Plan for Insulin Safety When You Fly

If you have diabetes, traveling by plane means some extra planning to make sure you have everything you need, and that your insulin supply is both available and effective when you need it.   Some insulin pumps may not work correctly in the air unless you take appropriate precautions before take-off.  Check out these tips for safe travel with insulin.

Plan your packing
Before you travel by plane, you’ll want to make sure you have all your supplies packed in your carry-on. Don’t risk losing your insulin or other supplies by packing them in a bag you intend to check.  You can help speed your progress through the airport security check by carrying a letter from your doctor explaining your condition and what supplies you need to carry. If you wear an insulin pump, be sure it is included in the doctor’s letter.

Plan for the TSA
Transportation Safety Administration (TSA) rules allow diabetics to carry insulin, syringes, and all other supplies on board the cabin without liquid volume limitations as long as the insulin is clearly labeled.  You can also carry as many unused syringes as you need as long as you have injectable insulin with you.  You can find a complete list of what you are allowed to take on board at the TSA website. The TSA also recommends that you call 72 hours before you fly to find out what you can expect during screening at the airport.   TSA Cares toll free number is 1-855-787-2227.

If you don’t want your insulin supplies to go through the X-ray machine at the security checkpoint, be sure to tell a TSA agent before you reach the X-ray machine.  To help with this, pack all your diabetes supplies in a separate bag or pouch that you can pull out of your carry-on. If you are wearing an insulin pump and don’t want to go through the metal detector, you can request a visual check and pat-down.  Be sure to explain to the TSA agent that your pump is connected to your body with a needle under the skin so it cannot be removed.

Plan for your pump
High altitude means lower air pressure in the airplane cabin which can affect how your insulin pump works.  A study published online in Diabetes Care shows that all pumps tested developed tiny bubbles in the pumps that displace insulin out of the pump during flight.  This extra insulin dose may result in hypoglycemia (low blood sugar) during or after the flight.  During landing, air pressure increases which forces insulin out of the line and back into the cartridge. This can result in low insulin delivery following the flight.  To avoid these issues:

  • Put the amount of insulin you need in the pump, but not extra insulin.  More insulin equals more bubbles.
  • Disconnect your pump before takeoff.
  • Once the plane reaches cruising altitude, take the cartridge out of the pump, remove any air bubbles, then reconnect the pump for normal use.
  • After the plane lands, disconnect the pump, prime the line for normal use, then reconnect the pump.

If your plane has an emergency that causes rapid decompression, such as something that causes oxygen masks to drop from the overhead bin, disconnect your insulin pump to prevent misdosing.  Reconnect your pump when conditions return to normal. 

Plan for injections
If you use a syringe to inject insulin, you also need to change your routine at high altitude.  Because of the difference in air pressure, do not inject air into the insulin bottle.  Also, remember that traveling long distances may mean changing time zones.  Be sure to track your insulin injections based on the time between shots, not the time of day in your destination city.

Denise DeWitt is a freelance writer for


Diabetes Forecast. Tips for Traveling With Diabetes. Tracey Neithercott. Web. May 28, 2012.

Diabetes Care. Changes in Altitude Cause Unintended Insulin Delivery From Insulin Pumps. Bruce R. King, FRACP, PHD et al. Web. May 28, 2012.

American Diabetes Association. Fact Sheet- Air Travel and Diabetes. Web. May 28, 2012.

National Diabetes Education Program. Have Diabetes. Will Travel. Web. May 28, 2012.

Transportation Security Administration. Hidden Disabilities. Web. May 28, 2012.

Transportation Security Administration. TSA Cares Help Line. Web. May 28, 2012.

Diabetes Forecast. Insulin Pumps and Airline Travel. Web. May 28, 2012.

Centers for Disease Control and Prevention. Managing Summer Heat, Travel With Diabetes. Web. May 28, 2012.

American Diabetes Association. Living With Diabetes: Air Travel and Diabetes. Web. May 28, 2012.

Related Links:

Travel Tips for People Living with Diabetes

10 Tips to Balance Blood Sugar and Insulin

Insulin Pump Therapy for Diabetes Type 1

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