Any type of travel is challenging, no matter who you are or where you go. It is even more stressful for the millions of Americans who travel with diabetes. Because of the need to continuously monitor and manage their blood sugar, most diabetics know they must take their medical supplies with them; however, those who are unaware of the requirements of the condition often don’t understand the sufferer’s specific needs.
In addition, the use of needles has a negative stigma associated with it. People often react fearfully to something they don’t understand, which can impact a diabetic’s experience while traveling, and especially while on public transportation or when going through airport security. However, with the proper preparation, traveling with diabetes can be far less stressful for everyone.
Planning and Packing
Most people who deal with diabetes are used to planning and packing for just about any type of trip. But aside from the more obvious, like obtaining a medical alert bracelet and keeping supplies at the ready, there are many things you can do to make getting out and about less stressful, faster and easier, such as:
- Becoming well-informed about what you’ll need to pack, depending on the length of time and your exact destination.
- Finding out exactly where you can get medical help and supplies wherever you go.
- Learn about what you’ll need to bring and present to authorities in order to stay out of legal hot waters before and during your trip, both on the outward journey and back again.
The tips and resources in this guide will help you with planning and preparation, so your trips will go more smoothly, and without any unnecessary worries.
Daily Commuting: On the Bus, Train or Taxi
Even if you are taking public transportation to work or for a day trip, you will still need to prepare. Public transportation may be more reliable than ever, but there can still be unexpected delays and cancellations. In addition, security and public transportation personnel are hyper-aware of bags and equipment.
Here’s what you can do:
- Carry or wear medical identification. Also, carry contact information for your physician.
- Take extra supplies and carry snacks in case of any unforeseen delays or cancellations.
- Be prepared to explain yourself should you need to eat, take medications or test your blood sugar on board.
Extended Road Trips and Vacations
Even on an extended road trip, when traveling overseas or on a vacation, you still need to continue your healthy lifestyle practices, such as eating right, exercising, taking all your meds and managing your blood sugar.
According to the Cleveland Clinic, here are some things to do before you leave on a long trip or vacation:
- Write down your entire itinerary from start to finish.
- Besides making a list of your clothing, footwear, accessories, including all diabetes gear and meds. A safe guideline is to pack twice as much as you think you’ll need.
- Visit your healthcare provider to discuss your trip and to get:
- Instructions on time changes. You will need to adjust for longer or shorter days, depending on your direction of travel, your current time zone and the time zone of your destination.
- A letter explaining your diabetic health care needs, also saying the doctor is giving you permission to carry all diabetes equipment and supplies. This is necessary in many foreign countries, especially with needles and syringes.
- Vaccinations and immunizations required for destination. Do this at least three to four weeks beforehand, in case you experience any side effect.
- Diabetes testing supplies and prescriptions, as well as a list of all medicines, including their generic versions.
- Insulin, including a list of the types you take, such as short-acting, rapid-acting, intermediate-acting or long-acting.
- Any other prescriptions, medicines and instructions necessary for the trip.
- Sign up for health and travel insurance. Remember, your regular health insurance or plans like Medicare may not be valid where you are going.
- Get a medical ID bracelet and don’t forget to wear it.
- Carry your health insurance card at all times.
- Check your health insurance policy for travel information and see if your travel destination is in your provider’s network. If it isn’t, find out what you have to do in order to have health insurance coverage out of network
If you are traveling to another state or internationally:
- Bring extra supplies and meds, because your prescriptions and supplies may not be available or refillable at your destination.
- Learn the words and phrases you’ll need in case of an emergency, and write them down for easy access.
- Note that many states have individual laws regarding the labeling of prescription medications that you need to comply with at all times.
Air Travel Preparations
If you are traveling by plane, you will need to make note of the extended trip instructions, above, as well as:
- Find out about acceptable carry-on diabetic equipment and items by contacting your airline.
- Be prepared to spend extra time pre-flight working with security regarding your diabetes supplies and medicines.
- Plan to eat every four to five hours during the day throughout the trip.
- Carry snacks for flight delays or unexpected situations.
- Learn about food and beverage rules for your specific flight by calling your airline or by speaking to the Transportation Security Administration (TSA) at 1-866-289-96731-866-289-9673 FREE
- Pack extra supplies in your carry-on luggage, just in case your check-in luggage is lost, stolen or delayed, such as:
- A first aid kit for cuts or sores
- Glucose tablets or gel
- Snacks like, hard candies, raisins or cheese and crackers
- Equipment manuals and maintenance logs
- Lancet device and supplies, like lancets and meter strips
- Extra batteries or power supplies
- Insulin, including an extra bottle
- Alcohol wipes
- Syringes, insulin pens and pen needles with a container for used items (needles and lancets)
- Oral medicines in their original containers
More Long Trip Tips
Sitting for long periods of time can be hazardous for anyone, due to the restricted blood flow and the pooling of blood in the feet and ankles. However, it is especially dangerous for diabetics, so here are six simple moves to try while you are sitting in that car, plane, train or bus:
- Put your feet flat on the floor.
- Lift your toes up from the floor, keeping your heels down.
- Hold this position for a few seconds.
- Alternate and lift your heels from the floor, keeping your toes down and hold for a few seconds.
- Pick both feet up off the floor.
- Move your feet in a slowly in a circular motion several times.
- Switch directions and do several more circles.
- Grab one knee with both hands.
- Pull your knee toward your chest and hold for several seconds.
- Place your leg back down onto floor and repeat with the other knee.
- Rotate head in a smooth, gentle motion to the right until your right ear reaches your right shoulder.
- Next, rotate head to left until left ear reaches left shoulder.
- Do several times slowly.
- Take a deep breath and allow your shoulder muscles to relax completely.
- Roll shoulders forward slowly, then backward.
- Do this several times.
- Place your right hand on your left shoulder
- Put your left hand over your right elbow and pull it gently and slowly toward your left shoulder.
- Hold this position for several seconds.
- Release and repeat on other side.
- Do this several times.
Traveling and Life Insurance Concerns
Life insurance is important, especially for a person with diabetes. As a person living with diabetes, you probably know how hard it is to obtain affordable life insurance, an increasing number of life insurance companies are treating people with diabetes more favorably, including both exam and no-exam companies. Rootfin recommends that diabetics to do their homework, because they can qualify for affordable life insurance, even without an exam, as long as their diabetes is under control. You will want to avoid policies from Primerica Life Insurance because they do not work well with diabetics and have no options with no examination. We offer company reviews for your reference to learn more of the pros and cons of each one, such as AIG Direct.
Individual life insurance companies vary in their policies regarding foreign travel for those with health conditions; however, they often use the following general factors for determining travel risks:
- Most life insurance policies cover international travel, but just to be sure, check with them to see if they have any exceptions for diabetics.
- Meet with your doctor first and get a letter from them stating you have met, received a travel plan to manage your condition, and all equipment and medications for the trip.
- They will also look at the country itself, checking the economic conditions, standards of sanitation, disease and public health, and overall access to hygienic medical facilities.
If you plan to purchase travel insurance:
- Insurance companies want to review all the factors above even more carefully, plus you will need to prove you are managing your diabetes well.
- When you fill out the medical questionnaire or medical underwriting form for travel insurance, they will take any medical condition you have into account.
- You should be able to obtain coverage, depending on your age and the stability of your condition.
- Stability generally means no changes in medication, no hospitalizations and no new diabetes complications within a certain timeframe
- Because of your diabetes, your premiums may be higher, so start early and shop around.
- If you know you are going on an international trip and you want travel insurance, start the application process as early as possible.
Sailing Through Airport Security
Although the TSA continues to improve its policies and procedures for those with diabetes and other health conditions, there are still many things diabetics need to know in order to make their trip go smoothly, and without any unexpected problems or delays. Even if there are no complications, you will still want to arrive at the airport at least two to three hours before your flight departure.
The TSA will allow any diabetes-related supplies, medications and equipment, including liquids, through the checkpoint once they have properly screened those items using X-rays or a hand inspection. If you encounter any problems when you try to go through airport security, you should ask to talk to the TSA Ground Security Commissioner or an international equivalent.
Important things to remember for making the process easier:
Although not required by the TSA, bringing your prescriptions and prescription labels will help you immensely should any complications occur or questions arise.
Label and separate all medical items from your other belongings before the screening starts. Keep in original containers, but you can separate them using clear plastic bags.
Declare all diabetes and medical items, including liquids, meds, freezer packs, pumps, IV bags, lancets and syringes by letting the officer who is conducting the screening know about any supplies on yourself, or in your carry-on bag.
If you don’t want the TSA officer to open or x-ray your gels, liquids or aerosols for screening, inform them before your screening begins. The security officer may ask you to open your gel or liquid for an additional screening, but TSA doesn’t touch the gel or liquid during the security check process.
If you get approved to use the TSA Pre✓® lane at any participating airport, you don’t have to take off any light jackets, belts or shoes, and laptops or 3-1-1 liquids are okay during the screening process.
TSA officers may swab your hands, equipment, mobility aids and other external medical devices to check for explosives with explosives trace detection technology.
Here’s are the specifics on diabetic needs according to the TSA:
Insulin Pumps, Lancets and Monitors – It is common for people to bring an insulin pump through airport security, but you should carry your TSA Disability Notification Card when you travel. Although most pumps and monitors can withstand everyday electromagnetic interference, in order to be safe, request a pat-down screening instead, and ask TSA to inspect your equipment visually.
If you can’t remove your insulin pump, explain that it includes a needle that sits under your skin, so they will need to do a pat-down instead. Lancets are fine as long as you cap them and carry them along with your glucose meter in their original packaging.
Insulin Delivery Devices – You will need to prove a doctor has prescribed any insulin and needles, so carry a pre-printed pharmaceutical label to identify your medication. Always carry the original glucose meter and insulin box with the original pharmaceutical label, too. These items are necessary in order for you to be able to board your airplane carrying insulin, syringes and other insulin delivery devices.
Insulin and Glucagon – Never store insulin or glucagon in your checked luggage. Severe changes in pressure and temperature can alter them. Inspect your insulin or glucagon carefully before you use it, and if you notice anything unusual about its appearance, call your doctor. Carry them in their original, pharmacy labeled containers.
Although there is a general rule that prohibits airline passengers from bringing liquids over 3.4 ounces through security, people with diabetes can bring glucagon or insulin, and any other necessary gels and liquids, including cake and juice gels through TSA checkpoints, even if they’re in containers larger than 3.4 ounces. The TSA also allows any accessories necessary to keep insulin cool, such as frozen gel or freezer packs through screening checkpoints.
Additional Resources for Traveling with Diabetes
If you plan to travel, here are some additional sources of help available to you:
- Legal Issues Regarding Travel: Help with any legal issues affecting diabetics, including travel. Call 1-800-DIABETES1-800-DIABETES (1-800-342-23831-800-342-2383 FREE) or visit www.diabetes.org/gethelp
- American Diabetes Association Air Travel FAQs: http://main.diabetes.org/dorg/PDFs/Advocacy/Discrimination/air-travel-and-diabetes.pdf
- TSA Screening: https://www.tsa.gov/travel/security-screening
- TSA Disability Notification Card: https://www.tsa.gov/travel/special-procedures and https://www.tsa.gov/sites/default/files/disability_notification_card_508.pdf
- TSA Disability and Medical Condition Procedures: https://www.tsa.gov/travel/special-procedures
- Health Insurance Tips: http://www.diabetes.org/living-with-diabetes/health-insurance/?loc=superfooter