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Diabetes (and/or Health) Traveling

UPDATE, ISSUE RESOLVED (I think!): I'm fairly new at traveling with all the stuff diabetics may need to travel. I've already encountered issues at Heathrow despite having a doctor's letter explaining my equipment needs. I have an insulin pump and a CPAP, so those require A LOT of equipment. In the USA, the parts and pieces are allowed as extra carry-ons, but in Europe and long haul flights, I'm rather fuzzy. I'd like RS to add a new category on tips that has to do with people traveling to Europe with medical supplies. For a month-long trip (we usually do two tours on each trip) this can be more than one carryon and personal item can hold. I'm interested in tips, tricks, bag options, security tales, quick recovery stories, equipment for cooling and sharps disposal. ANYTHING that relates to health, specifically diabetes would help me. We leave April 18. (I have been planning since January!)

Posted by
1065 posts

You are allowed to travel with essential medical equipment but Heathrow security is incredibly strict. 2 friends of mine who have diabetic children have had issues travelling through there as well as other U.K. airports. Return journeys are always much easier.

Security can insist on inspecting each item and asking a lot of questions. It’s very stressful, takes ages and you have to be able to say no to some unreasonable demands, eg opening packets that need to stay sterile. Basically, you just have to be prepared for it be difficult and try to remain calm so that you don’t end up losing track of all your other belongings. It shouldn’t be like this but unfortunately this is the reality.

I know you can get some sort of travel refrigeration device, like a mini battery operated fridge, to keep insulin in.

Posted by
1500 posts

I sympathize with you.

CPAP machines are usually not considered a piece of free carry on luggage in Europe.

I cannot think of much to add on top of my head, but in some EU countries, insulin can be purchased w/o a doctor's Rx. I had luck in Spain, but it depends on the pharmacist. In Germany, a companion ran out of insulin, but was able to get it as emergency supply, at the discretion of the pharmacist.

For going through security at airports, you will need a doctor's letter for your CPAP and your pump. I know this is a pain in the neck, but it's better to be safe than sorry. You can also ask for a manual check.

For hotel booking, make sure there is a fridge in your room and that there are sufficient outlets by the bed side. This requires more research in advance.

For water for the CPAC machine, it's not always easy to find distilled water at supermarkets. I suggest you go to a pharmacy. Tap water is usually pretty hard in Europe.

Posted by
4574 posts

As to adding a forum, the website is rather fixed and past requests for additions may vet noted but rarely actioned.
You can ask for the specific country, General Europe, Packing, or Disability Travel forums. I am not saying Diabetes is a disability, but the folks their may have unique solutions to some of your challenges.

Posted by
14098 posts

On my last RS tour there were 2 members who were insulin-dependent. They had a little cooler bag but it needed to be plugged in to the bus's power ports so there was always a commotion when we were starting out for the driver to turn on the power. It would have been better for them to have checked to see if their device could run on a power bank and just had that hooked up until the bus was at full power. Not all the power ports on the bus worked (normal for most of the tour buses I've been on in the last few years) so that was an issue as well.

It would be great for you to do a Trip Report when you get back especially with your experience thru Heathrow.

Posted by
45 posts

*That's too bad about not adding another RS forum permanent topic. Traveling with Rick Steves is a pretty specific kind of travel and requires a different way of packing, imo. I've researched diabetic forums and most people just respond to check my luggage and I'll have no issues. I'll be very upset if I have to resort to that. We've worked very hard to travel with carry-ons only and it makes travel so much easier.
I've already figured out how to remove distilled water from the equation, and I have a cooling system for insulin that doesn't require electricity.
*It's the new device, an insulin pump, that's put me over the carry-on edge. I need to carry 8 weekly sets of pump supplies for four weeks because sometimes "things go wrong" and I have to throw a set of something away. I've thought about mailing stuff to myself at some point along the way, but my brother lost his Rx sunglasses that way (the mail isn't very reliable, even DHL type deliveries).
As the Baby Boomers' travel surge gets into full swing, more and more people with these life-saving and very specific needs will hinder free travel for Rick's main constituency.

Posted by
6698 posts

CPAP machines are usually not considered a piece of free carry on luggage in Europe. ..For going through security at airports, you will need a doctor's letter for your CPAP.

I carry a CPAP and have never had either of these issues. I've always been able to bring on the CPAP with my carry-on and personal item, and have never brought (or needed) a doctor's letter. You might for the insulin, of course.

And I am assuming you know that you do not need distilled water for your CPAP. Distilled water just eliminates having to clean out the chemicals that can settle in from tap water. But you can do that with a soft towel or washcloth. There's no health hazard to using tap water at all.

But I'm am going to question your determination to use carry-on luggage only. Carry-on is great if you've got a small amount of stuff to carry on. But if you start having a lot of extra things like medical supplies or anything else that you need for your travels, it's going to make your life a lot easier if you check a bag. You can maneuver things around all you want, but let's face it, medical supplies take up space and also cause problems going through security, as others have noted.

Posted by
6788 posts

It's true that there is some inertia/friction/threshold to be overcome that works against adding a new category - not specifically working against adding the one you suggested, but just adding more categories generally. Too many categories and you eventually end up with....TripAdvisor (or something that resembles it structurally), where there are literally hundreds of forum and sub-forum categories, which must be daunting to administer and maintain (never mind simply navigating it as a user).

It's not unheard of to add a new category here (it does happen occasionally) but I'm sure isn't done without a lot of consideration. That's appropriate.

Something to consider: From a technical and administrative standpoint, it's probably a whole lot easier to rename an existing forum (and to "evolve" its focus as needs change) than it is to add a brand new one. (That's just a guess, but it's how things often work.)

There's an existing category now dedicated to "COVID-19 & Travel". Of course, we're not entirely done with COVID 19 yet (actually, that doesn't matter - what matters is that COVID 19 isn't done with us yet...) but things generally continue to trend in good directions as far as COVID and travel goes, and the activity in that forum appears to be declining (everyone says hooray to that, the webmaster probably most of all). Perhaps the name and focus of that forum category could evolve to something more encompassing, such as "COVID-19 & Other Travel Health Concerns."

There definitely needs to be a place where COVID-specific discussions (appropriate discussions, I would stress) still need to go. But as COVID continues its transition from the hair-on-fire, worldwide emergency for all things travel related, to something less disruptive that we all need to live with, maybe there's room in that (potentially-renamed) forum for other travel-related health issues?

Would a renamed "COVID-19 and Other Travel Concerns" category meet the OP's needs (as well as the needs of other travelers managing health issues) and still work for COVID-related discussions? I dunno, just something to consider.

Posted by
346 posts

My husband uses a CPAP and we've flown into England, Ireland, Spain, Germany, Belgium, Netherlands, and France with it. He's always carried it on along with another carry on item and it's never been an issue. It's been treated just like in the US which is as a piece of medical equipment that doesn't count as your carry on item. He's never been asked for a doctor's note.

Posted by
4970 posts

I'll be very upset if I have to resort to that. We've worked very hard to travel with carry-ons only and it makes travel so much easier.

As the Baby Boomers' travel surge gets into full swing, more and more
people with these life-saving and very specific needs will hinder free
travel for Rick's main constituency.

I want to agree with Mardee about digging in your heels on the carry on only issue. Yes, carry on only is nice IF it works for your needs. But it no longer works for your needs. Life happens. Circumstances change. So the wise ones adapt and change to meet those new challenges. And Rick's main "constituency" has never been restricted to only those who refuse to check bags under any circumstances. Although they can be a very vocal group. What Rick advocates is the elimination of unnecessary packing. There are PLENTY of Rick Steves devotees who dont think twice about both taking a slightly larger suitcase, and checking them for flights. Im one of them.

So what if you have to check one bag in order to manage your equipment and supplies? The only thing that matters is that you can handle that luggage from the time it arrives at the luggage caroussel until you drop it at the check in counter on your return trip.

Posted by
2444 posts

I don't think a new category would make any difference. Most of us regulars barely notice them as we use the All Topics list.

I've been on 10 RS tours, and have always checked a bag. What works for me is to check a 22" bag (my trekking poles go in this bag), and I use a smaller, wheeled backpack as my carry on. My CPAP goes in this bag. I am able to handle my luggage myself, and that's really all that matters.
I've never been asked for a doctor's note for the CPAP.

Posted by
45 posts

By Rick’s main constituency for tours, I meant those of us who are retired or close to retirement. That’s who has been on the 12 RS tours we’ve taken. Yes, there are occasionally younger folks (my daughter and her husband came on a trip with us last year). I’m talking trends here. I’m not hard and fast about never checking a bag, but it’s going to be a last resort for me. I’m tired of delayed and lost baggage. Makes the trip more stressful and if there’s a loss, untenable. And that means most of my clothes would go in the checked bag because for certain I won’t put medical equipment in the plane’s hold. First, because I can’t afford to lose it, and second, because much of it can’t go through the stronger x-Ray that checked bags go through (strong caution from the maker of those supplies). Thanks to everyone for thoughtful comments and suggestions. I still believe a category for people with special medical needs would appreciate a forum specifically targeted in this area. I’m not starting a petition or anything, but maybe someone will see the usefulness of it. I feel that I have a closing window of opportunity to travel with ease and semi-athletic effort. I’m planning on doing cruises when I can no longer climb Ireland’s rocky coasts, etc.

Posted by
292 posts

You can write to the airline and they'll give you an extra carry on allowance for your supplies. Normally we travel as a family, so one of the carryons is for diabetes supplies, a backpack where you put everything, don't ever check it, take it always with you.
Regarding the insulin, check FRIO , they're specially designed for carrying insulin, you just have to submerge the bag in cold water for a few minutes every 3 days and it will keep the insulin cool.

Posted by
1500 posts

Regarding carry-on allowances, the low cost airlines are usually not flexible. Also, depending on the size of the aircraft, you may have to gate check your CPAP if it's in a large bag or roller bag.

Posted by
37 posts

My husband and I are both Type 1 Diabetics and we will be doing our 11th RS tour in May. We do carry letters from our doctors explaining that we have to carry all these supplies with us, but we’ve never had to use them. We use Frio insulated pouches to keep our insulin cool. They need to be soaked in cold or cool water every few days, but they’ve kept our insulin good for month long trips. We also do back-to-back tours when we can. We are super diligent about packing light so that we have room for all of our diabetic supplies in my day pack or and my husband’s back-pack. Our personal items are usually completely full of our diabetic supplies and everything else goes in our carry-on bags. I use a pump and don’t risk going through the X-ray machine, so that always takes longer.

We have everything in marked ziplock bags and usually once we explain why we are carrying a mini-drug store, everything goes through okay. We have a sharps clipper (sort of like a toenail clipper with storage) that takes care of needles. We typically bring about 25% more supplies than we need, just in case. But because there are two of us, we can bring a little less. My husband’s pen needles are my backup because they take up less space than my pump supplies.

We tried bringing fewer glucose tablets and we unable to find them in Sicily and Turkey. Juice boxes will work in a pinch, but they are pretty inconvenient. We will get juice boxes when we are at a location for 2-3 days. Our preferred low treatment snacks are granola bars and we have had trouble finding the healthier ones we prefer sometimes. Despite not ever having had any serious issues, I still get extremely anxious going through security at each and every airport. But we love traveling so much that it’s worth it. PM me if you have questions.

Posted by
447 posts

I'm flying today to Amsterdam from the United States. I purchased ( paid for out of pocket) a travel sized CPAP machine a couple of years ago and am so glad that I did. It has been an excellent purchase for traveling. It not only is much smaller and lighter than my home CPAP, but it also doesn't need a humidifier or water at all. I was able to pack the CPAP, a fairly heavy down coat, a pair of boots, and my most of my clothes for this trip in my 21" Samsonite roller bag, and my other essentials in my personal item. As a retired airline employee, I usually fly standby and sometimes am required to check my carry on bag at the gate. If that happens, I will just remove my CPAP and coat from the roller bag and check the bag.

I always make sure I have a change of clothes packed in my personal item, as well as medication and electronics.

I have never had to bring a prescription from my doctor for the CPAP when entering or departing in Europe.

Posted by
68 posts

I'm another fan of FRIO insulated pouches. We've traveled several times with these for my insulin dependent son and have found they work beautifully. They come in different sizes, depending how many pens, etc. you have to carry. I also used TSA Cares which helps if you need extra help getting through security. I found it easier to keep all medical supplies in a separate bag (equipment, liquid meds, letters, pills, etc.) and just handed it over to the agent. I also packed an extra small empty sharps container (ordered from Amazon) in my bigger bag that I stuffed with sox until I arrived. One year, I carried a small Tupperware container with a lid and used that for sharps until I got home.

Posted by
1500 posts

BTW, if anybody flies Air Canada from the US to Europe, you may be able to get a stopover in Toronto or Montreal for free or a small fee. Go to a pharmacy or to Costco and buy insulin there. It does not require a doctor's Rx and it's MUCH, MUCH, MUCH cheaper. Think CA$30 vs US$150-200.

Posted by
4970 posts

Barkinpark, I would suggest you double check your sources. Most Insulin formulations are not an OTC drug in Ontario or Quebec. Or in any other province AFAIK. A pharmacist might permit an emergency dose, or doses. Otherwise a Rx from a Canadian doctor is required.

Posted by
45 posts

I use FRIO to keep pens and insulin cool, plus a neoprene cover for the insulin bottles. FYI I don't need to buy insulin in Canada. I am able to buy insulin at $35 a bottle in the USA (Medicare). I will only take one bottle as I have all this other stuff to carry on for the insulin pump. I have borrowed a carry-on from my daughter and it's slightly bigger than our ultra-lightweight Antler carry-on. I will have two personal items, one with all the medical supplies and it will have extra room if they insist we only have one each and my husband will put his smaller personal item in the bag with the medical stuff until we get on the plane. I've downloaded all the info and sheets provided by TSA and the UK so hopefully that will be good enough for France (we also fly Nice to Copenhagen). We then fly Bergen to Amsterdam, then Amsterdam to Seattle -- so hoping it all works then too. However at the end of our trip, I will have a LOT LESS medical equipment left so I might be able to consolidate. I've watched security trash items at Heathrow, but no other location we've been to has been so randomly harsh and irrational. I have the travel CPAP as well, no water needed and very compact. So I'm now fairly confident and I thank everyone who provided helpful suggestions and confirmation that I was on the right track. Thank you RS fans!

Posted by
1491 posts

I will add a few things.

Doctor's letters are not required for medical equipment and may in fact be completely ignored. They are completely useless because they are so easy to reproduce. I do recommend taking any pharmacy labels for prescription drugs/supplies.
Unless you are traveling for more than 30 days, keeping insulin at low temperatures isn't really necessary. It is necessary to keep the insulin from getting over 86 degrees F, so a cold pack is good insurance and would be needed in hot climates.

I am less sure about international travel, but regarding domestic travel, insulin pumps are well understood by TSA agents. I know hundreds of people on insulin pumps and not one of them has had a problem flying either domestically or internationally without a doctor's note.

Speak to your doctor or other reliable resource to get the best information, because completely relying on what people write on the internet might lead you astray : )