Again Bill...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:
Insulin pumps deliver excess insulin as ambient pressure decreases, which may cause hypoglycemia. ”
- The cartridge should only contain 1.5 mL of insulin.
- Disconnect the pump before takeoff.
- At cruising altitude, take the cartridge out of the pump and remove any air bubbles before reconnecting.
- After the airplane lands, disconnect the pump and prime the line with 2 units. Then reconnect the pump.
- During flight emergencies involving cabin decompression, disconnect the insulin pump.
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 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.
I believe most airlines allow this without the need to ask.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.
But I wanted to debunk the myth that stowed luggage is in no pressure or in below freezing.
Because that is a myth.
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