Flying with type one

(annab_0709) #1

I was diagnosed with t1d about a year ago, I will be flying for the first time this Saturday. Does anyone have any tips, advice, or anything I need to know? I wear an omnipod and dexcom CGM.

(patel41480) #2

Keep your meds with you. I usually pack my stuff in a larger purse. Keep extra food/candy with you, just to be on the safe side. If you’re flying to a different time zones figure out the best way with your meals/snacks. It may be wise to get a official document from your Dr. stating that you have T1D and that you need these meds–if you have time.

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(Patrick) #3

Monitor your blood sugar closely. There is some research showing the change in cabin pressure can cause overdosing from the pump. I, personally, have not had many issues, and I have been flying while wearing a pump for 17 years. @patel41480 is right, it sometimes helps to get a doctor’s note, and keep your meds in your carry-on. DO NOT go through the “body scan” machines. Ask TSA for an alternative screening while explaining that you wear an insulin pump. The pumps can be affected by the Scanners and X-Ray machines. You will be fine walking through a metal detector, though. Just tell the TSA agent that you are wearing an insulin pump. They are trained to handle that and screen you appropriately.

Safe travels!

(Dennis J. Dacey, pwD) #4

Hi @annab_0709, I would recommend that at the least, you suspend pump operations when taking off and landing. I’ve flown many times without turning off or disconnecting my pump and on a few occasions have had to treat a severe low while in the air; my pumps have all used tubing.

On my last four air flights I suspended my pump and physically disconnected and my BG levels stayed steady - it may have been just coincidence. If you van suspend and/or disconnect readily I’d recommend doing that; the old “ounce of prevention” thing.

I traveled with all my supplies in my carry-on, including three 6 oz. juice boxes, all permitted by rule for a person with T1D - the key words for TSA, “medical necessity”. before traveling, visit web sites, diabetes.org [American Diabetes Association] and print out the travel rehs and pack that page with your supplies. Specifically, print "exception 3-1-1.

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(Suzy W) #5

I fly all the time for work. Drinking a lot of water before and during the flight helps keep B.S. levels steady. I tend to run high on flights, especially longer flights over 2 hours. When you go thru security hand the agent anything you don’t want to be scanned, like your CGM receiver and pump, you said you wear the omni so no worries on that, and ask for a hand check. They will know what that means. You can use the xray but not the full body scanner. Don’t be afraid to speak up if the TSA folks get snippy, I’ve had to raise my voice and complain on several occasions with them. And i always buy water and bring nuts, jerky and cheese sticks to bring with me on the flight.

(lepley) #6

Like the others have said, carry on everything diabetes related. (As a typical rule, I pack double the supplies I would need for the time I am gone.) I have found that the TSA agents in the US are very familiar with diabetes supplies, etc (other countries have been interesting, lol). Before I walk through a detector, I tell the agent that I am a diabetic and am wearing a pump and where it is, such as my right pocket. They will then manually scan you and wipe your hands with a cloth to check for any illegal residue. After that, you are on your way.

I have not had any trouble with my insulin pump overdosing while flying. It’s interesting to read your stories about that though.

(Nancy) #7

As everyone else has said, flying while pumping is safe and easy. I’ve flown across the country, overseas, and to the Caribbean. My advice is to only reset basal times if you are going more than three time zones from home, and then only after you land. My basal rates are set to my biorhythms along with when I’m active, so when in France, I’ll be sightseeing when I’m normally getting ready for bed and I don’t need as much insulin. If you’re only going a zone or two, its not worth changing since you’re vacationing and more likely to sleep later, etc.

P.s., I wear my pump in my bra so the whole body scanner doesn’t see it, thereby skipping the whole swabbing for explosives performance. A tsa agent told me about that trick!

Happy travels!

(Lisa) #8

Hello Anna 0709, I’ve been T1D for 43yrs. Diagnosed aged 7. I’m well controlled using Omnipod for 5/6yrs. Despite odd glitches, I love being an Omnipod user. In the last yr however, I’ve weird experiences whilst flying, & I fly a lot. It’s not each flight, or specific flight duration. 1 section of the 7 of 10 r/trips in the last yr have results in 20’s BS range (7 of 20 flights) 3 just said LOW which resulted in unconsciousness. My BS were perfect before take off, and went downhill from there. I’m currently discussing options with Insulet the providers of Omnipod to find out what to do, since scenario of unplugging tube is not appropriate with pods, suspending mightn’t make a difference if insulin delivered by force which is suggested and what I think is happening. Think it depends on flight path/ascent, descent/ pressure etc. Really freaking me out I must confess, along with Rene on United who I scared to bits. Ask stewards to wake you so you can check BS regularly. Hope your flight was good, even though it was some time ago now. I’ll follow up if Insulet give recommendations for Omnipod users…

(joe) #9

Hello @LisaGiles, am I reading this correct: you’ve passed out from a low while flying in an airplane 3 times? May I ask what happened next or how you regained consciousness?

(Dennis J. Dacey, pwD) #10

Hi Lisa @LisaGiles, that is horrible… You are doing the right thing talking with Insulet; I hope that you provided the type of aircraft and the flight number so Insulet’s investigation, which must be shared with government agencies, can be more meaningful. I’ve had experiences where my BG has dropped while in-flight but never to the point of passing out - and we DO NOT need permission from flight attendants to do a BG Check.
Unlike you and your OmniPod, after experiencing drops in BG I have developed the practice of suspending and disconnecting my pump during takeoff and landing.

(Lisa) #11

Joe/Dennis, on two of these occasions, I was traveling with my husband. 1st time was short flight, he realized before descent and f/ attd gave him cartons of orange juice. I was wearing most of it by the time I was semi conscious, when you can see stuff but can’t move/ talk and everything is muddled in your brain. With long delays of an available gate, allowing everyone else to disembark 1st, husband got our sons to carry our bags, walking discreetly close whilst he held me on his shoes(like you would a little girl dancing). A wheelchair waiting by door. W/chair couldn’t fit In aisle, as stretcher could mean off to hospital! 2nd was late night flight, everyone was groggy and I was completely zoned out. I collapsed as we got off the plane, paramedics were called. They gave glucagon and waited til BS was over 75. It took over an hr. This was work & though colleague gave me OJ, I was too far gone, again wearing most of OJ. Paramedics at Newark brilliant! 3rd was last wk, and same as the 1st. No glucagon but Oj, but it’s not fast enough and tricky when your unconscious to give enough for adsorption. Seated by exit doors last wk, my husband picked me up and straight into w/chair. Maybe 2.5 hrs before ok. Traveling with glucagon always from now on and wearing black or orange! I keep boarding passes, so have passed all that info on, hoping Insulet can make sense if it. The Imnipod pump is tubeless & can be suspended, not disconnected. If a pressure scenario that forces unnecessary insulin, I’m not sure suspend helps. I’ll wait to hear what they say. Flying next wk, so will suspend for duration of flight & be super vigilant with BS and see. Would appear all pump co. say it’s not possible. Note to self, always have a glucagon to hand! Thank you for asking, there’s not much about these things happening, as searched a lot before I found this thread.

(Dennis J. Dacey, pwD) #12

You have the right approach Lisa @LisaGiles. Be proactive. Have what is necessary right at hand at all times, not only during air flights; such as:

  • Glucagon in your “at hand” bag or pouch - I have a camera bag on my belt;
  • Be proactive with your pump profiles/patterns. I plan to begin my gym workout at about 2:00 PM so this morning I switched to my “PM-Active” profile which reduces my basal to 50% at 9:30 ans to 0 [zero] units per hour from 11:15 AM until 5:15 PM - my 5:15 PM until 8:30 PM is 50% of my normal. We are all different and this helps me avoid hypoglycemia - it may or may not work for you.
  • When out and about on my bike or traveling [by air especially], I always have at least three 6 oz. juice boxes, two granola bars and two packages of crackers & PB in my bike gag / flight carry on bag. Yes you can have those supplies with you and carry through FDA check-points.
  • Be proactive in checking your BG, charting and writing down each check with the time. Observe patterns and learn to make prophylactic changes. For instance, on my PM-Active profile, my lunch-time carb rate provides less insulin than it would on a “Quiet” day.

Of course, another alternative for you could be to find alternate transportation modes while you are learning to maintain your insulin regimen.

(Lisa) #13

Thank you Dennis, I’ll be checking manual to see if my pdm has this option and scheduled an appt tomoro to discuss with dr. I rarely have very low BS as use temp basal settings when doing added ex, however I use temp basal when exercising such workouts, ski, swim etc. I’m very active. Issues are primarily when I fly, and maybe more extreme since I’ve a tighter control in last 2 yrs? Unfortunately Insulet are a little dismissive, though thanks to your post, I have today requested investigations be taken to higher level for discussion. I was also unaware that Oj was permitted as a medical necessity as was told after 9/11, not permissible. I’ve never questioned that statement, but will in future cite medical necessity. I can’t thank you enough for your advice.

(Cathleen) #14

@LisaGiles I am sorry to hear about your experience with flying and the omnipod and glad you are ok! Thank you for sharing with the forum. We are looking into this pump for my daughter and this travel concern really could be a deal breaker. It sounds like you enjoy the benefits of the pod enough to keep it, despite being a frequent flyer. Do you know of others who have had difficulties with omnipod and air travel? Please let us know how your trip next week goes and if you find any solutions.

@annab_0709 I know your trip was back in 11/17, but hope it went well!

(joe) #15

@LisaGiles Lisa, please take the time to report this as an adverse reaction to the US FDA. here: https://www.fda.gov/safety/medwatch/howtoreport/ucm053074.htm

Insulet HAS to respond to a report of adverse reaction what you are saying is very serious and very troubling.

Sorry I took time, but I was flying home from Ireland last night. While my reservoir could possibly be affected by changes in cabin pressure…(by looking at the reservoir and applying physics - it is possible that a change in pressure could either push applying higher ambient pressure, or pull, applying lower ambient pressure to the static environment -= this is very unlikely. Also I don’t have a pod but a reservoir with a plunger is a reservoir with a plunger.)

I have never had an issue with low blood sugar in hundreds of flights, in fact, I these days am increasing to 150% of normal basal for the duration of my flights due to prolonged high blood sugar, to which I have guesses is the lack of exercise and the increased stress of flying - but could maybe be from watching movies and eating and drinking a lot!

This could be one of these “everybody is different” issues as well. Don’t underestimate what stress can do to you and your blood sugar control.

This is also easily resolved by taking a pump holiday when you fly. Switching back to shots will likely resolve the question of “is it the pump or is it me”?

Since it is a great idea to bring syringes/pens with you as emergency backup for pod failure or if you run out of pods or other pod emergencies… you could simply not have a pod in you on the plane. This will also make TSA an easier experience for you.

good luck, whatever you decide to do.

(Dennis J. Dacey, pwD) #16

Hi Lisa @LisaGiles, I meant to get this link to you last week but didn’t think about it until I began packing my bags this morning.

Here is the Homeland Security / TSA official, and current, advice for air-traveling people with medical conditions. In the middle of the page is a “drop-down selection” menu; selected is “Medications” and visible is Rule 3-1-1 regarding liquids. Also available in the selection menu are CGM, pumps, etc.
https://www.tsa.gov/travel/special-procedures?field_disability_type_value=1%20

The link opens at the General Instruction page which emphasizes that the traveler inform the gate agent - I strongly recommend that you speak first and do not wait until you are asked or denied.

(Lisa) #17

Thanks you for the link Dennis, i have printed the card and will use for future travel. Demonstrates that though being diabetic for 43 yrs (since 7, and think I’m a know it all), there are unknown aids to help if you reach out.
I’ve spoken to Insulet several times, initially the person i spoke with said they were unaware of any issues of low BS with Omnipod users when flying. When i refused to be dismissed, i was told “Senior Management” are aware Low BS reports whilst flying. Followed by "they are unable to investigate due to many variables such as each persons height, weight etc, then flight info. I gave my flight info, etc but honestly felt they were not listening or interested! It was exasperating to be honest.
I will be flying again shortly, and my Doc has advise, though he’s is not sure it’ll work as using a tubeless system.
Have you any thoughts on how i should push Insulet for accountability and to investigate, possibly enabling Insulet to improve the Omnipod system? Like an Airplane mode for example??
I love the Omnipod and do not wish to change to a tubed system. I feel this will be very useful as people opt into pumps in the future.
Happy safe travels.

(Jay) #18

Looks like you have a bunch of answers. But, one thing you should know is you are allowed to take drinks through TSA, just tell them your diabetic and they will swab it and let you through. Usually only takes like 5 mins extra.

I have found just put them separate from bags is quicker. If they see drinks in any bag, they will have to investigate the entire bag contents. So If you scan them separate on their own it could eliminate the bag check.

(Lisa) #19

Thanks Joe, I’ll follow up FDA link. When I fly next wk, will seriously monitor suspension, see if that works. It’s tough to remove pod as they last 3 days, 1 have an additional 8 hrs to change as that how my pdm is set up. If I removed pod each flight, i’d use pods quicker than prescription allows. I get longer as push til the pods expires.
I’ll be following up with Insulet to get a reference number for my adverse effects notification.
As you say, our bodies are incredible, no one size fits all! I’ve found when traveling to Uk (where I’m from originally so travel there & Europe a lot) before using pods, blood would take 48 to settle into time zone changes. Could your issues be the timing your insulin is set to be released into your body? Ie if your normally active, when flying your insulin:carb ratio is higher as not on the go? I believe that is what your adjusting, some pumps have presets to can create. Know Ireland is a tough transition, as only 5hr flight!
And maybe I might consider a pump holiday too!

(Lisa) #20

Thanks Jay, until read this thread, I had no idea. Thanks to everyone’s advice, I know better. I’m adopting this as my travel norm and looking into European rules as often heading in that direction! Silly really, I never considered it a big deal, until now. That’s what happens when you’re diagnosed young in a huge family, it’s becomes the norm! Haha