Travelling with Insulin and Other Diabetes Equipment

Insulin 

Insulin supplies

• Carry plenty of insulin. To be on the safe side you should ideally take double the amount you think you will need. If you are travelling for a long time, however, you may need to get supplies while you are away.
• Remember you may need to change your usual daily dosage. The type of food you eat, the amount of exercise you take and the change in temperature can all affect your blood glucose levels.
• Before you travel, find out about the availability of insulin where you are going. Different countries often have different names and strengths and may not use insulin pens. Take with you the contact details of suppliers in the main cities of the countries you plan to visit.
• If your type of insulin is not available, a supplier can often arrange for insulin to be sent to a particular pharmacy or collection point.
• If you are not based anywhere with access to a fridge, you may need to get a new supply of insulin when you are away.

Insulin strength

Most countries now use U-100 strength insulin, but you may come across U-40 and U-80 strengths. If you are unable to get U-100 insulin and need to use a different strength, you will also need the correct syringe for the insulin strength, otherwise you will take the wrong dose. For example, if you use a U-100 syringe with U-40/80 insulin you will take a much smaller dose, or if you use U-100 insulin with a U-40/80 syringe you will take a higher dose.

Temperature and light

Extremes of temperature and light may cause your insulin and blood glucose testing equipment to be less effective.

• Some research suggests that insulin can be kept at 25° C for up to 10 months, losing 5% effectiveness, and at 40° C for several weeks.
• However, many manufacturers will only guarantee the stability of insulin kept out of the fridge at 25° C for one month, and recommend it should not be used after this. If possible, you should always store insulin in a fridge in hot climates to prevent it losing its effectiveness. Never keep it beside a direct source of heat, e.g. a radiator or a fire.
• Insulin loses its effectiveness more quickly in bright light than in the dark. Do not expose it to direct sunlight.

Transport and storage

• If you are travelling by plane, remember that insulin should not be kept in luggage going into the hold, as temperatures often drop below freezing there and there may also be changes in air pressure. Always take it in your hand luggage.
• Carry insulin in a coolbag or coolbox, or in a polystyrene container. Pre-cooled wide-necked vacuum flasks are also useful.
• If you use a container with frozen plastic blocks, make sure the insulin is not directly beside them as it may freeze.
• If you are keeping insulin in a backpack, do not put it in the top pocket or near the outside of the backpack where it may get too warm.
• FRÍO is a company that specialises in cooling products, including travel wallets for carrying insulin. These are light and compact and do not need to be kept in a fridge as they are activated by cold water. For more information see https://friouk.com/
• If a fridge is not available for storage, keep your insulin in the coolest, darkest part of the room. If it gets too warm, cover it with a cold, wet cloth.

Damaged insulin

Check the appearance of your insulin before you use it. The following may suggest that it has gone ‘off’.

• Soluble (clear and quick-acting insulin) may look cloudy or thick.
• Suspension or cloudy insulin may have lumps or clumps that do not disperse when gently mixed.
• The bottle or vial may have a frosted appearance with particles sticking to the sides. It may also look brownish in colour.

Continous glucose monitors (CGMs)

At the airport

CGM’s can also go through most airport metal detectors without causing any performance issues. This includes the normal archway that you walk through.

However, they should not be exposed to some airport full-body scanners (i.e. x-ray and millimetre radio-wave). 

 

You should never be asked to remove any of your CGM components. You can also request another type of screening to be performed by the Security Officer such as hand-wands, pat-downs, or visual inspections.

If you need to have a pat-down from security then make them aware of your sensor in case they knock it during their search.

Medical device awareness card

• Don’t forget to bring your medical evidence (e.g. letter from a medical practitioner) to confirm your medical device such as an insulin pump or Continuous Glucose Monitoring system (CGMs). Have this ready to show the Security Officer.
• Make the airport Security Officer aware of the device, and exactly what it is and where it is located.
• If you are carrying a spare medical device, remove it from your cabin bag before the x-ray and let the Security Officer know.
• And do contact the airport if you have any concerns or queries before you travel: note that screening equipment and processes may differ from airport to airport.
• Please check with your return airport on their arrangements for screening medical devices.

On the plane

CGM’s can be used at all times when on an aeroplane by connecting them to the handset or phone through Bluetooth. This will still work if you put your phone on airplane mode. For further guidance, check the manufacturers website.

When you’re away

There are a few things you may want to prepare for before you jet off that may affect your CGM and how it functions.

• Sensor adhesion

  • If it’s hot where you are going, then you may need a little help with keeping your sensor stuck down. Sweat, sand and sun cream can all be factors that can affect the stickiness of your sensor.

    Making sure that you prep your skin properly to start with is really important, making sure the sensor is applied to clean and dry skin. You can also try some of the adhesives that we listed in the ‘wearing your sensor’ topic.

• Swimming

  • CGM components are only water-resistant which means it is only designed for being worn in the bath, shower or swimming in certain depths for specified periods.

    For specific information about depth of water and how long they are water resistant for, check the manufacturers website.

• Extreme temperatures

  • Check the manufacturer’s website for the operating temperature range of your CGM sensor . If you are travelling somewhere very hot or very cold, you should discuss this with your healthcare team.