"The first time I traveled completely on my own, I flew to Israel. Between the long flight, unfamiliar food, a completely different schedule, and the excitement of being in a new country, I quickly learned that traveling with Type 1 diabetes comes with its own set of challenges. I had started using a continuous glucose monitor in 2017, and it changed everything about the way I felt navigating those moments.
There were still bumps along the way, but after nearly a decade of traveling with T1D, I’ve learned a lot about what makes travel feel safer, easier, and more enjoyable. We may not get to take a vacation from diabetes, but we still deserve to take vacations with confidence!!!
Whether you’re flying across the country, heading to the beach, exploring a new city, or hiking through the mountains, traveling with Type 1 diabetes definitely requires a little extra planning… but it shouldn’t keep you from exploring the world!
Travel often means changes in routine. Different meal times, increased activity, changing time zones, warmer temperatures, and disrupted sleep can all affect blood glucose levels and insulin needs. The good news? With the right preparation, you can feel confident managing your diabetes wherever your adventures take you!
Here’s what to know before, during, and after your trip."
With love,
Brooklynn Hamilton, DRC Development Coordinator
Before You Leave: Pack for the Unexpected
One of the best ways to reduce travel stress is to prepare for situations you hope never happen.
Flights can be delayed, luggage can get lost, infusion sets can fail, sensors can fall off early, and plans can change unexpectedly. Because of this, many diabetes healthcare professionals recommend packing at least two to three times the diabetes supplies you expect to need for your trip.
In addition to extra insulin, pump supplies, CGM sensors, glucose meter supplies, ketone strips, glucagon, batteries, and charging cables, keep plenty of fast-acting carbohydrates with you in case of unexpected lows.
Before leaving home, it’s also a good idea to:
- Save digital and printed copies of your prescriptions.
- Screenshot pump settings, including basal rates, carb ratios, correction factors, etc.
- Check expiration dates on insulin, glucagon, ketone strips, and emergency supplies.
- Research nearby pharmacies, hospitals, and urgent care centers at your destination.
- Review insurance coverage, especially traveling internationally.
- Wear or carry medical identification and emergency contact information.
A few minutes of prep before a trip can make a stressful situation much easier to manage if something unexpected happens.
Navigating Airport Security
Airport security is often one of the biggest concerns for travelers with Type 1 diabetes, but knowing your rights ahead of time can help make the process much smoother.
If you wear an insulin pump or continuous glucose monitor (CGM), review your device manufacturer’s travel recommendations before your trip. Some manufacturers recommend avoiding certain airport screening equipment, while others provide specific guidance for body scanners, X-ray machines, and metal detectors.
If you’re uncomfortable sending your device through screening equipment, you can always request an alternative screening or pat-down from an agent.
Medically necessary liquids—including insulin, glucagon, juice, gel packs, and other diabetes supplies—are exempt from standard TSA liquid limits when you inform a TSA officer. (Very important to keep those juice boxes on you in the airport!)
Preboarding May Be Helpful
Many people don’t realize that Type 1 diabetes is recognized as a disability under the Americans with Disabilities Act (ADA). Because of disability protections, travelers with diabetes may be eligible to preboard their flight by speaking with the gate agent before boarding begins.
Preboarding can make traveling with T1D safer and less stressful.
Boarding early gives you time to:
- Secure overhead bin space for medical supplies.
- Prevent important diabetes supplies from being gate-checked.
- Organize insulin, low treatments, and other medical equipment before takeoff.
If preboarding would make traveling easier, simply let the gate agent know you’re traveling with a disability and medical equipment at their desk prior to your flight.
The Hidden Disabilities Sunflower Program
Many airports around the world participate in the Hidden Disabilities Sunflower Program.
The sunflower lanyard is an internationally recognized symbol that discreetly lets airport staff know you may need additional time, assistance, patience, or understanding because of a non-visible disability or medical condition. While participation varies by airport, many provide the lanyards free of charge.
Managing Diabetes During Your Flight
Flying introduces several unique factors that can influence diabetes management.
Pressure changes, prolonged sitting, altered meal schedules, dehydration, travel excitement, and stress can all affect blood glucose levels in different ways.
Cabin Pressure Can Affect Insulin Delivery
As an airplane climbs, cabin pressure decreases. This change in pressure can cause tiny air bubbles to form or expand inside insulin pump tubing, occasionally leading to small amounts of unintended insulin delivery.
During descent, increasing cabin pressure may slightly reduce insulin delivery.If you use insulin pens, pressure changes can also introduce air bubbles into the cartridge. Priming your pen before injecting helps remove trapped air and improves dose accuracy.
While these changes are usually small, they’re important to understand during longer flights.
Don’t Rely on Airline Meal Schedules
Airline meals don’t always arrive when expected. Delays, turbulence, and schedule changes can all affect meal service.
Instead of planning around the airline’s schedule, keep familiar snacks and fast-acting carbohydrates with you so you can treat your blood sugar whenever necessary.
If you experience a low during your flight, don’t hesitate to ask a flight attendant for juice. Airlines routinely carry juice for medical situations.
Keep Supplies Within Reach
Always keep your diabetes supplies in your personal item and not just your carry-on stored overhead.
Having insulin, glucose, an extra infusion set, CGM supplies, and a complete pump site change within arm’s reach makes it much easier to respond quickly if you need them during the flight.
Move When Possible
If it’s safe to do so, getting up and walking the aisle periodically may help improve circulation and insulin sensitivity after sitting for long periods.
Traveling Across Time Zones
Changing time zones affects much more than your watch with T1D!
Your body’s internal clock helps regulate hormones such as cortisol, which naturally contributes to morning insulin resistance. Crossing multiple time zones can temporarily separate your local meal times from your body’s hormonal rhythm, leading to glucose patterns that may look different than they do at home.
Flying east shortens the day and may increase the risk of lows, while flying west creates a longer day with more opportunities to eat and potentially experience higher blood sugars.
Some people gradually adjust their pump clock before travel, while others change it after arriving at their destination. The best approach depends on your insulin regimen and should be discussed with your diabetes care team if you’re unsure. But don’t forget to change the times on all your technology!
During the first few days after arriving, checking your blood sugar more frequently can help you identify changing patterns and make adjustments as needed.
Mountain Adventures and High Altitude
If your trip includes hiking, camping, skiing, or visiting higher elevations, it’s important to understand how altitude can affect diabetes management.
At higher elevations, lower oxygen levels increase the release of stress hormones, which may temporarily raise blood glucose. At the same time, prolonged physical activity often increases insulin sensitivity, making lows more likely during or even several hours after exercise.
Some blood glucose meters may also become less accurate above their recommended operating elevations.
If you’re spending time in remote areas, remember pharmacies and hospitals may be hours away. Carry extra supplies, keep low treatments on you rather than buried in a backpack, and bring a portable charger or power bank for rechargeable devices.
Planning ahead becomes even more important when medical care isn’t immediately available!
Heat, Sun, Sand, and Water
Summer vacations bring another set of considerations for people living with Type 1 diabetes.
High temperatures can affect both your insulin and your diabetes devices. Insulin begins losing effectiveness when exposed to excessive heat, and temperatures inside parked vehicles can quickly become hot enough to damage medication. Never leave insulin in a car, even for a short period.
Direct sunlight can also warm insulin inside pump tubing throughout the day.
Heat affects your body as well. Dehydration can contribute to higher blood sugars, while a painful sunburn triggers inflammation and stress hormones that may temporarily raise glucose levels.
If you’re spending time at the beach, keep supplies shaded whenever possible and protect pumps and devices from sand, which can become trapped in charging ports and connectors.
Swimming presents its own challenges. Bluetooth signals don’t travel well through water, so your CGM may temporarily lose connection while submerged before reconnecting afterward. Before swimming, verify whether your insulin pump or CGM is waterproof and follow the manufacturer’s recommendations for water exposure and depth limits.
Hot tubs are an important mention as well because warm water increases blood flow near infusion sites, which may cause insulin to absorb more quickly than expected.
International Travel
Traveling internationally requires a little extra planning, but being prepared can make navigating another country’s healthcare system much easier.
Bring copies of your prescriptions, a physician’s letter explaining your diabetes supplies, travel insurance information, emergency contacts, and a translated diabetes emergency card if you’re visiting a country where you don’t speak the language.
It’s also helpful to know the generic names of your insulin, since brand names vary around the world.
Finally, always verify insulin concentration before using replacement insulin. While U-100 insulin is the most common, some countries also use U-40, U-200, or U-300 insulin. Different concentrations require different dosing, so never assume replacement insulin matches what you use at home.
Hotels, Food, and Daily Routines
Even after you’ve reached your destination, your diabetes routine may continue to look different.
Many hotel mini-refrigerators are designed for beverages rather than medications and may accidentally freeze insulin. If possible, request a medical refrigerator when booking your stay.
Keeping all of your diabetes supplies together in one designated location can also help prevent important items from being misplaced or accidentally thrown away during housekeeping.
Vacation meals often look different than meals at home. Buffets, family-style dining, and grazing throughout the day can make insulin dosing more challenging because you’re eating over an extended period rather than during one meal.
At the same time, sightseeing often means walking several more miles than you normally would in a typical day. More activity, different foods, and changing schedules mean your insulin needs may not look exactly like they do at home.
Checking your blood glucose more frequently throughout your trip can help you recognize these changes early and make adjustments as needed.
Enjoy the Journey!
Traveling with Type 1 diabetes requires some extra thought and work, but it shouldn’t prevent you from seeing the world.
No vacation comes with perfect blood sugars. Different foods, new routines, changing weather, excitement, and increased activity all create variables that can affect diabetes management.
By planning ahead, packing extra supplies, and understanding how travel can influence your blood sugar, you’ll be better equipped to handle the unexpected and spend more time focusing on what matters most: making memories and enjoying your adventure.
Want to learn more or support life-changing Type 1 diabetes research?
At Diabetes Research Connection, we fund early-career scientists working on innovative approaches to prevent, treat, and ultimately cure Type 1 diabetes.
Keep up to date with our latest helpful T1D lifestyle guides and research updates by signing up for our newsletter.
