Back in April, I wrote about what I pack on a day trip and promised at the time to follow up with a packing list for longer trips e.g. interstate and international travel for work and pleasure, using my recent trips to Germany and the US as my guide. As before, I will be referring to my reference spreadsheet, which has received some minor adjustments since the last article.
This list is not exclusively for people with diabetes; it covers all aspects of hotel-based travel. As you can see, I break the inventory down into:
- Luggage Items
- Carry On
While the focus will be on the Diabetes/Medical list, there are a few tips/tricks relevant in the other sections. Let us dive in.
My Diabetes Bag
Thanks to the US trip, I now have a new diabetes bag. This one is much larger and has lots of pockets and sections for the various things I carry. While often unnecessary with modern security scanning equipment, it also folds out to display the more noteworthy diabetes items e.g. needles, insulin etc.
Here are some tips for both the check-in and carry-on luggage.
For most airlines these days, medical supplies, such as those needed for diabetes do NOT count towards carry-on quotas. For Australian interstate travel this is handy for Jetstar who are meticulous about carry-on weight quotas, literally weighing carry-on luggage as you board the plane. Having a separate diabetes bag makes that experience so much easier.
It also came up on one of my QANTAS flights: one of the flight legs was particularly full and I had with me a backpack with my laptop and other bits and pieces in it and my diabetes bag.
I put the backpack in the overhead locker and kept the diabetes bag with me under the seat. The flight attendant informed if there was not enough room I may need to put BOTH bags under the seat in front of me and, actually, I was only permitted to bring one piece of carry-on. I replied, curtly, one was with medical supplies. She begrudgingly accepted the response and suggested I consider checking in one of bags in the future (given one had insulin and power banks and the other a laptop this was not possible). I refrained from informing her what I thought she should consider doing. Check your airline to be sure, but the moral of the story is being stressed about carry-on quotas because of diabetes supplies is generally unnecessary.
Storage cubes are great as a general packing tool but the smaller ones are fantastic for managing the various supplies. I use storage cubes and ziplocks for:
- The stuff customs may want to see when going to the gates (needles, insulin etc.)
- Items which need to be hand inspected, rather than going through the scanning machine
- Surplus supplies for set changes
- The stuff I use every time I do a set change/sensor change/reservoir change
- Power banks and cables
Having things in well organised categories/containers makes them easy to retrieve when the moments arise.
If you are travelling overseas, always have travel insurance. If you are travelling for business, confirm your workplace’s corporate policy covers diabetes. Do not take HR’s word for it that you are covered, get a copy of the policy and the contact numbers for when you are overseas.
More for international travel, having a travel guide can be helpful for saying key phrases (“Where is the nearest pharmacy/hospital/doctor?”, “I am diabetic”, “Do you speak English?”), providing maps of the locale, and for understanding how transportation works.
You may also want to research if the country you are going to has reciprocal health arrangements with your home country, how insulin is obtained etc.
While on the list, I have started comparing a well-made vacuum flask to a portable fridge with a decent power pack and finding the vacuum flask, under the right conditions, has superior performance. I will likely write about the findings and comparison in a future blog. It is to be confirmed formally but my belief is a vacuum flask, filled with water just above freezing, will give excellent performance on long haul flights (I managed to keep my insulin between 2-15C/36-59F for 48 hours doing this). If filled with water it will need to be checked in which is a risk but, again, the vacuum flask should protect the insulin if things get too cold in the luggage hold. The alternative is to not fill the flask with water and then it is permitted to be part of carry-on although I expect this will affect performance.
Where I covered an item in the previous day pack post, I will leave it out but here are my tips for extended travel.
Disposable Diabetes Supplies (Pump Stuff, CGM Stuff, Insulin)
The best advice here is take more than you need. In the spreadsheet I have a formulae, based on how long I am going for, to tell me what I need to take plus one or two extras. This is very much a work in progress and quite individual, depending on things like how often sensors fail to insert/work for you. On the trip to the US I actually miscalculated the insulin and cruised on the plane back home on my last reservoir of insulin after being very, very careful on what I ate in the last couple of days to ensure I did not spike and require too much additional insulin. You do not want that. Take more than you need rather than having to use your tourist book to ask for more insulin or pump supplies which may not be available/approved in the country you are visiting.
I have written a few blog articles about BreezyPacks in the past and I am a big fan. BreezyPacks have never sponsored or sent me freebies (I am open to it though for ‘review purposes’, hint hint). The fact is their product works and works well. Like a Frio, they work by absorbing heat through changing the phase of a material (changing between solid/liquid/gas). Frio uses water going from liquid to gas while BreezyPacks uses their own material going from solid to liquid. The big advantage of BreezyPacks is there is no soaking required and does not need exposure to the air to work. It works as it is.
If my insulin is outside of a vacuum flask while travelling, I always keep it in a BreezyPack.
Insulin Contingencies and my Diabetes Notebook
Like the airplane you may be flying in on the trip, all aspects of your diabetes management should have a backup system which can take over in case of total failure. While I use a CGM and pump, looped with CamAPS to manage type 1, I also take:
- A spare pump
- Injectable pens
- A finger pricking device and test strips
I also have a notebook with my basal settings and a bunch of other notes, tips and tricks. If the pump fails, I have the choice of booting up the spare pump or, if towards the end of the trip, doing multiple daily injections until my return.
I also make a point of identifying other people with type 1 diabetes, who I know, where I am going. This way even if I lose all my luggage, I can hit up a local for assistance.
While I rarely hypo, if ever (looping means I never over-correct), I do carry a glucagon pen on me. I have never needed to use it and it is largely there at my endocrinologist’s behest but, if you tend to go low, having one may bring peace of mind.
Charged Power Banks, Cables, and Power Adaptors
If you have a mobile phone or receiving device for your diabetes technology, you will want it powered up at all times. Therefore, you need to have backup power supplies in case that long plane flight does not have power in the seat. In my case, my mobile phone is the brains of my looping system so if the phone goes dead, the pump will default to its basal profile and rely on me for bolusing. Clearly my non-looping pump has more faith in me than I do. To ensure my mobile phone lasts for the longest of flights, my carry-on always has power banks and charging cables. Many airlines have strict rules which prevent putting power banks in check-in luggage so these usually have to be in your carry-on and, as they are a medical necessity, they should be in your diabetes bag not counting towards your carry-on quota.
Assuming you will also want to charge up your technology at the hotel, you will also probably need to bring plug adaptors and ensure your chargers are compatible with the local voltage. Most devices these days work between 100-250 volts which covers you for the world but check so you do not fry your charger or the receiver.
Prescriptions for all of your Medications
There appears to be an unwritten rule with chemists/pharmacists around the world that if you use a life-saving medication such as insulin, as long as you have a prescription from your country of origin, you can get it over the counter while overseas. Therefore it is necessary to always have prescriptions for your insulin and whatever other medications you need to manage the disease. For Germany, as my prescription was on file at my local pharmacy, I needed an extra prescription for the trip which I got from a local general practice doctor before I left. My experience has been that, if you explain the situation, most doctors will give you a script, even if they have not had you as a client before.
As well as a letter from someone in your medical team explaining you need to carry insulin, needles, hypo treatments etc. for airport security, a prescription can also help in convincing overzealous security officials you are a person with diabetes.
Needle Clipper and Sharps Container
If you need to inject or do a set change on the plane (more likely for longer trips), it is responsible to carry a sharps container with you or, if you are only disposing injection needles, a needle clipper. The BD Safe-Clip is the one I carry. This allows you to clip off the sharp part of the needle, which is then held securely in the body of the clipper, and throw away the rest of the pen in normal garbage. If you are also disposing of things like pump supplies, a sharps container may be a better option. I have a little one you can see in the diabetes fold out picture above which I use when on the plane.
Carrying the sharps container did raise questions when I went to the Seattle Space Needle but, after I declared I was a person with type 1 diabetes (annoying that I needed to declare my medical status to let through a sharps container!), they let it though.
Aussielent (QOTA) Power and Olive Oil
As mentioned in this other article, I saw potential in taking individual ziplocks of AussieLent and a bottle of olive oil on the trip for when I was hungry but food options were limited. In the case of the trip to the US, this was usually due to jetlag meaning I was hungry at a time when most food outlets were closed. The AussieLent was invaluable at covering the hunger pangs in a controlled, non-spiking way.
So far the above scheme has worked for the two overseas trips to Germany and the US, as well as multiple work trips interstate. As with the day pack, I expect it will get adjusted over time but, for now, it serves me pretty well. If you have items you do not travel without, feel free to add them to the comments.
Be aware the BD Safe-Clip is only rated to cut off needles that are 28G or finer.
Most pump infusion sets have insertion needles which are 27G (thicker). Thus you run a risk of breaking the Safe-Clip. However the steel infusion sets are generally either 29G or 31G (so fine enough).