping and eating habits, can have a dramatic affect on your blood glucose -- check your blood glucose levels more often and be sure to check them during the night.


High Altitude Areas and Airplanes Affect Pumps, Pens and Insulin Vials

Traveling to areas of high altitude can cause insulin to expand and contract, resulting in air pockets within the an insulin pump cartridge or insulin pens.  With a pen, you may need to do a few "air shots" to make sure that there are no air bubbles in the cartridge.  With in insulin pump, you may need to unhook and reprime the cartridge if you are experiencing hyperglycemia after a bolus.

This contraction from altitude and pressurized airplane cabins can also increase the pressure in vials of insulin.  On planes, and in high altitude areas, you will not need to inject air into the vial before drawing out the insulin.

Since the cabin is pressurized, do not inject air into the insulin vial before drawing it out, this will put too much air pressure into the vial.  Keep your insulin with you (not in the overhead compartment).  See Diabetes Monitor's site for useful information about traveling with insulin.


IOH Health Tip:  Injecting air bubbles will not hurt you but you won't get an accurate dose of insulin. If you are unsure, or cannot remove air bubbles, remember that you can always draw insulin from an insulin pump cartridge or pen with a syringe if necessary.

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Page Updated 05/02/2006