International Travel- Need your advice!

I’m traveling to Germany from the US in about a month and need all the advice you have to offer about traveling internationally with a dexcom and for MDI (I’m on Tresiba/Novolog). I haven’t traveled internationally since being diagnosed and while I’m used to traveling domestically with the dexcom, I have no idea what this means abroad.

Beyond bringing double the supplies I actually need, what do you suggest I pack? What do I need to ask my doctor about and/or for? Do I need to bring written prescriptions? What should I research beforehand? What should I expect in regards to flight/security issues? Anyone know about Germany airport security specifically? And the biggest looming in my mind- what do I do about the time change and my basal injections??

Any help, advice, comments, etc. are much appreciated!

Hi, there.

My son has been to Europe a few times over the past couple of years. We’ve overpacked on supplies (perhaps too much, but I don’t regret it). I’ve always had the prescription labels ready and a letter from the doctor explaining what he needs, but other than for peace of mind, I’ve never needed them. Even for international travel there is some awareness to these medical supplies.

I educated myself on local health policies - for example, in Italy, you can go to a hospital and they will provide you insulin without difficulty (and I’m told without cost).

Having access to carb counts is helpful - so international data plan was critical for Caleb and he even brought (and used) and small travel food scale. I don’t think that’s necessary particularly if you are comfortable with carb counting.

I’m not familiar with Germany’s particulars but I believe others who are will chime in. Caleb pumps, but I can say we’ve always only changed the time on his devices to local time and gone with it. We stay aware that he’s in a transition and may need a little more correction than normal. Dexcom is really helpful for this.

Good luck and enjoy!

In my experience traveling abroad, including to Germany, I didn’t need any scripts/Dr’s notes. That said, you may run into an issue if you insist on their not x-raying your Dexcom receiver if you use one; back when I did, I eventually just started x-raying it and it was fine, as have many other folks (now I just use my phone for everything which is easier). If you are bringing a receiver and plan to insist on it not being x-rayed, bring a doctor’s note, although that may not be sufficient to get them to let you not put your receiver through the x-ray without a significant argument about it (happened to me in Portugal).

My transmitter has only once ever tripped security going through the body scanners (usually they don’t pick up on it at all, although it’s always on my abdomen, so site placement may affect that), and when it did, it just meant that they did the swipe test for bomb residue on me, which wasn’t a big deal at all.

I used to warn security people that I had diabetes supplies etc with me in my bags (insulin pens etc), but I stopped, because they clearly see enough of that to not be phased by any of it.

Also, Tresiba makes the time change so much easier! I use Timesulin, so I always have a timer going on how long it has been since my last injection, which I found helpful in not having to think about it much at all.

I wouldn’t worry too much about it. I went to England and Spain last June, and I didn’t have any problems. Make sure to bring all medication/supplies in your carry-on (don’t put any in your luggage). I shifted my basal (Lantus) by a few hours, and it was as simple as that. You could run a bit low/high the first day you do it (not sure with Tresiba), so if you’re going to be there for a only short period of time it may be worth it to shift it ahead of time. I also made sure to bring something to treat lows because I had to walk around a lot.

I didn’t bring a written prescription, but I did bring the prescription labels for my insulin in case those were needed. I also brought a letter from my doctor stating that I needed this medication. No airport cared to ask about my supplies though, and I didn’t take them out of my bag when I went through security. Maybe you’re supposed to, but it didn’t end up being a problem. England and Spain had the old school metal detectors, so I didn’t worry about my transmitter going through them. I always opt for a pat down in the U.S. (though I’ve been told it’s unnecessary) because Dexcom hasn’t certified that it’s safe to put the transmitter through the new body scanners.

Healthcare in most European countries is cheaper than the U.S… One of the people that came to Spain with me got stung by a wasp several times and had an allergic reaction. It was super easy to get it treated at a hospital nearby, and it cost WAY less than it would’ve in the U.S. without insurance. So if you have an emergency, you shouldn’t have to break the bank to get treatment (unless it’s something huge maybe?). Healthcare quality is quite high in most European countries.

Have a good time! I bet the trip will be awesome :slight_smile:

I always travel with a letter from my endo specifying the equipment and supplies I am carrying. In roughly 40 years of flying internationally, I have only ever needed to show it once – but with Italian police pointing submachine guns at me, I was sure glad I had it.

I’ve travelled with my insulin at room temp in warm climates for up to a month, and it’s been fine. But if you’re concerned, check out Frio bags, which are popular. Do not keep insulin in a hotel-room fridge, which may freeze it. You don’t need a prescription to buy insulin in Germany, but make sure what you use is available there. Novolog is, but I think Tresiba was taken off the market a year or so ago. It may be back by now.

Most Europeans speak good English, but if you’re going off the beaten path, you may want to carry the contact info of an English-speaking endo or family doctor, because the local doctor (and if you’re in a remote place, there my not be a local doctor) may not speak very good English, and in a medical emergency, you want clear communication. You can find names and numbers online, or the US embassy or consulate closest to where you’re headed may be able to help.

It was said above but it’s worth repeating: carry all your medical supplies in your carry-on baggage. Triple-check your baggage allowance for your airline and your class. With many Star Alliance airlines you can board with two bags in economy, which should be ample. (If I had a dollar for every time I’ve had to watch someone repack their bags because they thought everything was carry-on …)

Remember to take your Dexcom charger adapter.

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I lived in Germany for years and actually got my pump while I was there :slight_smile: .

They are great regarding any prescription mishaps you might have (I needed insulin and just went to a hospital and got it no problem, minus the cost of course), and airport security is absolutely fine. I’m Canadian so I flew in from Canada but I’ve never ever had an issue with my pump, or even needles when I was injecting.

For travel, definitely bring more than you need just in case, and I would always recommend having a prescription receipt (or whatever you get from your doctor). For the time change, I have travelled quite extensively, and I always changed it as soon as I land. My sugars are typically a little off for the first day but correct afterwards. Also, make sure to constantly check while flying. On long flights, I tend to run a little high.

Have fun in Germany!!!

I suggest you ask your endo how he/she wants you to handle the time change. My end has always told me how to do it when I cross time zones.

For Tresiba, basal injections while traveling are relatively easy, since you have more flexibility built in. If you take it in the morning, you could just take it 6 or however many hours later to maintain the 24 hours easily enough (like, if you normally take it 10am, the day you land, you’d take it around 4pm, and that would be your travel injection time, and just set an alarm so you don’t forget). If you take it in the evening, you can likely put it to first thing in the morning and still be within the time flexibility for Tresiba (if it’s normally at 10pm; +6 hours puts it at 6am, but you can delay your injection by 3-4 hours safely and land at 9-10am and still be ok with Tresiba); if you do it early evening, just move it later/earlier by a few hours in the lead up to the trip so it’s all set for that change.

There should be a database for travelling diabetics. Including emergency numbers and places to get diabetic necessities. Also what documents you need in various countries. Listen, we’re above 10% of the population - I think that an international database shouldn’t be out of the question.

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Good questions (and answers, too). I’m traveling to Australia in May for a 2 week cruise from Darwin to Broome—no medical staff on board, so plan to be cautious and over-supplied for my pump and CGM! Any suggestions specifically for Australia or cruises?

Be very careful of heat in Australia. You might want to buy a temperature sensor to store with your insulin. I’ve never been to Australia but that the big thing that comes to mind for me.

Thanks, Firenza—I’m from Arizona and used to dealing with heat. Hopefully May temperatures “down under” will be like our September—hot, but survivable! Frio packs work well here.

In Darwin the temperature is usually about 32C, but it will be humid and thus will feel hotter. Nothing too terrible.

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