Stress-Free Tips for Traveling With T1D

Everything you need to know including, airport regulations, how timezones impact sugar levels, what to pack, and more.

Originally published by HealthCentral

Summer break is right around the corner for school kids and that means vacation planning kicks into high gear for parents. If you have a child with type 1 diabetes (T1D), you know it can be a juggle keeping their blood sugar levels steady through the travel rush. We went to the T1 experts for advice—from toting enough insulin to packing hacks—to help ensure smooth sailing for all.

Touch Base With Your Doc

Whether it’s a trip to Disneyland, a week at the beach, or a vacation abroad, you’ll want to do a quick check-in with your kid’s doctor—especially if it’s their first time on this type of getaway.

“Before travel, it’s important to reach out to your child’s endocrinologist to get personalized advice that may be helpful for your trip. For example, insulin doses may need to be adjusted when crossing time zones,” says Thomas Danne, M.D., the chief medical officer for Breakthrough T1D, a leading global nonprofit organization focused on type 1 diabetes that is based in New York City.

A flight eastward will shorten the day and may mean a reduction in insulin dosage, whereas a plane trip west extends the day and may mean an increase in insulin needs. Be sure to ask your child’s health care provider about when to change the time on their insulin pump device and continuous glucose meter (CGM) during the travel day. (You can learn how to update the time on your child’s devices prior to leaving on your trip but wait until the day of travel to change the time.)

Another key issue: It’s smart to bring double the T1D supplies like insulin of what you think you’ll need so speak to your doctor about getting an extra prescription before your departure.

“It’s also a good idea to have a letter from your doctor explaining the necessity of your [T1D] supplies for security checks,” says Dr. Danne. (More on that below.)

Double Up on Devices

Vacation is no time to find out that your child’s pump or CGM is malfunctioning—so being prepared with a backup if it does is the only way to go.

“Prior to your trip, contact your T1D tech company to see if they will supply a backup insulin pump, continuous glucose monitor transmitter, or receiver while you travel,” suggests Dr. Danne. “Many companies offer a low or no-cost rental program for travel.” For example, device maker Medtronic offers a loaner program at $50 for up to 90 days, while maker Tandem Diabetes Care offers a free loaner program. (Check the back of your pump and/or glucose meter for a customer service number or website where you can get assistance with this.)

While you’re talking to your tech company, also ask which security screenings your CGM and insulin pump can withstand, and which should be avoided; many pumps should not go through baggage X-ray machines or full body scanners that incorporate X-rays—since X-rays could interfere with the internal electronics in these devices, according to the U.S. Food and Drug Administration (FDA)—but may safely pass through metal detectors.

In addition to carrying extra supplies, it’s smart to bring materials that describe your child’s insulin pump, along with the brand name. This way, if your child’s supplies are lost or damaged, having all the specifics will make getting new supplies easier. It also doesn’t hurt to check with pharmacies at your vacation spot ahead of time to know if you’ll be able to find these devices if need be.

Overpack T1D Supplies

When it comes to T1D supplies, this is one case where you want to overpack: Bringing everything you need plus backup is a crucial step to simplifying travel for kids with T1D. “Make a list of all the supplies you will need and check them off as you go,” says Dr. Danne. “Always pack more than what you think you need. Many people choose to pack two to three times more supplies than they would typically need for the same amount of time.” Consider it your insurance plan against supplies getting lost in the vacation shuffle.

That can also mean, if your child uses a pump, bringing syringes along with you, notes Jen Hanson, the executive director of Connected in Motion, an organization in Ontario, Canada, devoted to experiential T1D education via sports and outdoor adventures. “I’m on an insulin pump, and I’ve had to switch to injection sometimes while traveling before,” says Hanson, who lives with T1D. “To make the transition easier, I always carry backup long-acting insulin and syringes, and I keep a written copy of the basic info I need to manage my diabetes without my pump. Being prepared like this means I can switch without stress when needed.”

Traveling by plane? Pack all your child’s diabetes supplies in your hand luggage so you have access to them at all times and take special care to ensure their insulin is in a climate-controlled pouch. “Traveling with insulin requires keeping it at a stable temperature. Insulated travel cases with ice packs are great for this,” says Dr. Danne. “Always carry insulin and supplies in your hand luggage to avoid extreme temperatures in the cargo hold.” (Igloo even makes insulated fanny packs which fit the equivalent of two canned drinks.)

Going Abroad

Take Extra Precautions With Foreign Travel

If traveling internationally, you’ll want to also ask your child’s pump distributor for a list of foreign suppliers, per the ADA;. knowing foreign suppliers will help you get a new pump quick if you’re in an overseas emergency.

Additionally, it doesn’t hurt to learn enough of the language—or download a few translated phrases—to be able to request emergency help. “Knowing how to ask for a doctor or pharmacy and having the number of the local emergency services programed into your cell is always good,” says Hanson. While larger hotels may have access to an English-speaking doctor available, to be safe, consider international hotel chains when available. Some credit cards, including Visa and Mastercard have an emergency service that will provide you with the names of English-speaking doctors in foreign countries. (You can check with your credit company for specific plans and options.)

Pre-Flight

Do a Pre-Flight Check for Glucose and Snacks

Fluctuations in glucose are common during travel, according to UCLA Health—whether it’s due to a change in activity levels, an increase in stress, or even a change in atmospheric pressure. So be sure to test your child’s glucose more frequently on travel days—setting reminders on your phone or giving them a schedule could help.

And don’t leave home without a day’s worth of balanced snacks to get your child through a long transit or in-flight meals that aren’t to their taste. “Bring foods that travel well and stabilize blood sugar fast. Things like trail mix, dark chocolate, and dried fruit,” suggests Felicia Stoler, R.D.N., a dietitian in Red Bank, NJ. “Delays happen—you’ll want to be ready for emergencies.”

Ace the TSA Screening

Headed for the airport? The Transportation Security Administration (TSA) states that diabetes-related supplies, equipment, and medications, including liquids, are allowed through the checkpoint once they have been properly screened by X-ray or hand inspection.

That means you should be allowed to bring insulin and other liquids and gels, including juice, through TSA checkpoints, even if they are in containers greater than 3.4 ounces, per the American Diabetes Association (ADA). The ADA has a handy list of what T1D supplies can go through security, including:

• All diabetes related meditations and supplies including insulin supplies, pumps, and continuous blood glucose monitors

• Glucagon emergency kit

• Liquids, including water, juice, gels, and liquid nutrition

• Lancets, blood glucose meters, test strips, testing solutions, and alcohol swabs

• Unlimited number of syringes (must be accompanied with insulin or other injectable medicines) and sharps disposal containers

• Urine ketone test strips

The ADA also advises people to bring prescription labels for medications and medical devices, although these are not required. They also recommend wearing medical identification and carrying the contact information for your child’s physician.

Being Prepared

Be Ready for the Unexpected

Being prepared and flexible while traveling can help prevent your child from feeling limited and teach them how to enjoy life while caring for their T1D. "My top travel tip for living with T1D is to always have a Plan B and a Plan C for your diabetes care—and practice using those strategies before you need them. That way, if something goes wrong, it doesn’t feel as scary,” says Hanson.

And by making sure T1D kids have what they need on vacation, you’ll help them feel confident for future travel. “It’s important for kids with type 1 diabetes to have a compact and easy-to-carry kit. A small pouch with essentials like a blood glucose meter, test strips, lancets, insulin, and a few snacks or glucose tablets. Some also carry a small sharps container and an emergency glucagon kit,” says Dr. Danne. “Everything should fit into a portable bag or case.”

With just a little smart preparation, you’ve got this travel with T1D down. Happy trails!