Diabetes, Insulin Pumps and Travel Precautions

17 Tips to Help with Airline Security

2006-08-13 Unfortunate events may make having diabetes and especially wearing insulin pumps and traveling on an airplane inconvenient - perhaps very inconvenient depending on who checks you through security. We can't fault the powers-that-be for their caution. Indeed, we are grateful. Clearly, the need exists for such scrutiny. However, this scrutiny may impact your diabetes and health, so be prepared. Although the diabetes associations may have travel guidelines in place, diabetes educators are already hearing sad travel tales. Below are my homegrown suggestions (yes, I'm a pumper and a diabetes educator)to make air travel with diabetes (with or without insulin pumps)as surprise-free as possible. And as likely as possible to end with you enjoying your trip.

17 Tips for Diabetes, Insulin Pumps & Airline Travel

1. Carry insulin (both rapid and yes the longer acting NPH or lantus / glargine) with you on board the airplane. Yes, even if you're on insulin pumps carry the NPH etc. You'll see why in a minute.

2. Have your insulins (or diabetes pills)in the original boxes with the prescription label and your name.

3. Make sure the name you use for your prescriptions matches the name you've used on your airline ticket. I know this sounds ludicrous, but some of us women use a hyphenated name for our husband's benefits plans but book our airline tickets with our maiden name only (since we're so attached to it). Make sure there is no room for confusion and no room for questioning - you don't know how picky the airport security staff will be. Please note, many of the tips below are also appropriate for non-pumpers.

4. Know how much NPH or Glargine/Lantus or Detemir/Levemir etc (yes, longer acting insulins) you would have to switch to if, in the worst case scenario, you had your insulin pump removed from you. Likely your educator would advise you to use a rapid insulin while on the plane. If you didn't have your pump when you landed, then you'd have to use the NPH or Lantus etc when you got to your destination that night. Do talk with your diabetes educator or endocrinologist in advance of your airplane trip so you'd have realistic idea of how much of the NPH or Lantus / Glargine to use. The same goes for the rapid if you have to give it every 2-3 hours. Remember, your trip might include lay-overs so don't plan to go without insulin if you and your pump get separated. I hope you don't have to remove your pump and place it in your checked baggage – HOWEVER, some people have been asked to do this. Be prepared and have those vials of insulin and syringes or insulin pens with you to carry on.

5. Now, this is me being very, very paranoid. Arrive at the airport early! Scout out the Fed Ex or Purolator services. Suppose, again I'm being paranoid, but suppose you get a airline security agent who insists you cannot take your insulin pump with you at all! Not even in the checked baggage. Then you will have time (since you arrived early) to ship your pump to your destination or to a trusted friend (so yes, take a friend's address with you). I know, I know. You're saying this will never happen. Let's hope not and you can all laugh at me later for being so paranoid.

6. Arrive early – yes, I've said it now twice, but I should be more specific. Go through airport security early to allow for any problems. I have heard through the grapevine of people being asked to place pumps in the checked baggage. No doubt this was a long discussion. You'd hate to miss your flight because of it. This issue here is that the liquid in the pump reservoir cannot be verified to be insulin (unless you have a D-tron insulin pump that takes the pen fill insulin vials directly in the pump). I'm not sure what the issue will be with the Omnipod Insulin pump as it is all enclosed on your skin and I'm not sure if you can see the reservoir. However, you will need to have your handheld unit to operate it since it is cordless. Worst case scenario is that since the pod can't be x-rayed you might have to remove it.

7. Wear an infusion set that can disconnect. Be prepared to disconnect and place your pump through the x-ray machine. I've been told my pump should have no problems being x-rayed – please check with your pump manufacturer to see if your pump can safely go through the x-ray machine. (I intentionally didn't tell you my brand so that you'd check it out for yourself, in case I was told the wrong thing I don't want to be the cause of any damaged pumps.) FYI: Most pumps don't set off the hand security wands if you wear them concealed. But why risk this? If they find something concealed, you will be under greater suspicion. (P.S. If you disconnect be sure to do an external prime – you know, where you bolus a few units and see it come out the end. You might not be aware, but most insulin pumps “suck back” insulin into the tube when you disconnect. Although not the D-Tron. So always do an external prime after you've disconnected and immediately before you reconnect or you might be missing a unit or more in your basal insulin needs. (eg. This applies to when you reconnect after the shower too.)

8. Try to avoid having any insulin pump alarms go off. Be sure your reservoir is full and you are not running a temporary basal that will alarm when it ends (as my old pump does). Put fresh batteries in before you leave for the airport. You don't want to draw attention to yourself with any alarms going off on your pump.

9. So here is my paranoia again. Ready for this one. I'm going to take some carb food (of course I would anyway, but not a liquid) and be prepared to disconnect, bolus a unit for them to see the insulin drip out externally, re-connect and then give another unit bolus to pacify them. Of course, I might have to eat some of that carbohydrate food after doing this. The only difference is be sure your carb foods are not liquid. (Again, be sure to re-prime externally BEFORE reconnecting. See half way down point 7.)

10. DO NOT take glucose gel. No. No. No. Take glucose tablets and take them in the original packages.

11. If you have a Paradigm Real Time Insulin Pump that displays your blood sugars on the insulin pump, don't forget to pack a normal glucose meter.

12. Always take your glucose meter on board and keep the strips in original containers. Be prepared to test your blood sugar in front of someone if they ask you to verify what the meter does.

13. Be prepared to offer that the stewardess or steward can keep your diabetes supplies like needles, meters etc locked up and that you can ask for them when you need them. You might ask for them a lot, but at least they'd be there when you needed them.

14. I normally carry extra infusion sets but gee, the insertion needle is so long it might panic a security officer. Take the extra set but be prepared to leave it behind if they see it as a threat. You'll have your syringes as backup. Also, be sure to put in a new cannula a few hours before you leave for the airport so one, you can see it is working alright and two, you know you have a fresh cannula.

15. Although they say that doctor letters are too easily forged, bring one with you anyway to explain why and what you are carrying as diabetes supplies. Have the business card attached just in case. If it's a long trip outside the country, it's a good idea to have a letter of introduction from your doctor briefly reviewing your medical history in case you need to see a doctor in that other country. Also, it would be good to have the name of a clinic or doctor that you could go to at your destination site just in case things go wrong there. I'm thinking more about when you travel outside your own country and want to know how to access medical care.

16. Be nice. Be patient. Line ups will be longer but this is for our benefit to have the extra security precautions. If you are prepared for anything, you'll still end up enjoying your trip, managing your diabetes (even if not as best you want), staying safe and still owning your pump even if not wearing it.

17. If you do experience problems, at some point afterwards please contact your national diabetes association so they can work with the governments to come up with solutions.

If you've got further things I should add to this list for insulin pumps and airplane travel, please let me know. Hit the “contact me” button on the left. In the mean time, prepare well and have a fabulous trip!!