If you’re about to fly with diabetes for the first time, I bet there are dozens of questions and worries shaking your brain right now.
Stay cool! Thousands of diabetics bring their insulin pumps, CGMs & injectable medicines on board every single day. The Transport and Security Administration (TSA) has made every step easy for diabetics to go through airport security screenings.
Here’s a series of 25 questions & answers about flying with diabetes. It's packed with tips and advice from a fellow Type 1 diabetic traveler!
TSA & Diabetes: What documents should I bring?
Good news: the Transport and Security Administration (TSA) does not require any specific documents to fly with diabetes and diabetic supplies. However, a medical certificate, or at least a TSA notification card, could help speed the process up and avoid misunderstandings with some security agents. If you’re traveling internationally, these documents are highly recommended.
Do I need a medical certificate?
No. TSA does not officially require any medical certificate to bring your diabetic supplies on the plane. However, visible prescription labels for your drugs and your medical devices can help smooth and accelerate the security process.
While not required by TSA agents, bringing a doctor's note that specifically explains your condition and lists all your diabetic devices and medications cannot do wrong. It will most certainly help if you're being attended by a new or a non-compliant security officer.
Do I need a TSA diabetes notification card?
Legally, you don’t need a TSA notification card to fly with diabetic supplies. However, TSA does recommend you fill out a TSA notification card for individuals with disabilities and medical conditions. Again, it can be useful to discreetly inform the agent about your diabetes, as well as to speed the screening process up.
Do I need to show documents to the airline company?
No. The airline company should not require passengers to show any medical documents. However, informing your airline company about your condition may give you the right to substitute your flight meals with diabetes-friendly ones.
What about international travel with diabetic supplies?
Traveling abroad with medicines and medical supplies requires a bit more preplanning and paperwork. Each country has its own rules regarding what medicines are allowed and what medicines should be delivered with medical prescription only. Violating medicine-related laws of your destination country can have serious consequences, ranging from a simple confiscation to severe penalties including imprisonment for international drug trafficking.
Now, diabetic supplies and medicines are widely known around the World. If you’re traveling with no more than what you need for your personal use during the length of your stay, you should be fine anyway.
Still, before your trip, be sure what medicine you're allowed to enter your destination country with, and what documents are required. The Center for Disease Control and Prevention is a good resource to refer to in that matter.
Flying with Diabetic supplies and Injectable Medicines
Air travel with diabetic supplies is very common. Thousands of diabetics are flying every single day from and to American airports. TSA agents are well aware of diabetic supplies and rarely cause problems.
What diabetic supplies can I bring on a plane?
You can bring any diabetic supplies on a plane. Insulin, injection devices, preloaded syringes (used and unused), needles, lancets, blood glucose meters & continuous blood glucose monitors, blood test strips, alcohol swabs, pumps, infusion kits, glucagon emergency kit, urine ketone strips, sharps disposal containers, liquids (juice for hypoglycemia), diabetes medications, pills, and any other injectable medicines (Victoza, Byetta, Ozempic, Trulicity, etc.)
Can you bring unused needles on a plane?
Yes, you can bring unused needles for prefilled injectable insulin pens. Traveling with needles for the injection of prescribed diabetes drugs such as insulin, Victoza, Trulicity, Ozempic, or Byetta is very common.
Can you fly with unused insulin syringes?
Yes, you can fly with insulin syringes, but only if they're accompanied by the medicine they're intended for. You're allowed to take them in your carry-on. Here's what TSA precisely says about traveling with syringes for injectable medicines:
“Unused syringes are allowed when accompanied by injectable medication. You must declare these items to security officers at the checkpoint for inspection. We recommend, but do not require, that your medications be labeled to facilitate the security process.”
What about used needles and syringes?
According to the TSA, used syringes and needles are allowed through airport security checkpoints but should be transported in Sharps disposal containers or “other similar hard-surface containers". If you do not have a Sharps disposal container, you can pack your used needles and syringes in a laundry detergent plastic bottle, or a coffee can for example. It must be a hard surface to prevent the needles from poking through and pricking somebody's fingers.
And diabetes lancets?
Diabetes lancets are sharp objects, but because they are part of your diabetes kit, they are allowed on the plane despite sharps restrictions. They should be capped and carried with your glucose meter.
Can I take liquids and fruit juices on board?
Despite regulations on liquids, as a diabetic you have to right to take juice, liquid nutrition, or glucose gels on board. Inform the security officer that you have diabetes (better if you’ve filled out a TSA notification card, and even better if you have a medical certificate!).
What does TSA say about Flying with insulin & Insulin Pumps?
Can I take insulin on a plane?
Yes, you can take insulin on a plane. Despite regulations prohibiting passengers to take liquids on board, injectable medicines such as insulin, Victoza, Byetta, Ozempic, Glucagon, hormones, EpiPen, and others are allowed even if they are in containers greater than 3.4 ounces.
Whether it is contained in vials, cartridges, injectable pens, or prefilled syringes, you have the right to carry your insulin on flights.
Actually, you MUST take your insulin in your carry-on. Hazardous temperature and atmospheric conditions in the hold could damage or freeze your medicine.
Can I fly with Victoza, Ozempic, Trulicity, Byetta, and other diabetes injectable medicines?
Yes, insulin, Victoza, Ozempic, Trulicity, Byetta, and any other injectable diabetes medicines are allowed on the plane. Be sure to keep the labels visible so the security agents can easily and quickly identify your meds.
Do I need a doctor's note to fly with insulin?
No, you do not need a doctor’s note to fly with insulin. The Transport and Security Administration (TSA) does not officially require any documents to take the plane with diabetic supplies and medicines.
However, having a medical certificate can help to speed the screening process up and to avoid misunderstandings. If you’re traveling to international destinations, I’d definitely recommend you get a medical certificate for the customs at arrival. 99% of the time, you won't be asked anything, but you never know.
Can insulin go through X-ray machines at the airport?
Insulin can safely go through X-ray machines and airport scanners without risking deterioration. However, it’s understandable you might not be comfortable with that idea. In that case, you have the right to ask a TSA agent to hand check your insulin pens or vials instead.
How to transport insulin on a plane?
Legally, there are no specific restrictions regarding the transport of insulin on a plane. All forms of containers are allowed: vials, cartridges, pens, syringes, etc.
The quantity of insulin you're traveling with is not limited either, although you might be asked a few questions by customs if you're caught with 3000 insulin vials! You must be able to justify they're for your personal use and not for illegal drug trafficking!
You do not have to put your insulin into the liquids' zip-lock bags at the airport. You can transport it in your purse or your carry-on. Before leaving home though, take some precautions and properly pack your insulin so your vials, pens, or cartridges don't break nor get shaken during your travel.
Your insulin and any other medicines should be easily identifiable by the security agents. It means that you should not remove the labels. Keeping the original cartoon box can also help but it's not required.
How to keep insulin cool on a plane?
Remember that insulin is highly sensitive to extreme temperatures and temperature changes. Unopened vials, pens, or cartridges must be stored at fridge temperature (36°F-46°F / 2°C - 8°C). Once opened or out of the fridge, insulin is safe for use within about a month at room temperature (56°F-80°F / 13°C - 26°C). After that time, it must be disposed of.
Related: How to keep insulin cool without electricity?
The stability of insulin at room temperature varies from 28 days to 56 days depending on the brand
If you’re traveling with insulin for less than a month, you simply need to make sure your insulin stays at room temperature (below 80°F / 26°C). It's very uncommon that it gets hotter than that on the plane, so you should be fine.
However, if during your travels to the airport at departure and from the airport at arrival, the outside temperature is above 80°F / 26°C, you need to protect your insulin. In that case, using an insulin cooler is the most convenient solution.
If you’re traveling with insulin for more than a month, you must find a way to always keep your insulin at fridge temperature (during the travels and the flight on the plane). Before 2001, it used to be quite common to ask the flight attendants to put our insulin in the fridge. However, due to security reasons, it's now completely prohibited.
The only way to keep insulin cool at fridge temperature while flying is to use a medicine travel cooler. Be sure it’s TSA-approved so you can take it on board!
4AllFamily's TSA-approved portable insulin cooler
4AllFamily's portable mini-fridges for medicines are all TSA approved. You can choose from 4 different models depending on your needs. Our most performant cooler is capable of maintaining fridge temperature without any electricity nor ice for up to 30 hours when the outside temperature is at 95°F / 35°C. If you plug it into a USB-power source, which most planes are equipped with today, it keeps your meds cool for as long as you need!
Is insulin injection allowed on flight?
Of course, you're allowed to inject your insulin during the flight. There are only a few precautions you should be aware of for your own safety.
Because of air pressure changes during take-off and landing, your insulin prefilled pens or your pump reservoir may accumulate air bubbles. Don’t panic though: air bubbles are only dangerous if injected into a blood vessel. When injected subcutaneously like with insulin, it won't seriously harm you. The problem is that because of the air bubbles, you inject less insulin than you think, so it might affect your blood glucose levels during the flight.
To avoid this complication, you must prime your insulin pens or vials before proceeding to the injection. Turn the dosage knob to 2 units and hold your pen upwards while injecting in the air. The air bubbles should be gone. If not, prime again, and again, until you can't see any bubbles in your insulin.
Insulin pumps & Continuous Glucose Monitors at TSA security screening
Of course, you can fly with your insulin pump, as well as all the accessories that go with it: insulin vials or cartridges, reservoir, infusion sets, extra pump batteries, etc. The same goes for your continuous glucose monitor system.
However, you should take some precautions regarding x-ray, metal detectors, and full-body scanners during security screenings at the airport. They could damage some of your electronic devices.Can an insulin pump go through a metal detector?
Some insulin pump manufacturers such as Medtronic assure that their insulin pumps could be deteriorated by metal detectors and x-ray machines. Others, such as Omnipod, say you can safely take your devices through security screening technologies.
Here’s what TSA officially says about insulin pumps at airport security screenings:
“Passengers with portable infusion pumps, such as insulin pumps or glucose monitors in standard lanes can be screened by advanced imaging technology, metal detector, or a pat-down (…)”.
It then says that you can require the TSA Officer to conduct a pat-down screening instead of a technology screening. You will not be required to remove your insulin pump.
Remember, if you doubt if your insulin pump can safely go through metal detectors or x-ray machines, you have the right to require a pat-down search instead. For more detailed information about insulin pumps and airport security, as well as specific information for each pump, read our new article on the subject:
Can I take my blood sugar monitor on a plane?
Yes, you can take your blood sugar monitor on the plane. But the same goes as for insulin pumps: some CGMs can safely go through the security screening process, while others risk deterioration by x-ray machines and should only be inspected by hand. Ask the manufacturer of your CGM before departure.
Can Dexcom G6 go through a metal detector?
Yes, your Dexcom G6 glucose monitor can go through a walk-through metal detector. However, the manufacturer recommends not take it through AIT body scanners and x-ray machines. Here's what Dexcom explicitly says about the matter:
“Hand-wanding, pat-downs, visual inspections, and walk-through metal detectors are all methods that can be used without worrying about damaging your G6 components. (…) Because we have not tested every AIT body scanner and x-ray machine or know the damage they may cause the G6 we recommend hand-wanding or full-body pat-down and visual inspection to be safe”.
Can you fly with FreeStyle Libre?
According to Abbott, manufacturer of the FreeStyle Libre Sensor, the CGM can safely go through x-ray machines. The company does not mention full-body scanners nor metal detectors.
In its Position Statement about Using Diabetes Technology at the Airport, Diabetes UK states that: “The FreeStyle Libre sensor can be worn during whole-body scanning with no effect on its performance. The Freestyle Libre reader can go through the airport X-ray screening system.”
More about Flying with Diabetes
Can you fly with gestational diabetes?
In the USA, 6% to 9% of pregnant women suffer from gestational diabetes. Pregnancies with gestational diabetes are considered "high-risk" pregnancies. Flying with gestational diabetes may affect your health and your baby's health. In any case, if you're planning to travel while being pregnant with gestational diabetes, always ask for your doctor’s advice first. Only him or her can say if you’re fit to fly.
Does flying affect blood sugar?
When traveling with diabetes, many things can affect your blood sugar levels. Stress, change of habits, dehydration, lack of sleep, altitude, etc. During the flight, you may experience higher levels of blood glucose than usual. Limit your carbohydrate intake and adjust your insulin dosage. On the contrary, you may experience hypoglycemic episodes you're not used to. Always have some fast-acting sugar snacks close to you in case it happens.
Rest assured that this is only temporary, and everything should go back to normal a few hours only after arrival at your destination.
What are good Diabetic snacks for air travel?
All diabetics face the same problem: snacking without spiking your blood sugar levels! Tasty diabetes-friendly travel snacks you can take through airport security screenings aren't that numerous. If you're running out of ideas, we've got you covered with the following article:
We hope you’ve found the answers to your questions in this article. Do not hesitate to ask your question in the comment section. We’ll be happy to reply!
Have a safe trip!