The first time I traveled internationally with T1D, I overpacked insulin and underpacked common sense. The second time, I forgot that insulin needs to stay cold and landed in Rome with a warm, unusable vial. The third time, TSA wanted to inspect every single thing in my diabetes supply bag while the rest of my travel group waited at the gate.
By trip four, I had a system.
Before You Leave: The Checklist
Supplies (always bring 2x what you think you need)
- Insulin: double your expected usage, plus one extra vial as emergency backup
- Pump supplies/pods: extra for the full trip length + 3 days
- CGM sensors and transmitters: same math
- Glucose tablets or gels (minimum 4 doses per day of travel)
- Glucagon kit or Baqsimi nasal spray
- Pump/CGM chargers AND international adapter
- Printed prescription for all medications (in English + translated if possible)
- Letter from your doctor on letterhead explaining your devices and medications
Insurance
- Call your insurer before you travel. Understand your out-of-network coverage.
- Know the address of at least one English-speaking hospital near your accommodations.
- Consider travel insurance that specifically covers pre-existing conditions.
At the Airport
TSA (in the US) does not require you to remove medical devices. You can request a manual pat-down instead of the full-body scanner — this is your right. Insulin pumps and CGMs should not go through the X-ray belt.
Tell the officer you have a medical device before you reach the scanner. Confidently, not apologetically.
In my carry-on, I keep all diabetes supplies in one dedicated bag that I can show them quickly. I have my doctor’s letter on my phone and printed out. I’ve been waved through every time for the past four trips.
Managing Blood Sugar Across Time Zones
This is genuinely complicated, and “here’s what worked for me” is not the same as “here’s what will work for you.” The main things I’ve learned:
East-bound travel (longer day): I tend to run slightly high on eastbound flights. I’ve learned to do a small correction an hour before landing.
West-bound travel (longer day): The opposite — I watch for lows, especially on the plane.
On the plane: Cabin pressure affects CGM accuracy slightly. I do more fingerstick checks than normal on flights over 6 hours.
Jet lag and blood sugar: Sleep disruption genuinely affects insulin sensitivity. Give yourself 48 hours before judging your numbers in a new time zone. They’ll stabilize.
The Thing I Always Pack Last
A sense of humor about the whole thing. Something will go wrong on every trip. A sensor will fail, or a pod will alarm, or you’ll miscalculate a local dish and spend an afternoon dealing with a high. This is fine. This is manageable. This is just T1D in a different country.
Go anyway. The world is too good to miss because of a pancreas.