Travel and diabetes

What to do before you travel and while you're away

Travel Insurance

Here is a list of some travel insurance companies that have been able to help fellow travellers living with diabetes (all types) as well as tips from other travellers living with diabetes. Also, consider the CHOICE travel insurance buying guide (March 2023).

Also:

• Take out travel insurance for both your health and belongings
• Make sure your travel insurance covers:
  • pre-existing conditions
  • the places you will visit and
  • the activities you plan to do.
• Declare your medical condition/s and check if there are any limitations for pre-existing conditions such as diabetes. Australia has reciprocal arrangements for emergency medical treatment in certain countries (for those who have access to Medicare), however this is not a substitute for travel insurance. More information can be found on the Service Australia website.
• If you use an insulin pump, consider insuring it separately as well.

A letter signed by your diabetes doctor/healthcare professional 

This letter needs to state that you have diabetes and is for you to show to the airport security screening officer if needed. Use this checklist as a guide of what to include in the letter.  We recommend this letter be sought as part of your annual cycle of care.

Sick day management 

If you become sick it is vital you know how to manage your diabetes during this time and that you have an up-to-date sick day plan and a travel-friendly sick day kit. Visit the Australian Diabetes Educator Association (ADEA) for examples of sick day action plans and discuss your specific care situation with your diabetes doctor/healthcare professional.

Insulin pump back up plans/pump

If you use an insulin pump, it is recommended that you know how to convert your pump settings to insulin injections if your pump should fail. You will also need to pack the equipment for your insulin injections back-up plan in case of pump failure. Don’t forget to pack some long-acting insulin as well. Have a copy of your pump settings recorded and keep it with you for easy reference.  Often people using an insulin pump hold onto their previous pump and travel with that as a back up. 
Some insulin pump companies may lend you a spare pump to take while travelling.
For example: https://www.amsldiabetes.com.au/resources/come-fly-with-me/
https://www.medtronicdiabetes.com/customer-support/traveling-with-an-insulin-pump-or-device

Check with your insulin pump company about their process and their insurance terms if you do borrow a pump travelling. 

Time zones

If you are travelling across different time zones, ask your diabetes doctor/healthcare professional for advice on how to adjust the times and doses of your medications (including insulin) and any devices (CGM or insulin pump). Make sure these instructions are written down and keep them safe with your travel documents.

Diabetes technology – manufacturer's recommendations

Download onto your phone or have a hard copy of the manufacturer’s recommendations for diabetes technology in regard to airport security scanning devices. Also make a note of their respective emergency 24/7 contact details in case devices stop working.

Insulin and diabetes medications/extra prescriptions

Medicines are usually exempt from the 100ml limit on liquids, aerosols and gels when travelling by plane. Check with your airline for specific information related to the place/s you will be travelling to.
Check that your medicine or medical device is allowed in your destination country. The Smartraveller website is a helpful place to look if you aren’t sure.

Check with your airline to see if you qualify for an additional carry-on luggage allowance for medical supplies.

Get extra prescriptions from your doctor for all your current medications, including glucagon if you have type 1 diabetes.

International travellers also need to be aware of any restrictions that may apply in regard to the quantity of PBS medication/s or medical devices that can be taken overseas (especially if travelling over a long period)

Travel vaccinations and medications

Speak to your general practitioner or a doctor at a specialist travel clinic to work out what specific vaccines (e.g. Hepatitis A, COVID) or special medicine (e.g. against Malaria) you might need. This will vary according to the countries you plan to visit. Allow at least 3 months prior to your travel date as sometimes a series of injections is required. Packing anti-nausea/diarrhoea medication in your travel first aid kit is also recommended.

Diabetes medication storage

Cooling wallets and cases are recommended for transporting insulin and injectable medications as aircraft cargo holds can experience wide ranging temperatures.  Many medications are temperature sensitive and need to be kept at a stable temperature. The type of case you choose will depend on whether you can have regular access to a fridge/freezer throughout your trip as some need to be re-activated. Check the Diabetes Shop for more information.

Apps which may be useful
•    Smartraveller   
•    Google Translate

MedicAlert bracelet or another form of medical identification/emergency contact details

Always carry identification and emergency contacts details. If you have a smartphone, consider using an ICE (In Case of Emergency) app. This will show your identification and emergency contact details on the home screen even when the phone is locked. Health apps are also available to store the medical information you might wish to store on your phone. Saving the contact details of the Embassy and public hospitals of the country/countries you are visiting is also recommended.

What to pack

Use this 'What to Pack' checklist to double check you have packed everything and haven’t forgotten anything.

On the day you travel (by plane) – what to expect

Before you begin the security screening process, advise the airport security screening staff that you are wearing medical device/s and need an alternative screening process (such as a wand or pat-down).

Have your letter from your diabetes doctor/healthcare professional and the manufacturer’s recommendations for diabetes technology in regard to airport scanning devices with you, to show to the airport security screening staff if needed. If front-line staff do not speak or read English, ask for a Manager to assist.

During the flight

• Keep your medications and other diabetes care supplies including hypo/emergency snacks close to you for easy access rather than in the overhead compartment during the flight.
• Keep track of time zones and take your medications as advised previously in conjunction with your diabetes team.
• Check your blood glucose levels more often to make sure you are in target range.
• Choose/or not to consume the meals provided during the flight, taking into consideration the timing and dosage of any oral medication/s or insulin.
• Keep hydrated and try to move around the cabin as often as you can.
• Some insulin pumps may need to be put on ‘flight mode’ – check with the company.

At your destination

Adjust your wristwatch and device clock/s to the time of your destination. Take your medications and meals at the new destination time zone or as previously advised by your diabetes team.

REMEMBER: A change in activity level, different foods and routines may require adjustments to your medications, insulin doses or pump settings. A change in temperature, particularly heat, can also effect insulin absorption. Discuss these things with your diabetes doctor/healthcare professional beforehand.

Troubleshooting

What to do ….

• If you feel you have experienced an inappropriate screening process at an airport security checkpoint, you can ask to speak with a supervisor at the checkpoint.
• You can also lodge a complaint with the airport. Please note this applies at Melbourne Airport only.
• If you lose your insulin, diabetes equipment and supplies?
• Go to the local hospital emergency department. You can also visit the International Diabetes Federation’s website for the contact details of the diabetes organisation in the country in which you are travelling (if applicable) for help in obtaining supplies in their country.
• If you become unwell? Activate your sick day plan.
• If your devices stop working? Contact manufacturer’s 24/7 helpline.

How do I …

• Keep several months’ supply of insulin cold?Insulin and some other injectable medicines must be stored correctly to work properly. Insulin can be kept at room temperature (below 25°C) for a maximum of one month. Spare insulin should always be kept in the fridge (never in the freezer) at 2°C - 8°C until the expiry date on the box/vial/pen.
• Use a cooling wallet when in transit and then transfer items to a fridge when you arrive at your destination (don’t forget to take it with you when you leave!).Consider using a wireless smart sensor to monitor insulin/medication temperature
• Dispose of sharps while travelling?
  Have an appropriate (usually small) container to store your used sharp items until you can dispose of them safely (often when you return home)

Car or driving trips

Do not leave insulin supplies in the car once you've reached your destination. Heat and cold can affect your insulin. Your insulin, meter and strips should also not be exposed to direct sunlight.

If you take insulin or diabetes medications:

• Check blood glucose levels before leaving. Make sure your glucose level is above 5mmol/L. A two point check is a good way of knowing whether your blood glucose level is on its way up or down. For example check 30 minutes before you leave and then again just before you drive off. This can give you an indication whether you blood glucose level is dropping. You should check your glucose levels regularly whilst driving to make sure you continue to be safe to drive.
• Always carry quick acting carbohydrates in the car with you in case you are low. If you are experiencing hypogycaemia, pull over to the side of the road as soon as you can safely do so. Turn off the ignition and take the keys out of the ignition. Treat your hypo and follow it up with long acting carbohydrates. Ensure that you are safe to drive by re-checking your blood glucose level. Do not drive until your blood glucose level is above 5mmol/L and you feel better. More information about driving and diabetes is available here.

More information abour driving and diabetes is available.

Camping

Camping is often not considered travelling because most people do not go overseas for it, but it still requires preparation and planning for a successful trip.

• Be cautious about camping alone in case of emergencies.
• Let someone at home know where you're going and your location.
• Consider the amount of activity you will be doing as you may need to adjust your insulin accordingly (discuss with your diabetes team).

Remember the following:

• Diabetes emergency kit
• Hypo kit (including glucagon if prescribed by doctor)
• Frio pack/ cooler
• Protective shoes
• Supplies of drinking water and water purification tablets
• Sunscreen, mosquito repellent, hat etc.