Going to the airport already takes a lot of planning: figuring out whether to bring checked or carry-on bags, getting a ride to the airport, keeping all your travel documents within reach—the list goes on and on. But when you live with a chronic condition such as diabetes, planning for air travel can be even more time-consuming, from packing the right amount of medication to navigating airport security lines with diabetes management supplies like syringes, needles, or wearable medical devices like a continuous glucose monitor (CGM) or insulin pump.
“My rule of thumb: It’s always better to be overprepared than underprepared,” says One Drop coach, Lisa Goldoor, a registered nurse (RN) and certified diabetes care and education specialist (CDCES). She recommends creating a “travel list” of everything you’ll need to manage your blood sugar when you’re flying—something you can reference for each trip you take so you never have to worry about forgetting anything.
Before creating that list, be sure to discuss your travel plans with your doctor, including any medication changes that might be needed depending on your destination, suggests Sherry Roberts, a registered dietitian/nutritionist (RDN) and CDCES who lives with type 1 diabetes.
Still, keep in mind that, no matter how diligently you plan ahead, your blood sugar levels might still reach higher levels than you’re used to, due to the inevitable stress, prolonged sitting, and even increased adrenaline levels that can come with air travel, notes One Drop coach, Lindsay Vettleson, RDN, CDCES, and certified personal trainer (CPT).
That said, it’s not about achieving “perfect” blood sugar levels throughout your travels; it’s about doing the best you can to manage your health. Here are a few tips to keep in mind during your trip.
Bring More Supplies Than You Think You Need
“Pack twice the amount of supplies and diabetes medication that you’ll need in case of travel delays or misplaced items (insulin, syringes, test strips, extra batteries for your insulin pump, glucagon kit, low blood sugar treatment, etc.),” suggests Vettleson. In the event that you do need more supplies when you reach your destination, many pharmacies can usually provide an emergency supply of medication for 30 days, adds Goldoor, but be sure to check with your pharmacy ahead of time to confirm that’s an option.
Whatever supplies you’re bringing, make sure you keep them in a carry-on rather than a checked bag. “Insulin should never be placed in checked baggage,” cautions Vettleson. “It could be affected by severe changes in air pressure and temperature.”
In the same carry-on bag, she continues, be sure to keep rapid-acting glucose sources within reach for any potential low blood sugar episodes—for example, dried fruit, candy (think: gummy bears or fruit chews; chocolate isn’t a good option as it’s high in fat and slower to bring blood sugars up), or even glucose gel or tablets. You can also pack snacks like nuts, seeds, protein bars, string cheese, meat sticks, and roasted chickpeas to help manage your blood sugar.
Yes, most airports have these snacks available, too, but Goldoor advises against assuming that you’ll have time to pick them up before you board the plane, as you never know when you might run into delays or other roadblocks that prevent you from getting the supplies you need.
As for medication, in addition to bringing extras, “try to bring medication in the original bottle with the label intact,” suggests Goldoor, so that airport security will know what they’re looking at.
Adjust Medication Doses As Needed
Generally speaking, says Roberts, with all the disruptions to your normal routine, it’s best to monitor your blood sugar more closely when traveling, and, if you take medication such as insulin, adjust your doses as needed with guidance from your doctor.
If, for example, you’re traveling from west to east (think: California to New York), the day will be shortened, so you might consider opting for a smaller dose of long-acting (or basal) insulin on the day you’re flying, says Roberts, then resuming your usual doses and dosing times on the first full day at your destination. Just make sure to dose according to the local time at your destination once you arrive (for instance, if you normally take a dose at 10 p.m. ET, take the same dose at 7 p.m. PT), and, if you’re using an insulin pump, change the pump time to the local time as well. To help smooth out that adjustment process, try moving your medication times by one or two hours each day to ensure there won’t be an overlap in doses or a period with no coverage.
“Repeat the same process for the return trip,” notes Roberts. Along the way, she stresses, always monitor your blood sugar and correct any high blood sugar as needed.
If you need to inject insulin during your flight, be sure to inject half as much air as you normally would into the vial, says Vettleson, as cabin pressure is lower than air pressure, meaning you don’t need as much pressure inside the vial. Again, pack as many extras of these supplies as you can in case something goes wrong and you need to troubleshoot.
Be Prepared for More Questions and a Longer Wait On Security Lines
Waiting on airport security lines is a notoriously tedious activity as it is, but when you’re wearing a medical device or carrying medication with you, the experience can get even more complicated and time-consuming.
To make the process a little easier, One Drop coaches recommend wearing or carrying a medical ID that states you have diabetes, in addition to labeling your carry-on bag of medical supplies accordingly, so that security is aware of what they’re inspecting. As an extra measure, consider bringing a doctor’s note that explains you have diabetes and lists your medications, as well as a prescription in case you need more during your trip, says Vettleson.
The Transportation Security Admission (TSA) also has an optional medical notification card you can fill out and bring to the airport, adds Vettleson. “You can hand the card to transportation security officers (TSOs) to inform them in a discreet manner that you have a medical condition or medical device that may affect security screening,” she explains. While the card won’t exempt you from security screening, it can make it easier to express your medical needs to TSOs without drawing too much attention or holding up the line.
But what diabetes supplies can (and can’t) safely go through airport X-ray machines, metal detectors, and body scanners?
“If you use an insulin pump or continuous glucose monitor (CGM), it’s best to check with the manufacturer regarding how your device interacts with airport security machinery,” says Vettleson. “Most manufacturers recommend that these devices are fine to go through metal detectors, but they usually do not recommend that you pass through body scanners while wearing your insulin pump or CGM, as the X-ray and body-scanning machines can affect the accuracy of your device.” Instead, ask the TSA agents to hand-inspect any supplies that can’t go through these scanners.
Again, leave as much extra time as you can to get through security lines, and if you’re questioned about your condition, rather than getting frustrated, “try to use that as an opportunity to educate those who aren’t familiar with diabetes,” suggests Roberts.
Stay Active Whenever You Can
Regardless of how much you prepare, air travel usually entails a lot of “hurry up and wait” experiences. But too much sedentary behavior can cause blood sugar to rise and make it harder to manage diabetes.
To avoid those spikes, in addition to opting for low-carb, high-fat, high-fiber, and high-protein snacks, seize the opportunity to move whenever you can.
“Walking in the airport during layovers, for example, is a good activity to help manage blood sugar,” says Vettleson. You can also find a spot in the terminal to “move in place” and get your heart pumping, adds Roberts. “For instance, you can march in place, step side to side, or even do squats and lunges.” (Try these no-equipment exercises for a quick total-body workout.)
Take advantage of the waiting you’re doing on the plane, too. When you’re allowed to walk around the cabin, get up and stroll the aisle every now and then to keep your blood sugar in check. “Stay hydrated during this time as well, as altitude and air pressure changes can impact people with diabetes differently, and staying hydrated will help combat the increase in blood sugars,” notes Roberts.
Looking for more travel tips for diabetes? Here’s how to manage your blood sugar throughout your vacation.
This article has been clinically reviewed by Jamillah Hoy-Rosas, MPH, RDN, CDCES, and VP of clinical operations and program design at One Drop.