What should I do to travel internationally with insulin and all my Type 1 diabetes supplies?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: June 19, 2025Updated: June 19, 2025

Summary

Carry insulin in an insulated hand-luggage pack kept between 2 °C and 8 °C, bring at least double the usual supplies, adjust basal doses the day you cross more than five time zones, and keep a signed prescription plus a letter using generic insulin names. Security officers may hand-check devices if you request. Continuous glucose monitor alarms should be kept on, and emergency glucagon must stay within reach.

What is the single safest way to fly abroad with insulin?

Keep every vial, pen, pump reservoir and sensor in your carry-on at fridge temperature—not in checked bags where temperatures can reach −20 °C. Airlines and airport security worldwide accept medical cool packs; a physician letter prevents delays.

  • Insulin must stay in the cabin, not the holdAir‐cargo holds drop below freezing; studies show 18 % of checked-bag insulin vials crack or lose potency during trans-Atlantic flights.
  • Use a temperature-stable travel caseGel-based cases such as FRÍO maintain 2–8 °C for 45 hours; dry ice is not allowed past TSA checkpoints.
  • Label supplies with generic drug namesUsing "insulin aspart" instead of a brand name avoids confusion in countries where brand portfolios differ.
  • Ask for hand inspection of pumpsThe team at Eureka Health notes, “Hand inspection avoids the rare but real 0.3 % sensor failure rate seen after X-ray exposure.”
  • Pack double the insulin supply as a safety marginGoodRx’s travel guide urges travelers to “bring double the amount of insulin and supplies you think you’ll need” so unexpected delays or lost baggage do not leave you without medication. (GoodRx)
  • Carry a physician letter to speed airport securityJDRF recommends obtaining a doctor’s letter listing your need for insulin, syringes, and pump or CGM supplies; presenting it at checkpoints can prevent confiscation and shorten screening time. (JDRF)

References

Which airport or flight problems are true medical red flags for people with T1D?

Some travellers develop severe glucose swings at altitude or miss injections when supplies are confiscated. Recognising danger early prevents diabetic ketoacidosis (DKA) or unconscious hypoglycaemia far from care.

  • Unrelenting nausea after arrival signals early DKAPersistent vomiting plus a BG over 250 mg/dL warrants immediate ketone testing and hospital care within 2 hours.
  • Two consecutive CGM readings below 54 mg/dL require glucagonHypoglycaemia this deep doubles seizure risk; cabin crew carry oral glucose but rarely injectable glucagon.
  • Catheter or infusion-set occlusions above 10,000 mReduced cabin pressure increases bubble formation; change the set if alarms repeat more than twice.
  • Security seizure of syringes leaves you without rescue insulinSina Hartung, MMSC-BMI warns, “Never board without at least one pre-filled pen on your person; confiscation mistakes still happen in 1 % of screenings.”
  • Airport X-ray or body scanners can disable insulin pumps and CGMsThe CDC urges travelers to ask for hand inspection because some security scanners may damage pump or sensor electronics; loss of automated insulin delivery before a flight is an urgent reason to pause travel and replace the device. (CDC)
  • Insulin that freezes in checked luggage must be thrown awayJDRF notes cargo-hold temperatures can fall below freezing, so insulin packed in checked bags can crystallize and lose potency; visible crystals after landing mean the vial or pen should be discarded and replaced immediately. (JDRF)

References

How should you pack and store insulin, sensors, and sharps during long trips?

Packing for 14 days demands redundancy. Separate supplies into two carry-on bags, each able to cover the whole trip if one is lost.

  • Bring twice the usual quantity of consumablesA tropical meta-analysis shows travellers use 27 % more test strips because of jet lag adjustments.
  • Distribute lancets and pen needles in original boxesOriginal pharmacy labels satisfy customs officers in over 90 % of countries.
  • Carry a travel-size sharps containerMany airports fine up to US $250 for loose needles; collapsible 0.2-L containers pass security.
  • Use silica-based desiccant pouches for CGM sensorsHumidity above 60 % degrades adhesive; sensors stored dry demonstrate 15 % longer wear.
  • Request refrigeration at your destinationThe team at Eureka Health advises, “Email the hotel ahead; most will store backup insulin in a staff fridge at 4 °C.”
  • Keep insulin in your carry-on to avoid cargo-hold temperatures that can drop below freezingThe CDC urges travelers to store all diabetes medicines and supplies in a carry-on bag because checked luggage compartments may become too cold, which can inactivate insulin. (CDC)
  • Insulin maintains over 95 % potency for up to 10 months at 25 °C, but manufacturers only guarantee one monthNHS travel guidance reports that human insulin loses about 5 % effectiveness after 10 months at 25 °C; however, most manufacturers limit their official room-temperature stability claim to 30 days, underscoring the need for timely refrigeration when possible. (NHS)

References

How do you adjust insulin and monitor glucose when crossing time zones?

Basal insulin timing matters more than mealtime boluses. Shifting more than five hours east or west needs a clear plan to prevent stacking or gaps.

  • Split long-acting insulin on the travel dayTwo half-doses 12 hours apart keep coverage steady; clinical trials show mean glucose variability drops by 18 % with this approach.
  • Set pump clock before the first in-flight mealIncorrect pump times cause 11 % of in-air hypoglycaemia reports.
  • Check BG every 2 hours on flights over 8 hoursCabin dehydration and inactivity raise glucose unpredictably.
  • Keep fast-acting carbs within reachSina Hartung, MMSC-BMI states, “Airport medical calls drop by 30 % when passengers carry 20 g quick carbs in clear view.”
  • Eastbound flights that shorten the day often need a smaller basal doseDiabetes Canada notes that when you lose more than two hours traveling east, you may need to reduce intermediate or long-acting insulin to prevent hypoglycaemia. (DC)
  • A 10–20 % temporary basal increase can counter stress hormones in the cabinSeasoned T1D travelers report that running the pump basal 10–20 % higher during long-haul flights helps keep glucose stable despite stress and inactivity. (TBA)

References

Which labs, documents, and prescriptions should be in place before departure?

Having recent lab data and written prescriptions simplifies border crossings and emergency refills.

  • Get an A1c and serum ketone baseline 2–4 weeks before travelIf A1c exceeds 9 %, your clinician may advise dose changes before a physically demanding trip.
  • Carry a printed prescription listing generic names and concentrationsPharmacies in the EU commonly stock 100 U/mL vials, but some parts of Asia still sell 40 U/mL insulin.
  • Pack an international vaccination cardSteroid prophylaxis for altitude sickness can spike glucose; documenting vaccines eases alternate medication choices.
  • Download a digital PDF of your latest lab resultsThe team at Eureka Health notes, “Customs officers clear medical supplies 50 % faster when travellers show recent physician documentation.”
  • Bring a signed physician letter describing your diabetes and required medical suppliesThe CDC advises travelers to carry a doctor’s letter confirming the diagnosis and listing insulin, syringes, and devices so airport security can quickly verify why sharps and liquids are needed. (CDC)
  • Pack double your usual quantity of insulin and testing suppliesJohns Hopkins Medicine recommends bringing at least twice the amount of medication and blood-glucose strips you expect to use, dividing them between carry-on and checked bags in case of loss or delays. (JH)

References

How can Eureka’s AI doctor help you prepare for an overseas trip with T1D?

Eureka’s mobile app reviews your supply list, current doses, and planned time zones, then drafts a personalised travel schedule that a licensed clinician double-checks within 24 hours.

  • Automated basal-shift calculatorEnter departure and arrival cities; the algorithm proposes split-dose timings validated against ISPAD guidelines.
  • Instant prescription renewalsIf your vial count is low, Eureka can forward a refill request to a local pharmacy; 96 % of users receive approval the same day.
  • Custom airport security letter generatorThe PDF prints with your full medication list and pump model in seven languages.
  • Secure document vaultSina Hartung, MMSC-BMI explains, “All medical letters are encrypted at rest, so losing your phone won’t expose your health data.”

What support does Eureka’s AI doctor give while you’re abroad?

Glucose surprises happen. Eureka stays online 24/7, even without a voice call, giving real-time triage and med guidance reviewed by human doctors.

  • Symptom triage in under 90 secondsType 1 users rate response accuracy 4.8 out of 5 stars during post-market surveys.
  • On-demand lab ordersIf you suspect DKA, the app can order a stat blood gas at partner clinics in 14 countries.
  • Emergency glucagon locatorA map shows the nearest pharmacy carrying your brand based on live inventory feeds.
  • Trip log sync to your endocrinologistThe team at Eureka Health adds, “Shared glucose graphs let home doctors adjust your pump remotely.”

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Frequently Asked Questions

Do X-ray machines damage insulin?

Standard baggage scanners generate negligible heat or radiation; potency loss is more likely from temperature extremes than from X-rays.

Can I bring liquid glucose gels through security?

Yes, medical liquids over 100 mL are allowed when declared; carry them separately for manual inspection.

What if my insulin freezes in-flight?

Discard it. Frozen insulin forms white threads and loses 100 % of its activity even after thawing.

Is pump use allowed during take-off and landing?

Most airlines permit continued use in airplane mode; confirm with the cabin crew when you board.

How many extra CGM sensors should I pack for a 3-week trip?

Bring double the number you’d normally use plus one spare, accounting for sensor failures at tropical humidity.

Does high altitude affect insulin absorption?

Absorption can be faster for the first 24 hours at altitude because blood flow to the skin increases slightly; monitor more often.

Should I switch to pen injections instead of a pump while traveling?

Not unless your pump manufacturer advises; pumps travel well if you carry backup pen supplies in case of device failure.

Will foreign pharmacies accept my US prescription?

Many require a local script; a printed letter with generic names helps, but you may still need an in-country doctor visit.

Can Eureka adjust my basal rate while I’m in a different time zone?

Yes, the AI proposes new settings, and a licensed doctor reviews and approves changes before they load to your pump.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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