International travel with Type 1 Diabetes
Whew! Back from one international trip and on to another next week! I will admit my eyes roll every time I get the "we're gunna need to pat you down" talk at TSA, but international travel is a whole different animal. I thought it might be fun to see what goes through my brain and into my bags for these types of trips!
I wouldn't be a NASA Flight Controller if I wasn't good at planning, the key to international travel as a T1D is PLANNING!
3 months prior
Assess supplies. Mine come in 90-days supplies so I like to inventory at least 3 months prior and make a plan to order more early if the trip is going to coincide with the end of my 90-day stock. In my experience supply companies are usually pretty good about adjusting orders as needed if you tell them the reason for the early request - just mention you have an international trip coming up and want to make sure to have plenty of supplies (and backups!) in time.
Request a loaner insulin pump. It's likely the company won't send you the physical loaner until closer to your trip, but it doesn't hurt to get the request started early!
Request a letter from your doctor that explains your diagnosis and clearly states the prescriptions and equipment you will be traveling with.
Start a paperwork file, add the doctor's letter, pump TSA letter and any other supporting documentation required for activities during the trip (i.e. doctor's note for SCUBA, etc)!
Order a medical ID bracelet if you don't already have one!
1 month prior
Reassess supplies. If a shortage is still looming, try another request for more supplies. Contact your endo's office to see if they have extra supplies to loan out. Worst case - crowdsource with online diabuddies!
1 week prior
Provide your itinerary, contact information, doctor's information, etc to someone who is staying in your home country.
Start laying out supplies. I usually plan my insulin pump supplies like this:
Trip length less than 5 days, site changes = # of days (so, for a 3 day trip, bring 3 site changes)
Trip length greater than 5 days, site changes = 3 + (number of days/3) ...so for a 9 day trip, that would be 3 + (9/3) = 6 site changes
This is just my general thought process, but keep in mind how often you normally change sites and how often you run into site issues (I've had some brands that perform worse than others!)
I always bring at least 2 bottles of insulin, even if they are both full and fresh and I'm only going to be gone 2 days because, well there was one time on Super Bowl Sunday that I busted my only good bottle.
I also bring 2 backup short-acting pens and plenty of needle tops. I only bring a long acting if I'm going to be gone longer than 3 days.
I don't normally test my blood sugar via finger pricks anymore (thanks Dexcom!), but I do always bring a meter and enough test strips to cover the entire trip, just in case my CGM or related electronics go down.
Dexcom sites are bulky, I usually just bring a whole box.
Don't forget the charging cords and possible power converters! I also bring power bricks that can be charged early and brought on those long flights in case an outlet isn't available. These are also handy if the electricity isn't the same as the US, that way you can charge the brick directly, but charge your pump or meter from the regulated power brick.
1 day prior
I like traveling with a fresh site so I don't have to mess with it on a crowded flight or strange airport.
Take inventory of your site locations! Make them easy to unhook/show to security if asked.
Make sure to pack all medical equipment in your carry-on luggage!
Pack snacks and fast-acting glucose in carry on just in case!
Be calm and cooperative, use precise words when describing the equipment, for instance, "this is my insulin pump" or "this is my continuous glucose monitor, I can't take it off".
Don't forget to check in on yourself! Don't be distracted by a foreign airport or a different language, make sure you take care of yourself first!