We just got back from our first trip to Europe! It was so exciting and we had so much fun! But traveling can be nerve-racking especially when you have diabetes.
Anytime I leave home, it seems like quite the production to make sure that I have all of the supplies that I need, and I always worry that I forgot something. I have a little practice doing this now and seem to have a mental list of the necessary medical devices I need stored in my head. If you are planning on traveling anytime soon, here are some tips to make sure that you can travel safely. You probably don't need as much as I took with me to Europe if you are staying local, but it is
good to be prepared when entering countries where you don't speak the language and don't know how you would get more supplies if you happened to run out or forget something.
Ask your doctor for a medical letter.
I have never done this before even when traveling outside of the country. This trip, however, I will be going to several different countries so I made sure to ask my doctor for a medical letter about a month before my planned travel dates. Once I got the letter which explains that I have diabetes and have medical devices that cannot be removed from my body, I saved this in my phone and printed out a copy to make sure I have access when needed. I have had friends whose medical letter ended up getting wet, so the back up in the phone should prove useful.
Have a backup plan... And a backup for your backup plan.
No one wants to be stuck somewhere without insulin, even just on a plane. Make sure that you have additional testing supplies, insulin and low blood sugar treatments next to you throughout travel.
Fill those back-up prescriptions. Since I was flying out of the country for 2 weeks, I went ahead and filled that backup lantus prescription that I’ve had for the last 3 years without needing to fill. If your pump were to fail while traveling, you would be able to use multiple daily injections until able to get a replacement pump.
Bring extra sensors and transmitter if able. I was able to get an extra transmitter and had enough sensors to bring 3 with me. I also brought my glucometer with additional test strips, lancets and batteries in case my sensor wasn't working correctly or broke.
Bring extra pump supplies – like for an additional week or two. You never know when an inset or pod is going to come off early or if an issue with it might come up.
Bring extra insulin. I brought enough insulin to last me 3 months which I knew was way more than I needed. Sometimes it is hard to get additional insulin prior to traveling but you can often call your insurance and explain that you will be out of the country and need additional supplies in case of emergency.
Bring prescription labels. It’s a good idea to have your original prescription labels, as well. Having your name linked to the detailed medication could help you in a pinch if you ran out of something or to prove that the medicine is indeed yours.
Wear that medic alert bracelet. This is one of those times that you don’t want to leave without it. You know, in case of emergency.
Bring glucagon and let someone know where it is and how to use it. I have experienced both highs and lows when traveling. For this trip, I had baqsimi (nasal glucagon) in my purse and a backup in my luggage.
Keep all supplies with you. No way do you want to do all the planning and then your luggage gets lost. No thank you! The Americans with Disabilities Act designates that you can take an additional carryon bag that is only for your medical supplies onto a plane with you. I am not sure that this applies to international flights so do your research ahead of time.
Bring lots of low blood sugar treatments. I try to bring a few different options that are self stable and won't melt (Starbursts, gummies, glucose tabs) as well as snacks to level out blood sugar after a low. You can get these anywhere, except on a plane!
Look into where you can eat. Since I also have celiac, I have to be careful about where I eat and that the food is safe for me. I have an app that I use that I was surprised to find has international listings. For each of the cities that we are traveling to, I have looked up some restaurants and other options for food, so I am hopeful that I can find some tasty authentic and safe cuisine.
Going through security.
This one is a bit tricky because it might depend on what devices you use. I never know what is the best option - body scanner or metal detector - but know that I have the option to ask for a pat-down (always a favorite, right?). When I was using a pump with a tube I would disconnect my pump and go through either the metal detector or the body scanner but would sometimes be flagged for my CGM. Since I started on the pod, I wasn’t sure if it would go off in the metal detector since it does have some metal in it or how familiar the TSA agents would be with the device.
As I planned going through security this time, I put my pod and CGM on my arm so that it would be easily visible to TSA. They had me walk through the body scanner (millimeter wave scanner) after which I let them know of the medical devices on my body. The TSA agent had me touch the devices and then swabbed my hands to detect if any hazardous material was on them. Then I got the go-ahead. Neither device was affected by it and it didn't take too much extra time.
When going through security in Europe, I was only ever asked to go through metal detectors. The Dexcom CGM and the Omnipod pump on my body did not alarm the metal detectors so no additional security check was needed. Both devices continued working after the metal detector, I wasn’t even stopped for a pat-down and I didn't have to fumble through explaining that I have diabetes. It was so much easier than I expected!
We had an amazing time on our vacation and I didn't run into any issues with missing supplies or failed technology. I used Activity Mode a lot to help manage blood sugar while walking over 20,000 steps each day which meant less sitting and waiting for that blood sugar to come back up. Being well prepared helped me to feel confident that I would have a safe and fun trip even if it did take up more space in my bags.
Some of the differences in Europe when traveling:
I was asked multiple times to check my bag because mine was considered too big for some of the planes that we boarded even though they were typical carryon size bags. I was not happy about this especially since you are often charged to check your bag. Plus, I had my back for my backup supplies in there! We ended up being able to rearrange what was in our carryon bags so that we only needed to check one and could take the one with my extra supplies on the plane with us. Phew!
If you are sitting in the front row, they will ask you to place your purse/small carryon in the overhead compartment for the flight. Again, I rearranged some of my storage to make sure that I had most of my supplies with me. It made me feel uncomfortable not having everything within my immediate reach but I tried to breathe through it and be realistic that my extra supplies were close by if needed.
Not all airports have water fill stations. Be prepared to purchase bottled water even if you brought your refillable water bottle.
Nutrition labels are different in Europe. Take extra time to look over the label and compare the serving to the size of the container. I'll speak more to this on a future blog.