A lot of things are needed to manage type 1 diabetes and prepare for the unexpected highs and lows and equipment malfunctions. Pharmacies are not available at 30,000 feet, so as a flight attendant who is away from home three nights a week, I always have to be prepared.
1. Travel sharps container - Sharps containers are near impossible to come by in public restrooms and they are nonexistent in hotels, so I make sure to carry my own while traveling. When I was using multiple daily injections (MDI), I ordered a set of these handy containers from Amazon. The labeling allows for a hassle-free trip through TSA and the lid seals and locks for quick and safe disposal, once the tube is full.
2. Insulin pens (long and fast acting) - In the unfortunate event my insulin pump (and back ups) fail to deliver insulin or sync with the PDM, I resort to MDI (this actually happened to me while on a trip in NYC). Added bonus carrying pens as my back up: if my vial of insulin is faulty or the pharmacy won't refill my Rx yet, I can use a syringe needle to extract the insulin from the pen to fill my pump.
3. Pen needles - Unfortunately, insulin must be injected, so when using MDI, I need the pen needles to get the insulin into my system. My first box of needles out of the hospital seemed like monsters compared to these guys. I jumped for joy when I read "4mm x 32G" on the box of the next order!
4. Alcohol swabs - Before injecting insulin or inserting a device, I have to ensure my skin is clean. Alcohol swabs are a good way to ensure that if you do not have access to soap and water.
5. Glucose tablets/gel - Hypos are no joke. I don't know about you, but when I have a hypo episode, depending on its severity, I get shaky, sweaty and unstable. Having fast-acting glucose is a must. Although not my favorite low BG treatment (I prefer Peach O's), I carry glucose tablets and/or gel in the event I need it.
6. Continuous Glucose Monitor (CGM) - I love my Dexcom G6 CGM and I always carry a spare with me. Sometimes I know I am scheduled for a site change during my trip, other times I carry it just in case something goes wrong and it fails for any reason.
7. Insulin pods - I use the Omnipod DASH tubeless insulin system. I have to change my site every 3 days, so I ensure I carry enough pods for any scheduled site changes and a couple extras (depending on the duration of my trip).
8. Adhesive remover wipes - Some sensors and pods come off so easily. Others are stubborn and take every tiny hair on your body with it, but still manage to leave the adhesive behind. I ordered these off Amazon to help ease the pain of removing a patch and to get off the excess adhesive afterwards.
9. Blood glucose meter - As great as the CGM is, like all technology, it has its pitfalls. The CGM can fail or need calibration. In those instances, I need to fingerstick to check my blood glucose levels. A diabetic cannot make informed decisions on management without knowing their blood sugar. I also use the meter when my CGM reading does not match how I am feeling. I never want to mistreat for an inaccurate high or low reading.
10. Glucagon - In the event of a severe hypoglycemic episode, I carry glucagon. I chose Baqsimi because it is an easily administered nasal powder. To administer a glucagon injection, yourself and a caregiver have to undergo training to learn how to mix and inject the solution. As a flight attendant, my caregiver is not always with me and I do not have time to train everyone I come into contact with, so I took a more user-friendly approach to playing it safe.
11. Vial insulin - Typically, I use vial insulin in my insulin pump. Vials hold more insulin than pens and are much easier to extract from. If I didn't hate needles so much, I probably would have requested a prescription for syringe needles to have all my insulin in vials, but I am a wuss (hence, pens are my back up).
12. Doctor's note - When I go through airport security, I have my supply kit hand-checked as the tech I use is not recommended to be put through the x-ray machine. When travelling for personal travel (aka not in uniform), I have to opt-out of the body scanner for the same reason. I carry a note from my endocrinologist that states I am a type 1 diabetic, I wear medical devices and that I carry supplies with me at all times. Typically, I do not get any push-back from TSA (except when we went to Barcelona, but don't get me started on that today), but in the event they need more proof, I have it with me.
13. Medical information - In addition to my doctor's note, I carry a print out of my medical information, including but not limited to: name and DOB, allergies, current medications, treatment (devices and doses), emergency contacts, and a copy of my insurance card.
When on a trip I let the people I am working or travelling with know I am a type 1 diabetic. I inform them I wear a CGM and insulin pump and where I keep my supply kit and medical information. I never want to scare them, but I want them to be informed, in the unlikely and unfortunate event that something does happen to me. It is always better to be over-prepared than under-prepared, especially as a type 1 diabetic. So yes, in addition to the suitcase, lunch cooler and tote I typically carry, this supply kit comes too!
Pro tip: When travelling, always carry your supply kit with you. You never know when your suitcase will go missing or you have an unexpected high or low in-flight. Keep your supplies handy. Airlines cannot require you to check your medical supplies. An announcement is actually made advising you to remove your medical supplies/equipment from your bags before checking them.
The information contained in this blog is a compilation of thoughts, opinions, and personal experience. Information is researched and gathered from reputable sources, but Ice Cream and Insulin is not responsible for errors or omissions in reporting or explanation. The discussions should not be considered advice, medical or otherwise. If you have concerns about your health, the information should not be used to self-diagnose or self-treat. Please consult a physician before making any changes to your medical plan.