Type 1 diabetes is an autoimmune disease in which a patient’s pancreas stops producing insulin. Insulin is a hormone that enables a person to derive energy from the food they consume. Essentially, the body’s natural immune system attacks and destroys the insulin-producing cells – called the beta cells – in the pancreas. Type 1 diabetes strikes children and adults at any age, causing dependence on insulin injections or pumped insulin for life.
According to the Juvenile Diabetes Research Foundation (JDRF), as many as three million Americans have Type 1 diabetes and the prevalence in those under age 20 appears to be rising.
Travelers with Type 1 diabetes face a wide range of risks that have little effect on healthy travelers. Some of those risks include:
Changes in physical activity
Meals away from your typical diet
Too much or too little sleep
Impact of stress
Even something as simple as a mild sunburn can have an affect on a diabetic traveler’s blood sugar level and cause a range of problems.
Before any trip, a traveler with Type 1 diabetes has to take extra precautions. See the following tips for a safe trip when you have Type 1 diabetes.
1. See your Doctor Ahead of Time
Your regular doctor will be able to give you some support including:
A letter to explain your insulin pump, injection supplies, etc.
A prescription for any medications you need
If you need immunizations for your trip, you’ll want to have those well ahead of time and with your regular doctor so you have plenty of time to recover before you leave. See our Essential Pre-travel Health Checklist for additional tips.
You should have more than enough insulin, syringes, test strips, and other supplies for your trip, but pack extra in case you experience a need for more insulin.
2. Be Prepared for an Emergency Abroad
Depending on where you are traveling, it’s important to be prepared for an emergency abroad. No matter where you go, wear your medical ID bracelet or necklace that shows you have diabetes.
Know how to find reliable and qualified medical care where you are traveling – particularly if you are unfamiliar with the language. Most travel experts recommend that travelers become members of the International Association for Medical Assistance to Travelers (IAMAT). They will help you locate doctors who can help you, no matter where you are.
In addition, you should check with your health insurance company and find you if they will pay for your medical treatment if you encounter the need abroad. If not, be sure to purchase a travel insurance plan with adequate medical limits and coverage for pre-existing medical conditions. Even though your diabetes is managed through insulin, it’s an always changing dose depending on your needs and it is (unfortunately) always going to be a pre-existing medical condition. Some travel insurance plans cover pre-ex automatically if you purchase it early in your travel plans and fully insure your pre-paid trip costs.
3. Have Plenty of Diabetes Supplies
You should always have the healthy snacks and sugar you need on hand so you can manage your blood sugar lows as much as possible. Many travelers with Type 1 experience erratic blood sugar spikes and plunges when they are exposed to air travel, so it’s important to be prepared for both at all times.
Pack your diabetes supplies in your carry-on and make sure you have:
Insulin and insulin-loaded dispensing products (vials, jet injectors, biojectors, epipens, infusers and preloaded syringes)
Lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs and meter-testing solutions
Insulin pumps and insulin pump supplies — cleaning agents, extra batteries, plastic tubing, infusion kits, catheters and needles (insulin pumps and supplies must be accompanied by insulin)
A glucagon emergency kit
Urine ketone test strips
In addition, you’ll want to have more supplies than you need and you’ll want to keep a close handle on those supplies. In some places, a package of clean unused syringes is worth a lot on the black market and therefore worth stealing from you.
4. Pack with your Diabetes in Mind
You’ll want to keep all your medication and supplies with you on the off-chance your luggage is stolen or lost, but you will also want to be organized so that you can reach what you need to get through security and on the plane.
Keep your medications in their original containers, but using plastic zipper bags or other clear packaging will make getting through security easier. Update your travel medical portfolio with any new medications you are taking, your doctor’s current contact information, etc.
Some doctors prefer that their patients travel with a backup loaner insulin pump in case something happens with the one they are wearing. In many cases, the pump companies are willing to loan pumps for this purpose and you may have to pay a fee.
If the airline doesn’t offer a meal that works with your diet, bring one of your own. Wearing shoes that you can slip off and warm socks is a good idea – especially on longer flights where the risk of blood clots is greater. While you’re in the air, you’re going to want to move around every couple of hours.
5. Protect your Insulin Pump at Security
According to Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N., Mayo Clinic diabetes educators:
“Apparently, when an insulin pump or sensor is passed through a full-body scanner or X-ray scanner, there may be a risk of electromagnetic malfunction.”
Insulin pump manufacturers typically recommend you remove your pump or continuous glucose monitoring device before going through the full-body scanner, but don’t send those devices through the X-ray machine as an alternative. The safest way to be sure what your medical device needs at the security line is to check with the manufacturer. (Call their service line or check their website.)
Many travelers with Type 1 prefer not to go through the scanners. Instead, they inform the security officer that they are wearing an insulin pump and ask them to visually inspect the pump and do a pat-down instead.
6. Upon Arrival
Once you arrive, your body may struggle a bit with the time change, so it’s important to check your blood sugar as soon as you land and often throughout your trip. Flying, being in different altitudes, and general exposure to stressors can affect your blood sugars.
Each day of your trip, be sure to keep the supplies you’ll need on hand and carry your doctor’s note. Of course, you know to always be prepared to treat low blood sugars, and that means having sugar or snacks on hand at all times because you can’t count on what you’ll be able to find or buy. Tell those you are traveling with that you have diabetes so they can inform emergency responders if something happens.
Be careful about the food you eat too. It should be fully cooked and hot so there is little risk of salmonella or other nasties that can cause food poisoning. The loss of food due to vomiting is much harder on those with diabetes.