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Air Travel with Diabetes

Tips for being prepared and flying healthier

Some years ago, my husband, who has type 1 diabetes, boarded a plane and stored his bag in the overhead compartment. That’s a perfectly fine thing to do, right?

Not necessarily if you live with diabetes.

As soon as the plane took off, my husband’s blood sugar started to drop. The seat belt sign was on, and he had no food or drink within reach. He tried to wait, but then understood that his hypoglycemia needed to be treated immediately. He asked passengers seated near him if anyone had sugar. Luckily, someone in his row did.

Air travel with diabetes may seem daunting, but planning all of your travel needs ahead of time and being organized may help it go more smoothly. It just takes a bit of extra work and some precautions.

Before traveling, Dr. Zachary Bloomgarden, clinical professor at Mount Sinai School of Medicine, recommends getting a letter from your doctor documenting all diagnoses, medications and allergies in case of illness or emergency while traveling. The letter should also confirm that you need to travel with any medication, syringes, blood glucose testing supplies or other medical supplies you require.


The American Diabetes Association suggests packing at least twice as much medication and blood-testing supplies as you think you’ll need. Furthermore, never pack your supplies in checked luggage – not only can insulin be affected by pressure and temperature changes, but your baggage could get lost. For extra precaution, you can split your supplies between two carry-on bags.

People on insulin pumps should carry any extra batteries and necessary back-up supplies – such as insulin and pens or syringes – in case of pump malfunction.

Be sure to have plenty of snacks with you, and, if you have one, wear your medical ID.

Transportation Security Administration (TSA) resources

TSA Cares is a help line to assist travelers with disabilities and medical conditions. TSA recommends that passengers call 72 hours ahead of travel for information about what to expect during screening. Travelers may also request a Passenger Support Specialist ahead of time by calling the TSA Cares hotline at 1-855-787-2227.

You are allowed to travel with your diabetes supplies, and TSA has information about how to prepare your medication for inspection. You can also download the My TSA Mobile App for updated information.

When you arrive at security, be sure to declare your diabetes and supplies as soon as inspection begins. Under normal conditions, insulin can safely pass through X-ray machines at airport terminals. If you have concerns about X-rays, you can request hand inspection.

If you wear an insulin pump, you can be screened without disconnecting. TSA says, “Passengers who have insulin pumps can be screened using imaging technology, metal detector, or a thorough patdown. A passenger can request to be screened by patdown in lieu of imaging technology.”

Based on my own and my husband’s personal experience, I would recommend checking with a pump’s manufacturer before passing it through a metal detector or imaging technology. As unpleasant as a patdown may be, it’s better than starting off your trip with the possibility of a broken pump.

In-flight tips

  •  If you’re traveling alone, tell a flight attendant that you have diabetes and how to help you in case of low blood sugar
  • Make sure you have easy access to your diabetes supplies
  • Do not inject insulin until you see your food arriving
  • Drink plenty of water

To keep track of injections and meals through changing time zones, keep your watch on your home time zone until the morning after you arrive. About a week before you embark on an overseas flight, you should schedule a visit with someone on your healthcare team to review blood sugar level management on the flight and in the new time zone.

While you may not have to refrigerate your insulin while flying, if you are concerned about being in a very hot climate once at your destination, you can store insulin in a refrigerator or in thermal insulated bags or containers.

If you inject insulin while in flight, frequent travelers suggest you be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can make it hard to measure insulin accurately. And you should be aware that insulin pumps may also experience problems in-flight, such as unintended insulin delivery resulting from bubble formation and expansion of existing bubbles.

Checking your blood glucose while flying is as important as when you are at home. The American Diabetes Association also suggests checking your blood glucose level as soon as possible after landing as jet lag may make it hard to tell if you have very low or very high blood glucose.

Jessica Apple is the co-founder and editor in chief of the online diabetes lifestyle magazine A Sweet Life. Her writing has appeared in many publications, including The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review and Tablet Magazine. Apple is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewees, and not of Sanofi US, its employees, agencies or affiliates.

© 2015 The DX: The Diabetes Experience

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