The ripple
effects of September 11th and subsequent acts of attempted terrorism continue
to affect travelers as airports implement tighter security procedures and
passengers are subjected to longer lines, frequent delays, rigorous screening
and new airport policies.
For the person
with diabetes, the new traveling environment can be an especially concerning
place, where insulin syringes and lancing devices (used to measure blood
sugar levels) could now be considered dangerous weapons and where unpredictable
waits and delays could lead to dangerously high or low blood sugars.
Dr. Robin Goland, noted authority on diabetes and co-director of the Naomi
Berrie Diabetes Center (www.nbdiabetes.org) at Columbia-Presbyterian Medical
Center in New York, offers suggestions and advice for travelers who have
diabetes.
Preparing to
Take Diabetes Medications and Supplies through Security
Because of concerns
about forgery, airline security officials are no longer accepting prescriptions
or letters from doctors stating you have diabetes and therefore need certain
medical supplies, such as insulin syringes or lancets. Airlines are
asking that passengers with diabetes bring all medicines and supplies in
original pharmacy packaging with pre-printed labels. It is a good
idea to begin saving all original packaging so that you'll be prepared
when it's time to travel.
Insulin vials
and pens may pose some specific problems since the pharmacy label is usually
on the box rather than the vial or pen.
Hang onto the
original boxes so you'll have them when taking insulin through the security
checkpoints. Lancets should be kept capped and be prepared to show
that you use them for glucose monitoring by showing the glucose meter to
the security personnel. In addition, you may have to demonstrate
the manufacturer's brand printed on your glucose meter matches the brand
of your glucose test strips. Insulin pump users should be prepared
to answer questions from security officials about the pump and demonstrate
how it works. With airport security at heightened state of vigilance,
being as patient and informative with security officials as possible will
help expedite the screening process.
Even with the
best planning, problems may arise. For issues which cannot be resolved,
such as not being allowed to board a flight because of questions about
your diabetes medications or supplies, you should ask to speak with the
airline's Complaint Resolution Officer so that your travel can proceed.
Be aware that
the rules may change daily. Calling ahead is essential. The
Federal Aviation Administration (FAA) advises all passengers to contact
their airline carrier at least one day in advance of the flight to learn
of the airline’s policy towards diabetes medication and supplies.
Packing for
the Trip
Be aware of
the limit on carry-on baggage. Be sure to pack all medicine, supplies and
food you'll need during the flight in your carry-on bag to bring on board
with you. Always bring enough medications and supplies for 2 days in case
unanticipated delays occur or your checked bags are lost.
Do not pack
your medicine and supplies in your checked luggage, no matter how short
the flight, as you may need them while in the air. Make sure your glucose
meter, lancets and medications are easily accessible. If you use
an insulin pump, make sure you have back-up supplies in your carry-on bag.
Always carry
identification, such as a wallet card, bracelet or necklace that indicates
you have diabetes; this is essential in case of an emergency. Also
be sure to have a card with names and numbers of your doctors, nurse educator,
and pharmacy in case you need help or extra medications and supplies while
you are away.
Checking in
for your Flight
Airlines are
advising passengers to arrive at the airport two hours before a domestic
flight. The longer security checkpoint lines and ticket counter delays
can have a major impact on people with diabetes who may need to eat at
specific intervals or at specific times in relation to medications.
Dr. Goland advises patients to consider the following while waiting at
the airport: Due to extra-long waits and unanticipated delays which
may accompany air travel, always carry plenty of snacks such as crackers,
pretzels, fruit and juice with you at all times. When at the security checkpoint,
be prepared to allow officials to search through your food. The security
guard may ask you to take a sip of your juice or bottled water.
In-Flight
With airlines
cutting costs and re-allocating money in different areas, in-flight meals
are becoming a common casualty. Most carriers offering domestic routes
less than three hours have already eliminated on-board meals. For someone
with diabetes, eating during the flight may be a necessity and proper arrangements
must be made in advance. Call your carrier ahead of time and ask
about in flight meals. If no meal is offered, you should plan ahead
and prepare a meal or snack. Many airlines will heat food for you;
ask the flight attendants prior to departure.
Exercise is
a part of the treatment plan for most patients with diabetes. Walking
around the airline terminal rather than sitting during long delays is recommended.
International
Flights
Increased security
means longer customs and immigration lines for international flights.
Again, plan ahead by having snacks and juice available as well as your
medications and glucose monitoring equipment. Always carry an extra
supply of syringes, insulin and insulin pump equipment if you use an insulin
pump in your carry-on and safely pack a back up set of supplies in your
checked luggage.
Speak to your
diabetes care team about how to adjust your diabetes medications when changing
time zones.
The world has
changed since September 11th, and traveling, particularly by air, has been
especially affected. However, with some advance preparation, the
delays and longer waits will not have a major detrimental effect on the
traveler with diabetes.
Considerations
for Travelers with Diabetes
1. Have all
prescription items in original pharmacy packaging including syringes or
lancets.
2. Be prepared
to answer questions about your insulin pump, if you use one, and be ready
to demonstrate how it works
3. Call your
airline at least one day in advance to learn of their policy toward diabetes
medication
4. Always carry
your medical supplies in your carry-on luggage with a back-up set in your
checked luggage
5. Always carry
medical I.D. verifying you have diabetes and an emergency phone numbers
list with names of all diabetes care team members
6. Keep plenty
of nutritious snacks and beverages handy for long terminal waits and flights
7. Be prepared
to provide and carry on your own in-flight meal
8. During long
terminal delays, walk around the airport
9. Talk to your
diabetes care team about how to adjust your medication when changing time
zones
10. Anticipating
delays and preparing for them adequately will help you have a better travel
experience.
The Naomi Berrie
Diabetes Center at Columbia-Presbyterian combines family-oriented patient
care and education with the most advanced diabetes treatment available
and innovative research programs.
The Center hosts
a world-class team of adult and pediatric diabetes experts in endocrinology,
ophthalmology, nutrition and family therapy. Its BD Family Learning
Center helps patients and families manage diabetes using an interactive
education wall with a range of multimedia equipment, exhibits and printed
materials; its children’s program integrates humor and fun into diabetes
education and lifestyle management.
The Center (www.nbdiabetes.org)
is located at Columbia-Presbyterian Medical Center in New York City.
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Information Provided By
The Naomi Berrie Diabetes Center at Columbia-presbyterian Medical Center
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