Type 1 Packing for going abroad!

[Mike d]

I've stowed hold baggage enough as an airport manager to know that a bay door might well be freezing (especially in winter) but the contents within are perfectly normal .... pets included

But insulin? Cabin bags always

 

[Celsus]

Again the CAA confirm it. “Patients who use insulin pumps should also be aware of the potential impact of changes in the cabin air pressure on insulin delivery. The reduction in ambient pressure on ascent may lead to a slight increase in delivery of insulin as a result of the formation / expansion of air bubbles, which may be sufficient to cause symptomatic hypoglycemia. A more severe impact could be seen in the (rare) event of sudden decompression of the cabin at altitude. A slight reduction in insulin delivery is also possible during descent.”
The pressure change can be equivalent to 8,000 ft (vertical!) in normal operations. Much more in the case of decompression. The longest chairlifts may approach 8,000 ft but in length, not in height.

And if you wish for medical evidence - http://care.diabetesjournals.org/content/34/9/1932

“CONCLUSIONS Atmospheric pressure reduction causes predictable, unintended insulin delivery in pumps by bubble formation and expansion of existing bubbles.

A 10-year-old girl with well-controlled type 1 diabetes managed with insulin pump therapy developed recurrent hypoglycemia 60 to 90 min after commencing commercial air travel. Upon direct inquiry, we are now aware of 50 children and adults using insulin pumps who experience this phenomenon.

In 1994, Aanderud et al. (1) demonstrated that insulin pumps delivered “more insulin than the set rate during decompression.” At sea level, the ambient pressure is 760 mmHg (1 atmosphere). When commercial planes ascend to 40,000 feet, the cabin pressure decreases by 200 mmHg to 560 mmHg (cabin pressure equivalent of 8,000 feet) (2). The objective of this study was to investigate the effects of pressure changes during airplane flight on insulin pump delivery.”

The study ends with recommendations that pumps should be disconnected before takeoff and landing.

“We recommend for flights:

1. The cartridge should only contain 1.5 mL of insulin.
   
   
2. Disconnect the pump before takeoff.
   
   
3. At cruising altitude, take the cartridge out of the pump and remove any air bubbles before reconnecting.
   
   
4. After the airplane lands, disconnect the pump and prime the line with 2 units. Then reconnect the pump.
   
   
5. During flight emergencies involving cabin decompression, disconnect the insulin pump.

Insulin pumps deliver excess insulin as ambient pressure decreases, which may cause hypoglycemia. ”

Again Bill...
Reason I asked the question: Should you dismantle your pump when you go for a day of alpine skiing?
But maybe you don't have the answer to that?

Commercial long-haul flights do though quote in modern times to maintain a cabin pressure equivalent to the outside air pressure at 1800–2400 m, so better conditions now than for your reference study from 1994. But situation is still equivalent to when you go alpine skiing. And when you go alpine skiing its like non-stop for the entire day that you go up/down/up/down/up/down...

But its such a fantastic life confirming experience to go to the top of e.g. Chamonix. Where you are literally on top of one of the highest peaks in Europe, walking down on the ridge of "Aiguille du Midi" to get to the start of the classic 'Vallee Blanche' piste. On this you do a vertical drop of more than 2755m ! So a bigger air pressure difference than what your study above use as reference for when the pump should be disconnected.

Truly takes your breath away but worth every effort going there.
Not a pumper myself anymore, but never thought about this issue before.
But if device manufacturers and air transportation authorities says its an issue for air flights, well then alpine skiing should be also. As well as mountain biking in the Alps in the summer, where its great to take the chairlift to the top with your bike and then free riding down with family and friends.

 

[Pcarnduff]

I would put EVERYTHING in your hand luggage, including fruit pastilles. You never know what you may need during the long flight and you don't want to risk losing anything if your luggage goes awry.
I am not aware of any reason why you need to proactively declare anything unless they ask if you have any sharps or, at security spot something in the x-ray. I recommend having a doctors note on hand just in case. I have been travelling regularly (with transfers) with diabetes for nearly 15 years and only had to show mine once.

I cannot remember/spot how you treat your diabetes - is it with a pen or a pump.
Whichever it is, make sure you have backups of everything.
If it is a pump, don't let it be x-rayed.

You are unlikely to see your suitcase until you get to your final destination (a few countries, like USA are awkward with transfers but Denmark is fine).
You may have to be security searched (through the x-rays) at Copenhagen. Different airports vary so I am not sure.

The only reason I can think of to declare your fruit pastilles is if Japan has strict rules on importing food. Sorry I have never been to Japan (but would love to). Otherwise, there is no need.

Have an amazing trip.

It's worth asking the airline when going abroad about medical supplies. We recently travelled with Jet2.Com and asked them about my pump supplies. They provided an email allowing us an extra cabin baggage allowance so allowed us to take an extra 10kg into the cabin. Very useful when most of my original cabin allowance was taken up by my pump supplies.

 

[Deleted Account]

It's worth asking the airline when going abroad about medical supplies. We recently travelled with Jet2.Com and asked them about my pump supplies. They provided an email allowing us an extra cabin baggage allowance so allowed us to take an extra 10kg into the cabin. Very useful when most of my original cabin allowance was taken up by my pump supplies.

I believe most airlines allow this without the need to ask.
However, I am a minimal packer (except my diabetes supplies) so I never need it.
I believe there was another thread about carry a "medical supplies bag" this a few months ago.

 

[Bill_St]

I have no definitive information on skiing with a pump but the aircraft information is very clear that insulin delivery Will change with a pressure change. That is just a matter of simple Physics and gas laws. It would seem that for safety a pump user should take that into account. It is a risk that should be assessed. Temperature change while skiing may also need to be considered.

I personally would make no statement on hold temperature and simply leave it to those whose profession is airline risk assessment. They give clear advice to medical professionals, I presume for them to pass on to patients.
Unless you carry a temperature data logger with your insulin (I do, but then I travel in some extreme temperatures both high and low) then it is up to a patient to assess the risk - or take the advice of the professionals but my assessment would be that I would rather trust my health to advice from organisations such as the CAA than to completely trust unreferenced statements on a message board.

Incidentally you may find it interesting to search for animal death numbers in air transit

 

[Zilsniggy]

I don't believe anyone has yet mentioned that your insulin SHOULD NOT be stored in your hold luggage. With temperatures at 40,000 feet of something between -50 to -60 outside and not a lot higher in the hold, the insulin will freeze, not recommended, as it then degrades and may well end up being completely useless to you. It should always be carried in hand luggage, if needs be in a cooled container, but not directly next to an ice block.

 

[Zilsniggy]

But I wanted to debunk the myth that stowed luggage is in no pressure or in below freezing.
Because that is a myth.

Sorry, I've literally taken items out of my hold luggage after a long haul flight and they have been frozen solid. I must have been imagining it then........