The ultimate guide to traveling with diabetes (with a packing list!)
Packing for a trip can be a challenge for anyone, but packing when you have diabetes can be an entirely different ballgame. I didn’t travel much as a child, but as an adult I’ve been lucky enough to travel to many countries for different lengths of time and diabetes has just been along for the ride!
It can be hard to know where to start when it comes to packing, and I’ve personally found that some of the other guides and lists out there aren’t fully comprehensive or don’t include all of the tips or tricks to make the process easier. So without further ado, let’s get into my guide for traveling with diabetes!
Planning your Travel
The first place to start is to figure out where you want to go, which is the fun part! Nowhere is off limits just because you have diabetes, so go where your heart desires. Here are some diabetes-specific things to consider during the planning stage of your travel:
How long will you be gone for?
How long will you need to fly?
Will you need to be mindful of timezone changes?
Will there be any extreme temperatures?
Is it a generally safe location, or do you need to take extra precautions with your diabetes technology (if applicable)?
At the planning stage, I like to set an alarm on my phone about three weeks before I leave to remind myself to order a backup pump (if needed) and get any supplies from the pharmacy so I’m not rushing around the day before. If it’s been over a year since I last traveled, I’ll also call my doctor’s office to get a new travel letter to explain all of my medical supplies.
Packing for your trip
Yay, your trip is finally here! This is where organization is key, but don’t worry, it’s totally manageable.
Overnight/Weekend Trip
I like to pack a Ziplock bag with my diabetes supplies for a shorter trip. Here’s what I usually include:
2-3 pump site changes
1 full vial of insulin (kept in the fridge and then put in my Frio cooler case when traveling)
1 backup rapid-acting and long-acting insulin pen
Pen needles
1 Dexcom sensor
2-3 alcohol wipes
2-3 remover wipes
Backup blood sugar meter with lancet and strips (I usually just bring 1 container of strips)
2x the usual amount of low blood sugar treats (I adjust this based on whether I’ve been having a lot of lows or not, or if I know I’m doing something active)
Glucagon
Travel letter (if I’m flying)
As someone who’s lived with diabetes for 20 years, I feel fairly confident that I can handle most situations so I don’t pack absolutely everything for a short 1-2 day trip, especially if I’m only bringing a carry-on. For example, I don’t usually bring a backup transmitter for my Dexcom unless I know it’s expiring soon because if something happened I’d just use my blood glucose meter, but if you’re newer at managing your diabetes or would feel more comfortable covering all of your bases, use the list below!
1-2 Week Trip
On longer trips, I’ll pack all of my diabetes supplies into a large packing cube which can then fit into my carry-on bag. Here’s what I typically bring:
2x the amount of insulin pump infusion sets I expect to need (usually 8-10 for my tandem pump)
10 alcohol swabs
5 removal swabs
3 full vials of insulin (pro tip: separate these in your bag just in case one side gets squashed and something happens!)
2 backup fast-acting and long-acting insulin pens
1 bag of syringes
1 bag of pen needle tips
Blood glucose meter (I just bring one vial of test strips but I make sure it’s full)
3 Dexcom sensors
1 spare Dexcom transmitter
5 Dexcom dressings
Ketone strips (I use the urine ones, but if you have a ketone blood meter bring the supplies for that)
Glucagon
Supplies to treat low blood sugars (Rockets are my favourite since they’re small and can fit anywhere, but whatever you prefer will work. Make sure to pack A LOT more than you think you need. Like, when it gets to the point where it’s comical, you know you’ve got the right amount)
In the case of Rockets, I like to bring one full bag which is about 75 Rockets, and I use 1-2 to treat each low.
4-7 protein bars (in case I get stranded somewhere)
Diabetes travel letter
Backup insulin pump (keep it in the sealed company box, but remove it from the shipping package it was sent in. I made that mistake in my early days when they told me not to open the box or I’d be charged and it would take up SO much space…*facepalm*)
Translated list of medications: If you’re traveling to a foreign country, having a printed list of your conditions and medications can be handy in case you aren’t able to communicate or access Google translate and need to go to a pharmacy to get supplies
1 set of extra batteries for anything that requires batteries (pro tip: change/charge the batteries of everything before you leave to prevent any issues)
Pump charging cable
Medical alert bracelet (in full transparency, I don’t always wear mine if I’m going somewhere with friends and family, but I know I should…)
2+ Week Trip
For any trips longer than two weeks, I’d recommend following the list above and doubling the quantities for anything you go through quickly (insulin pump sites, CGM sensors, insulin vials, etc.) and making sure you have a good grasp of how you’d get help if you needed it (local hospitals, pharmacies, etc.).
Travel Pro Tips
You can likely bring an extra medical bag when flying
I didn’t know this for the longest time, but most airlines will allow you to bring an extra carry-on bag just for your diabetes supplies without requiring you to pay. The important things to note are that it has to just have diabetes supplies in it (so no laptops, extra clothes, etc.), it must meet regular carry-on baggage sizes and weight limits, and you usually have to reach out to the customer service line at least a week in advance to get approval. Check with your airline a few weeks in advance and take advantage of this tip if you’re just bringing a carry-on bag for your clothes and don’t want half of your space taken up by diabetes supplies.
Get a travel letter
Before you travel, ask your medical team for a travel letter that states your medical condition and what you need to travel with (basically the entire list above). I usually try to get a new letter every 1-2 years so nobody questions it. I’ve traveled many times and nobody has ever asked to see my letter or proof of why I have my supplies, but it’s always better to have it and not need it than to need it and not have it. My letter is usually drafted by a nurse or admin on my healthcare team and then signed by my doctor.
Be Mindful of Timezone changes
Once you’ve landed, you’ll want to change your pump to the new local time, or begin taking insulin via injection as you would based on the new timezone. For example, if you land in the morning, take your morning insulin even though it’s 10 p.m. wherever you flew from. This can be a fun challenge as you’ll need to give your body a chance to get used to the change, so I often try not to plan anything important on the first day of my trip if I can help it. After 24 hours, you should be good to go!
Keep medications in their proper boxes
Although it’s more convenient to take your insulin pens and vials out of their prescription boxes, it’s best to keep them in just in case you have to prove that the medication belongs to you. This doesn’t matter if you’re staying within your country, but could be an issue if you try to cross the border without proper labeling on your medication.
Keep medical devices in accessible spots to show security
Trust me, there’s nothing worse than being hustled through security and trying to communicate that you have diabetes and then remembering that your pump is on your upper butt and your sensor is on your stomach while you’re wearing a dress (not speaking from experience or anything…). While it certainly isn’t necessary to adjust your medical devices if you have spots on your body that work well for you, in my experience I’ve found that it’s much less of a hassle if I can easily pull my pump out of my pocket and gesture to where it is on my body. Lately I’ve also had security want to scan my pump and CGM with their drug detector wand (is that the technical term?), so having it in a convenient spot can be handy.
Be mindful of device placement when sitting for long periods
On the topic of site or sensor placement, be mindful that any medical devices in your leg or butt might cause issues if you’re sitting for long periods of time. Pressure on an insulin pump can cause annoying occlusion alarms to go off (Omnipod, looking at you) or sensors to lose connectivity, and it can be painful to sit on something for hours on end. I will usually try to place my devices on my arms or upper stomach and don’t usually have issues.
Keep supplies accessible and in the cabin of the plane
This is a standard tip you’ll hear everywhere, but make sure your supplies stay with you in the cabin when flying so the temperature doesn’t ruin your insulin and you don’t risk your baggage getting lost. I like to take that one step further and make sure my supplies are always accessible if I need them in a hurry. This usually means that I try to get a spot for my bag right over my seat (ask your flight attendant for help if your storage bin is already full and they should be able to bump someone else’s bag so there’s room for yours - a diabetes perk!) and I make sure it’s not shoved to the back of the storage bin or crushed by other people’s things, especially when I’m traveling alone and can’t ask for help getting my bag down.
I once ran into an issue where I put my bag in a storage bin a few rows down and then of course my insulin pump started alarming and I had to awkwardly walk back to get my bag, drag it back to my seat, get what I needed, and then wait until the aisle was clear to put it back. I vowed to never do that again.
Preventing and treating high blood sugars while traveling
Is there anything worse than watching your blood sugar climb while you’re trapped in your seat and can’t do much about it? I think not. Here are some tips I use to prevent high blood sugars:
Avoid foods you don’t know the carb counts for
Try to avoid super carb-heavy or sugar-laden food, if possible (although if that’s the only thing available, don’t beat yourself up over it)
Pack your own snacks when possible
Pre-bolus as far in advance as you can. I like to pre-bolus at least 20 minutes when possible so the insulin is ready to go when I eat. I will sometimes ask the flight attendants when they expect to serve the food and go off of that (have low snacks ready in case they are delayed) or will just wait until the end to eat the most carb-heavy foods if provided a cabin meal
Drink water or sugar-free drinks
Put on a temporary basal of 10-15% to combat highs if you’re used to being more active and know sitting will cause issues
If I don’t already have a temporary basal on, sometimes I’ll bolus 10-15% more than I normally would just to account for the lack of movement
When driving, get out and walk around every two hours or so
If your blood sugar is already high or starting to climb, I like to use these tactics:
Drink water
AVOID obsessing over your CGM or glucose meter
Avoid stacking insulin (bolusing over and over in a short period) just because you’re frustrated. What will likely happen is that the insulin will sit and not impact your blood sugars much until you go to move and then it will hit all at once, ensuring you’re drastically dropping while getting your bags and figuring out where to go in the airport. Fun times!
Go to the bathroom and do 25-30 squats to help your insulin kick in (be careful not to touch anything!)
Accept that flying or driving for long distances can make you go high a bit more and just practice acceptance (always a work in progress)
Bring a paperclip and keep it handy!
This is a tip that has saved me several times (once I learned about it) and is also something I haven’t really seen others talk about. Many pumps will struggle with the altitude when flying and will subsequently start alarming. I’ve had this happen with my Omnipod pump and my Tandem pump, and no amount of clearing the alarm will fix it. It also stops all insulin delivery, so it’s not exactly something you can wait to figure out later. The trick is to use the paperclip (I keep one in my wallet) to press the little reset button in the back of the pump. Don’t worry, this won’t reset all of your pump settings, but it will turn off the alarm and allow you to resume insulin delivery (yay!).
Be prepared for the change of pace on vacation
Depending on the trip you’re planning, your day-to-day activities might look wildly different than they do at home, whether it’s because you’re hiking mountains or planning to chill out at an all-inclusive resort. If you’ll be having a more active vacation, plan for extra low snacks and possibly reduce your basal rate on the first few days until you get familiarized. Alternatively, if you’ll be much less active than normal, consider increasing your basal and insulin-to-carb ratio to account for less movement. If you’re going the all-inclusive route, check out my post about my experience managing my diabetes while on an all-inclusive vacation here!
