I've Traveled to 40 Countries with Insulin — Here's the Worst Advice I Ever Got

I've been Type 1 diabetic for years. I've injected insulin on the side of a road in Guatemala, inside a moving sleeper train in Vietnam, on a rickety ferry between Greek islands, and once — memorably — in a bathroom stall at JFK that smelled strongly of ambition and regret. I have taken my insulin to roughly forty countries across five continents.

And in that time, I have received some truly spectacular advice.

Not bad advice in a mean-spirited way. Most of it came from people who genuinely cared — well-meaning family members, fellow passengers, strangers who spotted my insulin pen or the CGM on my arm and felt compelled to share their wisdom.

But some of it was so spectacularly wrong that, looking back, I'm almost impressed.

So here, in no particular order, is the worst travel advice I've ever received about traveling with insulin — and what I actually do instead.

"Just stick your insulin in the hotel mini-fridge. You'll be fine."

Ah, the hotel mini-fridge. That miraculous little appliance stocked with $12 candy bars and lukewarm sparkling water. Here's what nobody tells you: the temperature inside those things is genuinely a mystery.

They're built to keep sodas vaguely chilled, not to maintain the 36°F–46°F that unopened insulin requires for proper storage. I've opened one that was essentially a warm cabinet with a light inside.

Handing your entire insulin supply over to a hotel mini-fridge is a little like trusting your 401(k) to a slot machine. Optimistic. Unlikely to end well.

✅ What I do instead: I travel with a dedicated insulin cooler built specifically for the job — one that holds a consistent, safe temperature whether I'm in a luxury hotel or a guesthouse with questionable wiring. The mini-fridge keeps the sparkling water. My insulin has its own cooler.

"You don't need a doctor's letter. TSA never actually checks medication."

Sometimes that's true. I've been waved through airport security without a second glance more times than I can count.

But I've also been pulled aside at a security lane for twenty minutes while two officers examined my insulin pens and had an extended conversation I couldn't follow. I've had my insulin cooler opened, inspected, questioned, and photographed.

A letter from your doctor costs nothing and takes maybe ten minutes to request. It has saved me enormous amounts of stress — especially when traveling internationally to countries where TSA-style agents may not be familiar with insulin pumps or CGMs.

The ADA (American Diabetes Association) recommends carrying documentation of your diagnosis and medications whenever you travel — and for good reason.

✅ What I do instead: Before every trip, I get a signed diabetes travel letter from my doctor confirming my diagnosis and listing everything I carry. I keep a printed copy in my carry-on next to my passport, and digital copies backed up in my email. I have never once regretted having it. I have absolutely regretted the times I've traveled less prepared.

👉 Our guide on Diabetes Travel Letters explains exactly what yours should include — and has a free downloadable template you can take straight to your doctor before your trip.

"Pack your insulin in checked luggage — the cargo hold stays cooler."

Please don't do this. The cargo hold of a commercial aircraft is not a climate-controlled refrigerator. Temperatures down there can swing dramatically — and at altitude, it can get cold enough to freeze your insulin solid.

Frozen insulin is destroyed insulin. You cannot thaw it and use it. You're left with a very expensive, completely useless pen.

And that's before you factor in the very real possibility of your checked bag getting lost. Your luggage ends up in Phoenix while you're in Portland, and suddenly you're a Type 1 diabetic in an unfamiliar city with no insulin. That scenario is not theoretical. It happens.

The TSA is clear on this: essential medications belong in your carry-on.

✅ What I do instead: My insulin is in my carry-on. Every single time, no exceptions. Along with enough supplies to cover several extra days — because delays are a fact of life, and they tend to happen at the least convenient moments imaginable.

👉 For a full breakdown of what TSA allows at US security checkpoints — including your rights around liquid limits, pump screening, and CGM procedures — our guide on TSA Rules for Diabetic Travelers covers everything before you reach the airport.

"Just ask the flight attendant to keep your insulin in the plane's fridge"

This advice comes from a good place. Unfortunately, most commercial aircraft don't have a passenger-accessible refrigerator at all. The ones that do are generally reserved for crew meals and galley supplies — not passenger medications.

Handing your insulin to a flight attendant to "keep somewhere cool" means your medication is out of your hands, out of your sight, and possibly not being stored at the right temperature.

I tried this once on a long-haul flight. My insulin came back fine. But the expression on the flight attendant's face when I asked for it at landing — that brief flash of "the what now?" — was enough to cure me of that habit permanently.

✅ What I do instead: On long flights, I use 4AllFamily's Pioneer PRO Mini Fridge. It runs on a portable battery pack, keeps my insulin refrigerated for hours, and fits neatly under the seat in front of me. My insulin never leaves my control. Problem solved.

👉 For a complete guide to keeping insulin at the right temperature throughout an entire international journey — from leaving home to arriving at your destination — my guide on How to Keep Insulin Cool When Traveling covers every scenario I've encountered.

"Travel insurance for diabetes is a rip-off. Skip it."

I understand the impulse. Diabetes-specific travel insurance can run meaningfully higher than a standard policy, and when you're already budgeting for flights, hotels, and everything else, it's tempting to look for places to cut.

Here's the thing: the cost of a medical emergency abroad — or even just replacing lost insulin and supplies — can be staggering. I lost a bag containing three insulin pens in Morocco. My insurer covered the replacement. Without coverage, that would have been a very different, very stressful experience.

And if you end up in a hospital in a country without universal healthcare? The bill can be life-altering.

The U.S. State Department recommends travel insurance for all travelers with pre-existing conditions. Diabetes is very much a pre-existing condition.

✅ What I do instead: I always purchase travel insurance that explicitly covers Type 1 diabetes and related emergencies — including lost, stolen, or damaged medication. It costs more than a basic policy. It costs considerably less than a foreign ER visit.

"Once your insulin pen is open, you don't need to keep it refrigerated."

This one is technically partially true, which makes it the most dangerous kind of wrong.

Yes — opened insulin can be kept at room temperature. But only below 77°F, and only for around 28 days, depending on your insulin type and brand.

The "room temperature" you're used to at home in, say, Seattle or Chicago is not the room temperature you'll encounter in Arizona in July, or in a rental car parked in the Florida sun, or in a tent in New Mexico in August.

I've had insulin go cloudy on me during a heat wave. If you've never held up a pen and watched something that should be perfectly clear look vaguely milky and wrong, I hope you never do. It's an unsettling experience — and it means your insulin is no longer safe to use.

Always check the storage guidelines for your specific insulin brand. And don't assume "room temperature" is a universal constant.

✅ What I do instead: Whenever temperatures might climb above 77°F — which covers most of the American South in summer, all of Southeast Asia, the Caribbean, Mexico, and anywhere I'm spending significant time outdoors — my open insulin pens go in a cooling pouch. When in doubt, the cooler comes out.

"Your diabetes routine won't change much when you travel."

Reader, my insulin needs when I travel bear only a passing resemblance to my insulin needs at home on a quiet Tuesday.

There's the time zone disruption, which can require real adjustments to basal insulin timing — ideally discussed with your endocrinologist before you leave.

There's the effect of walking dramatically more than usual (I've hit 25,000 steps on a city trip and been genuinely blindsided by unexpected lows).

There's eating unfamiliar foods at strange hours, the cortisol spike of airports, the altitude on certain destinations, the sheer unpredictability of being somewhere new.

It all affects your blood sugar. All of it.

✅ What I do instead: I pack at least 50% more insulin and supplies than I think I'll need. I check in with my endocrinologist before any significant trip. And I make peace with the fact that my numbers will be less predictable on the road — because that's just travel, and the extra insulin isn't wasted. It's a buffer. It's sanity.

The Only Advice That Actually Matters

After years of traveling with insulin across forty countries and every kind of terrain, here's what I know for certain:

The best travel advice for Type 1 diabetics is almost boringly practical. Because boring is exactly what keeps you safe — and what gives you the freedom to actually enjoy the trip.

• Get the documentation.
• Pack more than you think you need.
• Keep your insulin in your carry-on.
• Invest in a quality insulin cooler.
• Get travel insurance that genuinely covers you.
• Talk to your endocrinologist before you go.
• And familiarize yourself with TSA's guidelines for traveling with diabetes supplies — because a smooth security line is one of life's underrated pleasures.

Everything else? That's just travel.

And travel — even with Type 1 diabetes, even with the planning and the packing lists and the backup pens — is one of the best things in the world.

The insulin comes with me. The bad advice stays home.

💬 We'd Love to Hear From You!

Have you received memorably bad — or surprisingly helpful — travel advice about managing diabetes on the road? 
Drop your story in the comments below.