“I have a good grasp on how to manage my diabetes, but for a number of reasons, traveling is difficult. It’s something I haven’t yet mastered,” says Jack Corbett. “But I always enjoy it. There is something exciting about being self-sufficient, which makes it all the more fulfilling.”
Travel is all about stepping away from one’s daily routine in the spirit of exploration and growth. For most people, this departure can be a challenge. And for the one in ten Americans with type 1 and type 2 diabetes -- a disease affecting the body’s glucose, a vital energy source -- this process is immensely more complicated. Many individuals (most commonly with type 1 diabetes) manage their condition with an insulin pump, a device attached to the abdomen that delivers insulin, the hormone that regulates glucose. Traveling with this device, and the disease itself, presents its fair share of challenges, between airport security, insulin refrigeration, and daily nutrition management. However, with proper planning and know-how, traveling with an insulin pump is extremely manageable.
We spoke to two members of our community, Jack Corbett and Tiffany Smith, both of whom have type 1 diabetes, to learn more about their collective experiences traveling. Read on for their stories, as well as expert tips on packing, best practices, and beyond.
Please note that every individual with diabetes has different needs, and one should always consult with their doctor about traveling. The following is not meant to be taken as medical advice, but first-hand knowledge and experience.
1. Research the Destination
“I really enjoy hiking. I’ve been to the Grand Canyon, the Rocky Mountains, Big Sur, Yosemite, and beyond. These are not necessarily places you can easily find a bottle of insulin!” noted Jack Corbett, a native of Richmond, VA and a camping enthusiast.
In addition to planning activities and meals, travelers should familiarize themselves with the destination, including its setting and general infrastructure, in case of a supply snafu or medical issue. This process may involve mapping a driving route to make note of pharmacies (especially if in a rural area), or confirming nearby medical facilities with a hotel staff. For group trips or cruises, travelers should note their condition ahead of time and ask clarifying questions, even in advance of booking. In the case of Tiffany Smith, a passionate traveler and native of Madison, WI, she discovered the cruise line was unfamiliar with insulin management while on board. “I realized I would need to address my issues [with the cruise] before booking travel next time,” she said.
2. Pack with a Plan
When it comes to packing snacks and extras, “I’m happy if I don't need them, but if I don't pack extra, I need them,” says Smith.
Managing medical supplies and their proper storage conditions is crucial for a traveler with diabetes (more on that below). This process begins with expert packing. “Maybe you can wing it, but I feel more comfortable having thought through everything,” said Corbett, who advises making double- (and triple-) checking a habit. “Before leaving the house, I always stop to make sure I have everything I need. It’s not worth it to take a chance,” he said.
Supplies vary between individuals, but most travelers will require a medical bag of essentials (in addition to their insulin pump), which will contain hardware, tubing and syringes, as well as insulin, which must be kept cold. When in transit, this bag should be kept on one’s person at all times. If flying, many opt to keep all supplies in one carry-on bag in the event that a checked bag gets lost or damaged. Travelers should also keep food handy in their personal bag or (if flying) carry-on suitcase. “Knowing where food is when you need it is very helpful!” says Smith. “When driving, I keep my basic back-ups in my purse. Juice, Starbursts, string cheese, and protein bars are my current go-to’s.”
3. Bring Twice the Amount of Supplies You Think You Need, Including Back-Up Materials
“As a rule of thumb, I usually bring at least twice the amount of supplies I anticipate using. If I’m traveling for a week, I’ll bring two weeks worth of supplies,” says Corbett.
Smith especially advises packing back-up bottles of insulin and extra syringes, “I learned that lesson the hard way after dropping two bottles of insulin in hotel bathrooms. No matter how quick our trip, the car is always full [of extra supplies]!”
Corbett noted he takes extra precaution, even for day trips. “If I’m going farther than an hour from my house, I’m going to bring the amount of supplies for a weekend (extra insulin, syringes, extra supplies for my insulin pump, etc.).”
4. Plan Ahead for Airport Security
In Corbett's case, “airport security has gotten much easier over time. When I was in high school ten years ago, TSA was less familiar with medical devices than they are now,” he says.
Even though it’s likely that TSA agents at major city airports wilI be familiar with diabetes supplies (including an insulin pump and a glucose monitor, a device the size of a flash drive, often taped to one’s arm), it’s important to factor in extra time at airport security. “Security always takes longer for me!” Smith said. “When I flew out for a cruise, my friends couldn't believe how much longer it took. It was nice for them to get a peek into my reality."
Smith advises planning ahead for the overall airport experience, starting with setting one’s insulin pump to reflect upcoming exercise. “The airport dash, and running around beforehand, tends to keep [my blood sugar] low. If I set my pump like I'm going to be working out, I stay a lot more even.”
Lastly, it's important to do research on your specific supplies (on the airline’s website, TSA, and the supply manufacturer) to be armed with as much knowledge as possible on supply transport. It doesn’t hurt to print out TSA recommendations or any helpful specifications to have on hand (especially if websites cannot be accessed). Smith mentioned having an additional medical carry-on bag*, which was a game-changer. “Having everything in one bag made TSA so much easier,” she said. “I have mine marked with a medic alert symbol, and it lists Type 1 Diabetes. I keep my prescriptions and doctor’s letter ready to go when questioned. I may get dirty looks from other passengers, but the medic alert sign helps give me confidence.”
A note on medical carry-on bags: some airlines allow individuals to bring a second (medical) bag on the plane, at no extra charge. We recommend researching and/or calling the airline at least 48 hours ahead of time to confirm the specifics.
5. Keep in Constant Touch with Your Body, and Keep Tabs on Your Supplies
"You always want to make sure you’re not putting yourself in a risky situation,” advises Corbett.
In addition to monitoring your blood sugar, it’s crucial to verify that your energy levels and physical wellbeing are in check, especially in an unfamiliar environment. For instance, when traveling, you’re more likely to eat at restaurants and try new foods. “If I’m in Spain and I’ve never eaten croquetas, I won’t know how much insulin to take,” says Corbett.
Monitoring your supplies is crucial, especially with insulin. The longer the hormone stays out of the refrigerator, the less effective it is, which could put the user at risk for high blood sugar. “This happens if you’re camping in the woods, likely using portable coolers,” said Corbett. “But even if I’m going to a place that is hot, like the beach, I notice a difference in the quality of the insulin over time,” he says. “In mild cases, I feel uncomfortable -- nauseous after I eat, sluggish, dehydrated -- but over a period of time, it’s actually dangerous.”
Many individuals use a CGM (continuous glucose monitor that sends blood sugar to the phone), which, in Smith’s case, adds an extra element of safety. “[With a CGM], I feel I can be more independent. On a recent trip I flew alone, and [the CGM] helped me stay alert and attune to how I was feeling in an environment that I was super nervous to be in,” she recalled.
6. Make Use of the Best Resources
“Things have really changed over the years. Technology keeps growing and there are so many more options to find what works for our individual needs,” says Smith. “Knowing how to use my devices and how they work makes it much more fun to think about travel and how I can enjoy the whole experience!”
Here are a few of her recommendations:
“I use the Dexcom app, and my husband uses the ‘Follow’ feature that alerts him if my blood sugar is low. This gives us peace of mind when we're apart, especially if I'm alone or driving.
The t:connect app displays my insulin pump information on my phone screen. It's a lot easier to check my phone than digging out my pump. When driving, I have the app open, which allows me to not be caught by surprise low blood sugar.
I like the Happy Bob app, which displays pops-up telling me how I'm doing. It brings a smile to my face, especially if I'm struggling.
Sugarmate app provides similar information to Dexcom, but in a different manner. Having multiple ways to view data can help give a more complete picture.
I use the LoseIt app to help count my carbs. It has an excellent restaurant database, which is very helpful when I'm traveling or in unfamiliar surroundings. It also allows me to enter in recipes, so all of my home cooking this year is saved and I'm able to retrieve it to have a better idea of carb/fiber counts.
My favorite exercise support has been from the Diabetes Strong website and Facebook group. With the knowledge I've gained through their resources, I've been able to better approach exercise, movement, and new situations in a way that helps me enjoy them rather than avoid them.”
In short, traveling with diabetes will not always be a seamless experience. For individuals with a health condition such as diabetes, travel inevitably presents a set of risks and logistical complexities. It’s important to prepare (both logistically and mentally) for these. But with thoughtful planning, research, and vigilance, it’s possible for people with insulin pumps to have enjoyable travel experiences.
Happy travels from the Blue Trunk team!
Please note that every individual with diabetes has different needs, and one should always consult with their doctor about traveling. This article is not meant to be taken as medical advice, but first-hand knowledge and experience.
Contributors
Jack Corbett
Originally from Richmond, VA, Jack Corbett was diagnosed with Type 1 Diabetes at age six and is going on 20 years with the disease. He is currently pursuing a PhD in Systems Engineering at University of Virginia, one of the only schools in the country doing research on artificial pancreases.
Tiffany Smith
A native of Madison, WI, Tiffany was diagnosed with Type 1 Diabetes in 1994, a month before the start of high school. She graduated from UW-Whitewater and currently resides in Madison, WI, working as a marketing coordinator and independent beauty consultant. She is also a participant in the T1D Exchange, a research study “designed to harness the power of individuals with type 1 diabetes."