Flying with Diabetes: Tips for a Smoother Journey
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Flying with Type 1 Diabetes? It can be a little nerve wracking. I get it. We just flew for the first time after my son’s diagnosis, and I remember the nerves I felt before the trip. Today, I'm going to share everything I learned—the good, the bad, and the indispensable tips—for flying with diabetes, so your next airport adventure can glide as smooth as a plane on a clear day.
In this episode, I’ll discuss:
[02:30] - Preparing to Fly with Type 1 Diabetes
[10:37] - Packing Tips for Flying with Type 1 Diabetes
[18:18] - Tips for Getting Through Airport Security with Type 1 Diabetes
[22:07] - Strategies for Managing Diabetes In-Flight and Post-Landing Care
[24:52] - Navigating Diabetes Management While Traveling
Whether you're navigating this for the first time or looking to refine your travel routine, this episode is your boarding pass to a less turbulent journey.
More of a reader? I got you…
First-Time Flying with Type 1 Diabetes
When you’re newly diagnosed with Type 1 Diabetes or a parent of a newly diagnosed kiddo, all the firsts can be so overwhelming. The first holiday trying to figure out how many carbs are in grandma’s apple pie. The first soccer game trying to figure out how to avoid a low. The first beach day trying to keep blood sugars steady and insulin cool in the sun.
My son was diagnosed with Type 1 Diabetes almost two years ago, and we’ve navigated lots of firsts since then. But, this was the first time we would be flying as a family after his diagnosis. And I was honestly so nervous.
As an anxious girly that loves to be overly prepared, I dedicated countless hours before our trip to reading blog posts and articles, combing through diabetic Facebook groups reading others’ experiences and listening to podcasts about traveling with diabetes, with the hope that all this preparation would help the flight and the trip go as smoothly as possible for us. All the research helped a lot, but we still had a few hiccups we learned from.
Today, I’m sharing all about it. I put together everything I learned from my research that was useful along with what we learned from our own personal experiences. It’s basically the guide I wish I had when preparing to fly and travel with my son who has Type 1 Diabetes.
Let’s dive in.
Preparing to Fly with Type 1 Diabetes
The first phase of our adventure began several months before the trip where I prepared the best I could for the flight.
Research
I started our preparation with a lot of research. My goal with this post/episode is to streamline your research process. However, given the variability among CGMs and pumps, I strongly recommend that you review any travel-specific guidelines provided by your specific device(s) manufacturer. It's also helpful to talk with your endocrinologist.
Additionally, I recommend listening to these incredibly informative episodes of the Juicebox Podcast, featuring a diabetes educator discussing travel with diabetes:
#355 Ask Scott And Jenny: Chapter Thirteen (Fast-forward to the part about flying with insulin pumps)
Also, I highly recommend joining the free Juicebox Podcast Facebook group. This group is an invaluable resource, offering support far beyond just travel advice.
Talk to your endocrinologist and get a travel letter
We contacted our endocrinologist to see if they had any specific instructions for us and to get a letter to show TSA. On the letter it lists the supplies my son needs to be able to travel with and states that his cgm and pump can not go through the scanners. Now, none of the TSA agents actually read the letter, but I had it right there on top for them to read if needed as we went through security.
Consider TSA Pre-Check
This next step might not be essential for everyone, but it was incredibly beneficial for us. Given we're managing diabetes supplies and both of my children are autistic, which sometimes makes it challenging for them to follow complex instructions, I aimed to simplify our travel experience as much as possible by obtaining TSA Pre-Check.
With TSA precheck:
You get to go through a separate TSA Pre-check line, which is generally faster than the usual security line.
You don’t have to take off your shoes, light jacket or belt when going through security, you can just leave them on.
You can leave your laptop in your bag.
And you can leave your small liquids in your bag.
Cost
About $80, as of 2024
Kids under 17 can go through TSA pre-check line with you, without paying extra.
We decided that only I would get TSA Pre-Check. Paying the cost for both my husband and myself didn't seem necessary, but we figured it was worth it for at least one of us to have it. That way, our kids could avoid long lines and the hassle of removing shoes and jackets or unpacking their laptops and iPads.
How to Get TSA Pre-Check
Complete a form online and schedule an appointment locally for fingerprinting, ID verification and to complete your application.
After applying, there's a waiting period for approval. The wait varies. Mine took just a few days, but it can extend up to 60 days, so it's wise to apply several months ahead of your travel plans. Once approved, you'll receive a Known Traveler Number.
When booking a flight, you can enter your Known Traveler Number so it appears on your boarding pass. We booked our flights before I received my number, but I was able to add it once I received the number.
This was my first experience with TSA Pre-Check, so I'm not sure if all airports do this, but at security, we were given laminated cards to show TSA agents indicating we were TSA Pre-Check passengers, allowing us to keep our shoes on and items in our bags.
We flew out of small airports where the regular lines were as short as the TSA Pre-Check lines, but having TSA Pre-Check still made the process easier by not having to unpack or remove shoes/jackets.
Hidden Disabilities Lanyard
After TSA Pre-Check simplified security for us, we further improved the airport experience for my son by getting him a hidden disability lanyard, adorned with sunflowers and a card stating, “I am autistic with Type 1 Diabetes.” This subtle signal was meant to alert airport staff to his needs, encouraging support and understanding. Originating in the UK, the sunflower lanyard is gaining recognition in the US at various airports and airlines. Although not every person with diabetes may require this, my son's additional needs made it a useful tool for us. It brought him comfort, knowing his challenges were visually communicated, fostering a more accommodating environment. While I wish for a world where empathy is the norm, in busy, security-focused settings, such visual aids can be incredibly beneficial.
Here's the link to the official Hidden Disability Lanyard. However, due to shipping times and costs from overseas, we opted for a similar lanyard from Amazon and created our own cards.
TSA Cares Passenger Support Specialist
We requested a TSA Cares Passenger Support Specialist to ease our security experience, which requires at least 72 hours' notice. The phone service didn't work for me, so I used their online form to explain my children's disabilities and how it might affect our security check. Some airports may coordinate support in advance, but we only received an email with general tips and no in-person assistance at the airport (possible because they were both small airports.) Despite this, since others have had positive experiences, I believe it's worthwhile and plan to request help again for future flights.
Preparing for Flight: Easing Travel Anxiety with a Visual Guide
Even with all this preparation, we knew that navigating airport security was particularly daunting for my son, given his autism and diabetes. To calm his nerves, I made a visual guide filled with pictures detailing every step of the journey——from leaving home, airport check-in, and security, to the flight and getting our rental car. We went over it several times, allowing him to get familiar with the process, voice any concerns and ask any questions. This helped ease his anxiety and boost his confidence. Spoiler: It went great! And he was so proud of himself afterward!
Packing Tips for Flying with Type 1 Diabetes
Pack extra diabetes supplies for the trip!
This is the most important tip! Obviously, you want to make sure that you have enough supplies for the entire time you will be traveling, but you also want to have backups of everything! Unexpected issues can arise—like insulin spoiling, CGM malfunctions, or pump errors—so being over-prepared is crucial. And if you’re in a bind, don't hesitate to seek support from diabetes communities online, like diabetic Facebook groups or the Juicebox Podcast Facebook community. They're great resources for assistance and advice. Remember, it's better to have it and not need it than to need it and not have it.
How to keep backup insulin cold while traveling
I like to store backup insulin in a Yeti Rambler bottle* with ice packs to keep it cold during the flight. In a 36 oz bottle, I was able to fit 3 unopened vials + 3 pens + ice packs (I cut these ice packs into strips and just used a couple strips). Some prefer to use a Frio Cooling Wallet* since its super compact, lightweight and can keep insulin cool for a long time.
Always pack diabetes supplies in your carry-on or personal item!
This keeps your supplies safe in the cabin's stable conditions and avoids the risk of losing them if your luggage is misplaced.
Precautions for Full Flights
If overhead bins are full, your carry-on may need to be checked. To avoid this with medical supplies, we made sure all our diabetes supplies fit in our personal items—we each brought a backpack that fit under the seat. (This is the backpack I used and my kids each used one of these.) If you do pack them in your carry-on or a separate medical supply bag, it’s a good idea to make sure they’re clearly marked (maybe with tags like these*), to help you explain to the flight crew that they can’t go in the cargo area.
Organization is Key
Organize supplies in a way that's easy to access and review, especially for TSA checks. Consider keeping supplies in original packaging and carry a letter from your endo as well as prescriptions for verification.
Packing for highs + lows
I packed two juice boxes in a small ziplock bag for quick carbs during the flight or at the airport, despite being above the TSA liquid limit, as they're allowed for medical reasons. In a lunch box, I packed other low snacks like organic gummy bears* and Bear dried fruit rolls* along with protein containing snacks (to sustain his blood sugar after lows) such as GoGo squeeZ Yogurtz* pouches (4 grams of protein and they don’t need to be refrigerated) and our favorite regular snacks too.
For highs, I made sure we had ketone test strips with us, and I brought an empty Yeti water bottle* that we filled with water after we got through security.
Medical ID Bracelets
To prepare for any potential emergencies, I made sure both boys wore their medical ID bracelets throughout our trip.
Tech Preparedness
I fully charged all our electronic devices and packed a power bank if we needed to recharge my son’s phone for blood sugar readings or his insulin pump, especially if there were flight delays and no available charging stations. Luckily, we didn't need it during the flight, but it was essential for the rest of our trip.
Tips for Getting Through Airport Security with Type 1 Diabetes
Communicating with TSA
I verbally-informed TSA agents directly about my son's medical devices that can't be scanned and let them know that he is autistic and needs to stay close to me at all times. For a quieter approach, TSA provides a card to explain your situation. Dressing my son in shorts and short sleeves made his devices visible for easy inspection. TSA Pre-Check simplified the process further, allowing us to keep our shoes and jackets on.
Handling Diabetes Equipment
Special items like some CGM sensors and pump equipment can't go through scanners. Initially, I gave them the entire bag containing all diabetes supplies for hand inspection, which was very time-consuming and kind of a fiasco. Next time, I’ll only have them hand-check the non-scannable items and put the rest through the scanner.
Metal detectors + scanners
Since my son's devices can't pass through metal detectors or the full-body scanners, they led him through a side gate next to the metal detector, where he waited close by for me and my youngest to pass through. Since he’s under 12, they didn’t do a pat down. Instead, they tested our hands for bomb residue.
Strategies for Managing Diabetes In-Flight and Post-Landing Care
We selected our seats online long before the flight, to ensure I’d be right next to the boys, with my husband close by. Throughout the flight, I kept his small diabetes kit on my lap, so I could easily check his blood sugar or give quick carbs if needed.
Even in airplane mode, the Dexcom app continued to provide blood sugar readings, but my Follow app, which gives me a copy of his readings on my phone, can’t operate without data or wifi. So, I relied on his devices directly to keep tabs on his blood sugar.
From the Juice Box Podcast, I learned air pressure might affect insulin delivery. For those with tubed pumps, disconnecting during takeoff and landing is advised, but that's not an option for his Omnipod. Aware that pressure changes could unexpectedly increase insulin delivery (it’s rare, but can happen) I kept his sugar levels slightly higher and had plenty of snacks ready.
Some parents of young children that are very sensitive to small boluses of insulin, choose to remove the pod for flights and use an insulin pen in-flight, but my son hates shots and is less affected by minor dosage changes, so we kept his on.
We noticed his blood sugar tended to rise too high during the flight, which is common, so we'll adjust our strategy next time to try to avoid that. I’ve heard it’s common to go low after the flight while walking through the airport and baggage claim. But, since my son was so high at the end of the flight, that wasn’t an issue for us and we were trying to bring his blood sugar back down.
Navigating Diabetes Management While Traveling
Now, while the focus of the episode is flying with diabetes, I also want to briefly touch on managing diabetes once you’ve reached your destination.
Avoid the Hotel Mini-Fridge
Thankfully, our Airbnb had a full-size fridge where we stored extra insulin, which is more reliable than the hotel mini-fridge, which are notorious for freezing insulin. On past vacations, when we only had a hotel mini-fridge, we kept the insulin in the Yeti bottle and kept refilling the ice. And if you can get a thermometer to keep with your insulin to monitor temperatures, even better!
Be Prepared to Adjust Your Insulin Dose
We’ve learned that my son doesn’t eat as much while traveling, so we have to adjust his pump settings to prevent lows. I typically set his target blood sugar a little higher and dial back a bit on the carb ratios.
It’s a Learning Experience
But don't think we've got it all figured out! This was our first trip navigating diabetes in the cold and since we live in a super warm climate, there was a learning curve.
We were in Utah for my sister’s wedding and it was an exceptionally cold and windy day. My son was out in the bitter cold for a while for pictures. After the group shots, I sent him to the car to warm up and he ate some snacks while waiting for me. I tried to guess the carb count, but wasn't sure what he ate.
The combination of those uncovered carbs, the extreme cold, and the stress of the day caused a giant spike in his blood sugar. Between his high blood sugar and the aftermath of my other son's meltdown (iykyk), we ended up missing the wedding luncheon entirely.
It was a tough lesson in the delicate balance of managing diabetes against the backdrop of cold weather, autism, stress, and the chaos of a big event. But thankfully, we were able to bring his blood sugar back down safely and make it to the other events that day. And my sister looked so beautiful and happy.
Managing Diabetes in the Cold
For the most part, though, we managed okay in the cold. We kept his pump pod protected under his clothes to prevent it from getting too cold. We carried insulin with us in an insulated bag, keeping it from getting too cold.
Clear Skies Ahead: Navigating Travel with Diabetes
The skies are wide open, even with Type One Diabetes as your constant travel companion. Today we've discussed preparation, packing, airport security, flying and settling in at your destination, all with diabetes in tow. It's my hope that these insights and stories will help you travel smoothly and confidently.
If there's one thing my family's experience has taught me, it's that diabetes doesn't have to clip your wings. Yes, it requires extra planning and a bit of learning on the fly, but the world is still yours to explore.
So whether you're embarking on your first flight post diagnosis or you're a seasoned traveler looking to refine your routine, here's to clear skies and smooth landings ahead.
Let’s Connect
Thanks for tuning in today as I discussed flying with Type 1 Diabetes.
I’d love to hear from you! If you’re traveling with diabetes for the first time, I’d love to hear how it goes! And if you’ve traveled before, I’d love to hear what you’ve learned from traveling with Type 1 Diabetes. You can send me a DM on Instagram at @maybethiswillbethecure.
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Disclaimer: The information shared in this podcast & the show notes is for informational purposes only and is not a substitute for professional medical advice. Consult your physician before making any changes to your health plan. The host, Megan, is not a healthcare provider. Always seek guidance from a qualified health professional for your individual needs.