The Practical Diabetic

Our family recently did a big trip to the USA from Australia.

The trip had us go through customs in:

• Sydney, Australia -> Hawaii
• Hawaii -> New York via Los Angeles
• New York -> Los Angeles
• Los Angeles -> Sydney, Australia

I thought this would give me a good opportunity to try out carrying my insulin using a vacuum flask. I could test the flask in a real world scenario and see how it fared through customs. This was the rig I used.

The digital display is for a temperature sensor inside, held onto the flask with a rubber band. Yes, it looks like a pipe bomb (or a sex toy according to some of the folk on Facebook but that probably says more about them than the rig). Please note it is recommended that insulin is taken in your carry-on luggage as the temperature in the cargo hold is not as predictable and frozen insulin is useless.

Some of the predictions from the JDRF 25+ Facebook group (where I posted my intentions) included:

“I’ll be surprised if you don’t get shot in the US with that… Any cylindrical tube with a screen and wires on it will cause a lockdown.”

“Expect long delays”

“Kinda glad I’m not flying anywhere today as the airport will probably go into lock down… if it somehow gets through Australia I guess we will see on the news tomorrow of ‘Australian shot by American airport police and airport in lockdown dew to fake bomb found’ “

Given I am writing this blog I clearly did not get shot. So how did I go?

Sydney -> Hawaii

At every location where an x-ray of bags was happening, I took the rig out of my bag, put it in the tray and alerted the security officer that it was insulin.

In Sydney, this information brought a smile and the response “You know what it looks like, right?” Knowing full well one does not say the b-word (bomb) at an airport, I acknowledged I did and he waved me through. He also told me that insulin is allowed to be carried through Australian customs with ice or gel packs in the special case of diabetics.

As I walked through the metal detector, the officer called his colleague over to watch the x-ray screen, using my device as an exercise to show the difference between insulin pens and incendiary devices.

All went well.

For the record, the officer is correct in regards to gels and ice packs, although finding the details on the Australian Home Affairs site is difficult. Eventually I found this page which quotes:

“If you plan to bring medication onboard, remember to:

• obtain supporting documentation, such as a medical identification card or a letter from a doctor. The letter should itemise any prescription and non-prescription powder, liquid, aerosol or gel medication, prescribed medical devices or equipment, for example, ice or gel packs used to regulate temperatures, or the need for hypodermic needles.
• check the restrictions for medicines and medical devices before you travel.
• have medication and accompanying documents ready for inspection before you arrive at the airport security screening point.

For prescription medication, make sure the name on the prescription label matches the name on your boarding pass or the name of the person travelling in your care.”

The medical identification card for Australian diabetics is the NDSS card. You will know if you have one. Interestingly, while I was carrying a letter from my endocrinologist, it did not explicitly say the insulin needed a gel or ice pack to keep it viable. Also, while I do carry prescription pills, the doctor’s itemised list of medications I carried was old and did not correctly list them.

In principle, a fussy customs officer could have confiscated any ice packs I was carrying and confiscated my pills. This did not happen, thankfully.

While not explicitly stated on this site, the NDSS site states diabetic medication is exempt from the 100mL rule for liquids (although it does need to be presented at the security point). My endocrinologist letter also mentioned my need for juice boxes so, based on the above, these would also be exempt.

Landing in Hawaii there were no scans or checkpoints so things were uneventful at that end.

Hawaii -> New York via Los Angeles

As with Sydney, I pulled the device out of my bag, put it in the tray and announced what it was. While my pipe bomb was not used as a learning opportunity for another officer in Hawaii, they were fine with me carrying it through. They did insist I open it up for a visual inspection and asked if there was anything sharp in there. There were the needles but, as I explained, they are all sealed up and safe.

After a quick visual inspection I was good to go. Again I asked if insulin can be carried through US customer in ice or with a gel pack and they confirmed it can be.

This is confirmed on the TSA website. Also, the Medtronic web site says if you encounter problems to ask to speak to the TSA Ground Security Commissioner.

New York (JFK) -> Los Angeles

Mostly incident free. I put it in the tray, said what it was and they did not bat an eyelid. They did ask me what the device on my arm was which, I explained, was a CGM for monitoring my blood sugar. They accepted this and waved me on.

Los Angeles -> Sydney

Almost incident free. It turns out the coconut flavored peanut butter I bought in Hawaii is considered a liquid/gel and being over 100mL (3.4 ounces) it had to be confiscated. I tried playing the diabetes card but to no avail. Peanut butter was not considered essential to my medical condition (it certainly is not mentioned on the doctor’s list of medications.)

How Did The Container Fare?

My initial tests at home with ice inside were promising. The temperature stayed cool for over a day. On the trip, as the container had actual insulin pens in it, I was reluctant to put ice in there as well (frozen insulin = bad insulin). So there was nothing to keep the insulin cool in the wild. I simply removed it from the fridge at home and took it on the flight with a view of putting it in the fridge on arrival. This plan worked fine, except the initial leg (Sydney to Hawaii, 9 hour flight). By the time we got to the house where we were staying, the internal temperature was matching the outside (28C/82F). This is at the upper limits for insulin so on my next trip I will see how gel or evaporative cooling fares. However, for shorter trips, the vacuum flask would work fine and is easy to carry.