Type 1 Plane travel

[Gardevoir]

Hi,

I'll be travelling far in a few months and I was wondering if there's something I should be aware of.

I already have a declaration from my specialist which also states that I may not go through x-ray machines and should be pat down by a person instead.
I was also advised to bring 3x of what I think I'll need. I won't be bringing 3x with me but I'll make sure to bring spares and spares for the spares. Just in case something breaks, I'll have spares for that too (e.g. pump base).

I don't know which company I'll be flying with (yet) as I'm still looking at tickets. The flight is expected to take around ~20 hours so I'll be up there for quite a while
Is there something I should let either of the airports know or ask about? Is there anything "special" I can request (like a seat hehe)? Does anything require me to call them in advance?

Thank you

 

[urbanracer]

Hi,

I'll be travelling far in a few months and I was wondering if there's something I should be aware of.

I already have a declaration from my specialist which also states that I may not go through x-ray machines and should be pat down by a person instead.
I was also advised to bring 3x of what I think I'll need. I won't be bringing 3x with me but I'll make sure to bring spares and spares for the spares. Just in case something breaks, I'll have spares for that too (e.g. pump base).

I don't know which company I'll be flying with (yet) as I'm still looking at tickets. The flight is expected to take around ~20 hours so I'll be up there for quite a while
Is there something I should let either of the airports know or ask about? Is there anything "special" I can request (like a seat hehe)? Does anything require me to call them in advance?

Thank you

Hi @Gardevoir

I have taken a good few flights to Europe, USA and Asia and struggled to get any airport or airline personnel at either end to show any interest in my diabetes or my kit. I proffer it up to them at the security screening desperate for attention and I get waived through with a look of - 'are you quite mad'.

Seriously, it sounds like you have most of the angles covered but don't put your supplies in the hold just in case your bag goes missing en-route (thankfully it's very rare these days anyway). Maybe consider keeping a copy of your prescription with you so that you can show that you're (officially) an insulin user if you need to speak to a doctor in another country. I too, carry a doctor's letter but have never been asked for it.

Keep your emergency carb's handy during the flight, - sounds obvious but they aren't too useful in the overhead locker, 3 or 4 rows back when things go wrong (Yes - I'm speaking from experience.) Do you have a method of keeping insulin cool ?

Not sure if your concern about X-rays is because of a pump or a monitor but if you are using needles, an empty 330ml water bottle is a good receptacle for sharps.

A 20hr flight (assuming from UK) probably means you're off to Aus or NZ ? Have a great time.

 

[Marikev]

Let your travel insurance company know.
Sounds like you use a pump, you need check how the altered cabin pressure affects it. Make sure you have plenty of snacks about your person, in case of delays. Don’t order the diabetic meal, if offered! Just pick your way through whatever is offered, or if travelling with a companion..book different meals so you have two choices to go at! Make sure you keep hydrated and when putting your phone on airplane mode, switch the Bluetooth back on.
Have a great trip.

 

[EllieM]

Don’t order the diabetic meal, if offered!

I can second that comment. Only did it once (out of curiosity) and once was more than enough.

I recommend a spare glucometer (mine broke on one of my trips and I had to buy a US spare, which didn't check ketones and also means I'm now good at diving by 18 in my head). And if you are using cgm sensors, I recommend you have enough so that you can have at least two fail on start up. It happens, and sourcing replacement sensors is very hard (impossible in my experience) when away from home.

Top tips from me
1) make sure your glucose is always to hand (eg in a pocket). Hypos aren't fun when you are going through airport security and you also don't want your glucose in an overhead locker when you are hypo in a plane and the fasten seatbelt sign is on.
2) Wear shoes that are easy to take on and off because you'll probably have to remove them every time you go through airport security and are manually patted down.


Enjoy your trip.

 

[Gardevoir]

@urbanracer @Marikev @EllieM Thank you so much for the responses

Do you have a method of keeping insulin cool ?

I do not. Do you have any recommendations?

Not sure if your concern about X-rays is because of a pump or a monitor but if you are using needles, an empty 330ml water bottle is a good receptacle for sharps.

It's for my pump but I'll be carrying needles with me as well just in case. Good to know I can just use an empty water bottle.

Let your travel insurance company know.

That does indeed sound like a good idea I will

Sounds like you use a pump, you need check how the altered cabin pressure affects it.

I do indeed use a pump and did not realize this was something to keep in mind. I'll give them a call to ask them about it!

And if you are using cgm sensors, I recommend you have enough so that you can have at least two fail on start up. It happens, and sourcing replacement sensors is very hard (impossible in my experience) when away from home.

This is my biggest concern but it sounds like I'll be doing alright if I bring enough spares of everything and have easy access to sugar (on person/hip bag).

I think all that's left for me is to keep my insulin cool in flight. I expect to have a vial on person just in case my pump fails and I need to replace it on the plane but I'm not sure how to keep the others cool in my luggage (which will hopefully be overhead anyways).

 

[EllieM]

How long are you going to be away for @Gardevoir ?

I don't normally worry about temperature on the flight because the cabin is temperature controlled.

You could investigate frio bags if you are going somewhere hot?

Remember that most insulins are OK out of the fridge for a month so my main worry would be if it was going to be sitting somewhere in extreme heat or cold. (I would never put my insulin in the hold, both because it might get lost and also because I don't know how cold it would get there.)

 

[Gardevoir]

How long are you going to be away for @Gardevoir ?

I don't normally worry about temperature on the flight because the cabin is temperature controlled.

You could investigate frio bags if you are going somewhere hot?

Remember that most insulins are OK out of the fridge for a month so my main worry would be if it was going to be sitting somewhere in extreme heat or cold. (I would never put my insulin in the hold, both because it might get lost and also because I don't know how cold it would get there.)

I expect to be away for 3 weeks. The country is known to be warm but I'll be visiting when it's colder. I'll be in a house so my insulin can be put back in a fridge upon arrival until I leave. Is it okay to have insulin out of the fridge for around 20 hours (1 layover) if I can get it back in the fridge within 2 hours upon landing?

I expect my luggage to be in the overhead compartment but I'm not sure what the regulations are regarding that. What if every passenger aimed to have their luggage there?

 

[Marikev]

«I expect my luggage to be in the overhead compartment but I'm not sure what the regulations are regarding that. What if every passenger aimed to have their luggage there?»
you need to check the luggage restrictions of whichever airline(s) you are travelling with. There will be a weight and size limit for your bag. Also whatever you take into the cabin with you is subject to the rigorous security check at airports these days. liquids and pastes need to be in a see through, plastic 1 litre bag, available at airports at security, there was a phase of them being charged for but that seems to have stopped. Scissors are subject to strict rules…not sure about razors…
it’s quite an art to pack for 3 weeks in a carry on, even without all the diabetes equipment.
I try and get a boarding pass printed these days, have had problems finding the boarding card on the phone.
getting through security can take quite a while, everyone who has something ‘illegal’in their bags gets pulled over, and there are only so many security people at each channel. I’ve had my blood sugar take a dive whilst waiting for my bag to be ‘gone through’.
On my second flight after diagnosis, Stansted to Billlund, I know.. yes..Legoland.. we arrived in the airport at 05:00 for a 07:00 flight to discover the whole check in area rammed! I sought out passenger assistance and proffered my letter from my doctor and was given a sunflower lanyard and an assistant who took us to the front of the check in queue. Don’t use that lanyard often, sometimes it is quicker to not use it. And my travelling companions are often embarrassed about me using it, but it can speed things up a bit

 

[Gardevoir]

Thank you @Marikev. Always good to hear other people's experiences as well! Will come in very handy
I'll check out the regulations regarding the overhead compartment and how much I'll need to bring with me in the first place once I've decided which airline I'll be flying with.

 

[Nicola M]

I went abroad recently to feurteventura, admittedly it was only for a week so everything fit in my carry on backpack but the temperature over there was around 30-35 degrees and my insulin had been out of the fridge for roughly 18 hours by the time I got it back in the fridge and it was absolutely fine.

I put everything in my backpack all in separate clear bags for each item (infusion sets, needles, insulin, CGM sensors etc). Most airports and airport personnel are ever aware of diabetics and what they carry and that most cannot go through X-ray. I carry my letter but I’ve never needed to actually use it. My CGM supplies couldn’t go through X-ray so I passed them to one of the workers and said as such and they placed them in a box with a no X-ray sign. The airport I went to also no longer had the old style metal detectors just the stand up full body X-ray machines so I just told someone I couldn’t go through that, they patted me down and swabbed my pump/CGM extremely quickly. My bag of supplies went through X-ray fine and the non x-ray items were swabbed and handed back to me promptly.

Diabetics who can’t go through X-ray are much more common these days and I think airport staff are very used to it and the processes that go along with that.

 

[oldtypeone]

It sounds like you've been very lucky with your experiences at airports. One security supervisor wouldn't accept my Medtronic letter because it wasn't signed and wouldn't accept my diabetes team letter either( that was signed) she said I would have to wait to be searched and if I missed the plane it would be my responsibility. Another time I gave my letters to the security person and she put them in a tray and wouldn't give them back to me. I didn't then have them with me when I was refusing x-rays and scanners. Yes there are a lot more people with pumps than seven and a half years ago when I got my first pump but security staff can be a law unto themselves. Allow plenty of time.

 

[Lynne C J]

I went abroad recently to feurteventura, admittedly it was only for a week so everything fit in my carry on backpack but the temperature over there was around 30-35 degrees and my insulin had been out of the fridge for roughly 18 hours by the time I got it back in the fridge and it was absolutely fine.

I put everything in my backpack all in separate clear bags for each item (infusion sets, needles, insulin, CGM sensors etc). Most airports and airport personnel are ever aware of diabetics and what they carry and that most cannot go through X-ray. I carry my letter but I’ve never needed to actually use it. My CGM supplies couldn’t go through X-ray so I passed them to one of the workers and said as such and they placed them in a box with a no X-ray sign. The airport I went to also no longer had the old style metal detectors just the stand up full body X-ray machines so I just told someone I couldn’t go through that, they patted me down and swabbed my pump/CGM extremely quickly. My bag of supplies went through X-ray fine and the non x-ray items were swabbed and handed back to me promptly.

Diabetics who can’t go through X-ray are much more common these days and I think airport staff are very used to it and the processes that go along with that.

I always keep my insulin in Frio wallets, you use cold water from a tap. I've been in temperatures up to 42C and down to before freezing and they keep your insulin cool. At Heathrow in September due the first time I was asked to taken them out of the Frio to show security but no issues.
I have a Freestyle Libre 2, went through scanners, no problem but I always tell Security I am diabetic and carrying insulin, again, never had a problem and I've travelled all over the world.

 

[debby_mcconnell]

Medical insurance is a must, especially if travelling to a place where healthcare is expensive. One emergency trip to hospital could set you back thousands. I use a BD safe clip when travelling. It's like a little stapler that snips off needles when you're done with them and acts as a mini sharps box. Definitely have a medic alert necklace/bracelet on you in case of emergency, and keep your medical details (including the fact that removing an insulin pump/CGM without your consent is a crime) with your travel documents/passport. Don't forget to take ketosticks with you. Spare insulin will be fine in your hand luggage for 24 hours, but ensure it does not go near the x ray machines as the insulin will drastically lose it's potency. Frio bags are great if you're worried, but 20 hours in a cold plane shouldn't be a problem. Have a fantastic trip!

 

[Case_]

Spare insulin will be fine in your hand luggage for 24 hours, but ensure it does not go near the x ray machines as the insulin will drastically lose it's potency.

I just spent 15 minutes trying to find out any reliable source that would confirm this. The only source I found were some claims at forums like this. No official source seems to mention any special precautions regarding insulin or its "potency" and x-ray checks on the airport (unlike when it comes to insulin pumps, which are not to be put through an x-ray airport scanner). So, what's the source of the claim of it "drastically losing its potency"?

 

[debby_mcconnell]

I just spent 15 minutes trying to find out any reliable source that would confirm this. The only source I found were some claims at forums like this. No official source seems to mention any special precautions regarding insulin or its "potency" and x-ray checks on the airport (unlike when it comes to insulin pumps, which are not to be put through an x-ray airport scanner). So, what's the source of the claim of it "drastically losing its potency"?

20 years of personal experience, and several hospital visits with DKA from my insulin not working properly after going through x rays. Two different diabetic specialist nurses have also warned against it, and manufacturers do not recommend putting insulin through x rays. It may not be proven fact yet, but it's not a risk anyone should be taking, especially since it is proven that x rays denature proteins similar to insulin. I always keep spare insulin separate with my pump and sensors now and they swab it and move on no problem.

 

[Andy_Nash]

Hi,

I'll be travelling far in a few months and I was wondering if there's something I should be aware of.

I already have a declaration from my specialist which also states that I may not go through x-ray machines and should be pat down by a person instead.
I was also advised to bring 3x of what I think I'll need. I won't be bringing 3x with me but I'll make sure to bring spares and spares for the spares. Just in case something breaks, I'll have spares for that too (e.g. pump base).

I don't know which company I'll be flying with (yet) as I'm still looking at tickets. The flight is expected to take around ~20 hours so I'll be up there for quite a while
Is there something I should let either of the airports know or ask about? Is there anything "special" I can request (like a seat hehe)? Does anything require me to call them in advance?

Thank you

I'm not able to advise on advance engagement with airports. I always take a doctor's letter with me, but don't think I've ever been asked to show it. However, building on urbanracer's suggestion, I'd absolutely recommend taking your prescription with you too. I didn't always do this in the past but had an alarming experience at Auckland airport in 2013 when a check-in operator gave the impression that she wouldn't let me take my insulin and injecting devices into the cabin for my return flight to the UK unless I proved that they were prescription medicine, which would basically have prevented me boarding as I clearly wouldn't have been willing to go nearly 30 hours without insulin!

On that occasion, thankfully, I did have my prescription, and I'm also hopeful that, if I hadn't, I'd have been referred to a more understanding senior staff member. However, I've certainly always taken one with me since!

 

[urbanracer]

In view of some of the comments here, I thought I would just come back and add my tuppenceworth.

I work in R+D for a company that manufactures radiotherapy equipment. We manufacture both X-Ray and MRI equipment and although I'm an engineer by profession and not a physicist, I have learned a fair bit over the years.

Not all X-Rays are created equal. The power of X-rays emitted by hospital equipment can alter DNA which is a fundamental principle underlying how radiation kills cancer cells. X-ray energies range from 100ev (electron Volts) to 160 MeV (Mega electron Volts - 1 million times higher)

The (back scatter) X-Ray equipment used at airports and other public places is in the kilovolt range and therefore is not strong enough to alter DNA and will NOT affect your insulin - especially from a single dose. Where insulin manufacturers issue a warning it is related to multiple exposures to a high strength beam because "dose" is accumulated over time. This is why we go for multiple treatments to kill cancer cells (although there's plenty of research going on into high dose short treatment protocols.) So wearing a pump containing the same insulin for multiple treatments migh be a problem = discuss with your physician.

Relax and fly safe.

Urb'