1. Document all prescriptions.   It is easiest to bring the boxes your insulin or medicine came in, since the original labels prove the medication belongs to you.  Other receipts or the hand-written prescription cannot be used.  
2. Cap all lancets & have an identifiable glucometer.  Lancets may be brought on board for testing blood glucose levels, as long as they are capped. A glucose meter must accompany the lancets with a permanent manufacturer's name (i.e. "One Touch" ) embossed on it.
3. Glucagon kit in original box.  A brand new glucagon kit with the original pharmaceutical label and box container can be included in medical bag (box must remain intact) for the trip back.
4. Check with airline for other requirements.  It is recommended that the traveler check's with individual airlines prior to flights to see if they have other requirements for the trip.  These rules only apply within the 50 United States.  If one is traveling outside of the United States it is recommended that they call the foreign embassy of the country visiting and find out about any legal restrictions. The contact information for most foreign embassies can be found at http://embassy.org

[Top]

Preparing For Your Trip

• Before you leave...

• What to bring...

• Once your there...

• Insulin Adjustment Table

Before you leave on your trip

1. Doctor check-up -- If it has been a while since your last check-up, this is a good time to meet with your doctor.  Tell your doctor about your travel plans, make sure you have current prescription information for the airline, and ask your doctor for any other suggestions.  Your doctor may also prescribe anti-diarrhea and nausea medicine for your trip.
2. Call the airline for special arrangements -- Your airline may have special boarding instructions.  If you have type 2 diabetes, you may want to order a diabetic meal if needed/available. If you have type 1 diabetes you may want to bring a supplemental meal because most airlines have diabetic meals geared toward weight control for Type 2 diabetics.  For information on laws see section above.
3. Check on vaccination requirements for travel destination. -- If you are traveling to a country where a vaccination may be needed, get it a week or two ahead of time in case of complications with medications (see the "Resources" section for finding this information).
4. Obtain a medic alert bracelet -- If you don't have this type of bracelet you may want to obtain one for your trip.
5. List medications and doctor contact information -- Make a list of all the medications you currently take, along with your doctor's name and phone number to keep with you during your trip.

Extra tip:  In case of emergency learn how to say simple phrases such as "help", "I have diabetes", "sugar", "doctor", in the native language of the country where you are traveling.

What to bring with you

1. Medication supplies -- Bring all medication and supplies you will need for the entire trip.  Don't forget to include supplies for a few extra days or weeks, depending on the duration of your stay.
2. Prescriptions & other documentation -- All medications and packages should be documented.
3. Carry medication and supplies with you -- If you are insulin dependent, carry all your supplies on the plane with you. The baggage area of the plane is not temperature regulated and your medication can freeze or get too hot. This also eliminates any chance of medications getting lost if your luggage is lost.  This also applies to cars, buses, and trains.
4. Emergency food supply -- Bring your own snacks and make a small emergency bag with crackers, juice box, candy, and other items as needed.
5. Foot care supply -- Bring a bag of foot care products (first-aid cream, bandages), a comfortable pair of shoes for walking, and some beach shoes to protect your feet.

Once you're there

1. Caution when using your room's refrigerator -- If your room has a refrigerator you may not wish to use it, since these may not be properly maintained and may have temperature fluctuations.  It is best to keep your insulin at room temperature.
2. Foot care -- Bring your most comfortable shoes and check your feet often. Tend quickly to any cuts or sores that develop and take frequent breaks throughout your day to rest your feet.  Avoid going barefoot on the beach.  Instead, wear shoes designed for the beach that are not open toed or flip-flops. Keep an emergency kit with bandages, ointments, and fresh socks handy.
3. Test your blood sugar -- Time difference and other changes in your daily schedule can have drastic effects on your blood sugar, make sure you test it often and as recommended by your doctor. Bring along your "My Diabetes Record"  when traveling to help you keep track of your testing. 
4. Food supply -- Always have a snack bag handy since you never know where you may be when your blood sugar is too low or too high.

What adjustments need to be made to your insulin injection schedule?

The only adjustment needed is if you are traveling across six or more time zones.  Otherwise stick to your normal insulin schedule.*  

Eastbound Travel	Departure Day	First morning after Arrival	Ten Hours after Morning dose	Second Day after Arrival
One-dose schedule	Usual dose	2/3 usual dose	Check blood glucose. If it's over 13mm/l (240mg/dl) use remaining 1/3	Usual dose
Two-dose schedule	Usual dose	2/3 usual morning dose	Add remaining 1/3 to evening dose	Usual dose

Westbound travel	Departure Day	Eighteen Hours after  Morning Dose	First Morning after Arrival
One-dose schedule	Usual dose	Check blood glucose. If 13mm/l (240mg/dl) or less, no additional needed. If it'' over 13mm/l (240mg/dl): 1/3 usual dose followed by meal  or snack	Usual dose
Two-dose schedule	Usual dose	1/3 usual morning dose followed  by meal or snack	Usual dose

 [Insulin adjustment table produced by Edward Benson, MD, Virginia Mason Clinic, Seattle, WA, USA]

Traveling within the continental United States makes insulin dosage easier to follow.  You may not need to bring along enough medication and supplies to last the whole trip in case drug stores are not available.  Follow recommendations in the section "What to bring with you" in case there are any unexpected delays.

* If you have any questions regarding your insulin schedule when taking a long trip, ask your health care provider what is right for you. If you are using an insulin pump and traveling across time zones talk with your doctor about whether you should adjust your basal rates.

Resources

Blood Sugar Converter -In the United States it is common to use mg/dl, but in other countries they may use mmol/l. Here is a converter that will figure out the numbers for you. http://www.childrenwithdiabetes.com/bs_conv.htm

Diabetes Foundation of Rhode Island
209 Cottage Street
Pawtucket, RI 02908
(401) 222-3442

American Diabetes Association
2348 Post Rd.
Warwick, RI 02886
(401) 738-6464
1-888-DIABETES (Toll Free)

Rhode Island Department of Health
Diabetes Prevention and Control Program
3 Capitol Hill
Providence, RI 02908
(401) 222-3442

"My Trip Planner"

Download a trip planner to help you prepare for your journey and include your emergency information. (PDF file) [PDF help]