When traveling with diabetes, it will require some preplanning in order to have a successful and healthy trip. I’d like to see you enjoy your travels to the fullest. To help you do so, here are some travel tips, along with suggestions from the American Diabetes Association.

Visit your Doctor

A visit to your doctor prior to travel is a good idea. Ask them to provide a prescription for your medication and a letter (on letterhead) stating that you have diabetes and the medicine and equipment you will be traveling with (i.e. insulin, syringes, and any other devices). The letter should include any allergies you may have.

This documentation is important if you are traveling abroad. Some countries may require proof of why you are traveling with medications and supplies. When going through security at U.S. airports, it may be necessary to present this to the TSA.

If crossing time zones, bring your flight schedule and time zone changes, so your doctor can help you plan the timing of your injections. If you will need to give yourself an insulin shot while on the plane, get specifics on how to do this properly to avoid any complications.

Ask for suggestions on exercises you can do while on the plane for an extended period of time.

Review Prescription Laws of the Country you are Visiting

In some countries, your prescription drugs or diabetic supplies may be prohibited or have specific entry requirements. Find out in advance if this may be an issue by visiting the U.S. Department of State or that country’s Embassy.

TSA Security Checkpoints

Pack your medications in their original container and put them in a clear bag. Declare these items and all diabetic supplies at the checkpoint and remove them from your bag for inspection. Liquid medications over the 3.4 oz. requirement are allowed.

If you wear an insulin pump, be sure to inform the TSA in advance of the screening. Also, check with the manufacturer of the pump to ensure that it is safe to go through AIT scanners. If you are concerned, you can request a pat down instead.

For questions, contact TSA Cares at 1-855-787-2227.

Precautionary Steps

• Wear a medical bracelet or necklace stating that you have diabetes (in the event of an emergency) and learn how to say certain words in the language of the country you are visiting, such as I have diabetes. Please, I need some orange juice or sugar.
• Notify the airline in advance that you would like a diabetic meal or one that is low in fats, cholesterol, and sugars.
• Contact the Embassy in the country you will be traveling to for a recommendation on a reputable physician and the closest hospital. Keep the address and phone number with you.
• Check your health insurance plan. Does it provide coverage when abroad and are there any stipulations? For example, do you have to go to a designated physician or hospital? The majority of insurance companies do not cover the cost of an emergency medical evacuation if you have to be transported back to a hospital in the U.S. It’s a good idea to look into purchasing travel medical insurance and make sure that it covers pre-existing conditions. This usually requires that you purchase the insurance early, oftentimes within 7 – 21 days of your first travel deposit.

Vaccines and Routine Immunizations

If vaccines are required for the country you are traveling to, or if you need to get up-to-date on your routine immunization shots, get them at least a month in advance of your travel date. If you experience any side effects, you will have time to recover. Some vaccines may take up to eight weeks to complete the series, so you will need to take that into consideration.

What to Pack in Your Carry-on Bag

• Insulin and syringes that you will need for the duration of your trip, plus extras in case there is a delay.
• Blood and urine testing supplies (include extra batteries for the glucose meter).
• Oral medications and other medical supplies, such as glucagon, anti-diarrhea medication, antibiotic ointment, and anti-nausea drugs, if needed.
• Diabetes identity card.
• Snack pack of crackers with cheese, peanut butter, fruit, juice box, and some form of sugar for low blood glucose.
• Pack your insulin in a special travel pack to protect it from getting too cold or too hot, which could affect the strength. It is recommended you stick with the exact brand and formulation of insulin as prescribed by your doctor.
• If you plan on swimming, bring water shoes.

While in the Air

• Keep your carry-on bag under your seat for easy access rather than putting it in the overhead storage bin.
•  According to the American Diabetes Association, if you take insulin, wait to give yourself a shot until you see your food being delivered (get specific instructions from your doctor). A delay could lead to low blood glucose. Carry some food with you to be on the safe side. Take extra precautions to guard against injecting air into the insulin bottle. Pressure differences in the cabin can cause some problems with the plunger and can make it difficult to measure your insulin correctly.
• Follow the exercise recommendations (from your doctor) to reduce your risk of getting blood clots. Get up and move around every hour or two.
• Since you will be going through different time zones, this could cause some confusion. To keep track of shots and meals, it is recommended you keep your watch on your home time zone until you arrive.
• Check your blood glucose level as soon as possible after landing. Jet lag makes it more difficult to know if you have very low or very high blood glucose.

Tips while Abroad

• After a long flight, it is recommended you keep your activity light for a few days and check your blood glucose often. Changes in what you eat, activity levels, and time zones can affect your blood glucose.
• Carry snacks to treat low blood glucose just in case (crackers, cheese, peanut butter, nutrition bars, and some form of sugar).
• To avoid food poisoning, do not drink the local tap water or drinks with ice cubes, and do not eat raw seafood, foods washed with tap water (lettuce, fruits, etc.), or juices and sodas made with tap water. Some foods could affect your diabetes control.
• Be sure to wear shoes to avoid getting cuts on your feet and wear water shoes when on the beach or in the water.
• Wash your hands often.
• According to the American Diabetes Association, insulin used in the U.S. is the strength of U-100 (100 units of insulin per mL). In foreign countries, insulin may be U-40 or U-80.  If you need to use one of these formulas, you will need to purchase new syringes to match the new level of insulin to avoid an incorrect dose. If you use U-100 syringes for U-40 or U-80, you would end up taking less insulin than your recommended dose – and if you use U-100 insulin in a U-40 or U-80 syringe, you would end up taking too much insulin.  For more information check out the Diabetes.org or call them at 800-342-2383.

Additional Resources

International Association for Medical Assistance to Travellers:

They provide information to travelers on vaccinations, health risks, food and water safety in other countries, as well as international travel tips. They also provide information on qualified doctors (who speak English) and medical facilities that will provide a higher quality of medical treatment. These health care providers are licensed in their country of residence and are in good standing within their field of practice.

To access this information, you need to become a member (membership is free for one year and then renewable with a donation).  You can contact them online at IAMAT.org or call them at 716-754-4883.

Centers for Disease Control and Prevention Travelers Health Page:

The CDC provides general guidelines on health precautions, such as safe food and water precautions, insect-bite protection, and more. They also offer an International Travelers’ Hotline at 877-394-8747 where you can get more information on health-related issues when traveling.

For more travel insight, check out my book

Know Before You Go: Traveling the U.S. and Abroad

Available at Amazon, Barnes & Noble, and wherever books are sold.