I tried searching for previous topics on the matter and couldn’t find anything, so I’ve started a new discussion!
I’m heading to Europe (Greece) for a month, 27 days to be exact. My carry-on will be loaded with extra supplies (infusion sets, cartridges, strips) and enough insulin to last the whole of the trip.
By overestimating my insulin usage, I’ve calculated that I’ll need eight 3mL vials for 30 days at a rate of 80u/day (high estimates!). I’ve decided that I’ll bring 12 along with me just in case some unknown unknowns crops up–however this now poses a challenge: how do I keep all of them cold for the 12 hour trip?!
Has anyone been in a similar situation before? How should I prepare?
I have not traveled to Europe, only here in the U.S. I have found this website to be quite helpful in choosing something to keep my insulin at the proper temperature.
Love the Frio wallet & it’s kept insulin cool for over 24 hours, but 12 vials is a lot. You can ask the flight attendent to refigerate some for you & check to be sure their refigerator won’t freeze them. Bring an extra meter, extra batteries & syringes along also. Good to take your prescriptions just in case.
You should really double the amount of any of your medication on any trip abroad in case of accident, insulins going off, infection etc.
There are several options on keeping it cool. A food flask which has been put in the fridge overnight before you go. Wrap the insulins in wet paper and just before you leave, put it into the cold flask.
Or you could buy a couple of frio wallets. I understand that keeps things cold for about 48 hours.
Or, I wrap all the insulins in the cold wet paper and put it in a small clippy box and put more paper on top and a frozen ice block also wrapped on the top of it all.
Some people use small metal drinking flasks too.
As soon as you get to your destination make finding a refrigerator your priority! Check the insulin and remove the paper and store as usual.
If you need to carry spares during the holiday put it in with your cool box.
I have had these experiences since I went to Latvia last year and there was a heatwave, so I found that I did not need so much insulin, though there was a lot of eating going on!
My experience of Greece when I went there several times as a child was that restaurant service is ultra slow! I remember waiting for meals for a good couple of hours, so you will need to keep snacks with you to keep you going while you wait - and only drink bottled water that has not been tampered with!
I do not know wether you have flown before while diabetic, but it is vital that you inform your airline steward that you are diabetic and might need extra snacks. They are usually fine about it and very attentive. I went to the US in January and did not do so and hypoed on the way. They told me to tell the next stewards and they were brilliant!
Have a good holiday. Take something with you for dehydration and diaohhreah, just in case.
Another thought, take a copy of your prescriptions, all insurance papers and if you can, get or make a card printed in Greek stating that you have diabetes and might need to be served with food before anyone else.
I travel quite alot and I know some of this has been mentioned below but I will tell you what I do!
In my hand luggage I carry enough Insulin for about a week (in case main luggage gets delayed), I also carry a letter stating that I am carrying medicine and I am a Diabetic (just in case of customs, but I have not been stopped for this yet), and a full prescription if some thing goes wrong!!
Then in my main luggage I have a complete spare test meter and spare batteries. Also enough insulin, needles and strips for twice the length of my stay. Then you should be OK.
I got stuck in Europe during the Iceland ash cloud disaster and I got by, I was getting close to running out of insulin, but hotel put me in contact with a doctor who would help if required, but I got a flight out before it was required.
It’s not safe to keep insulin in checked luggage. The temperature in the cargo hold varies & it can be freezing at high altitudes during long flights. Always a chance of luggage being lost also.
Those Frio-bags (as linked in a post) are a good choice.
We used to take one of these on our summer holidays and they did a good job. Never had to throw any insulin away.
Since the old bag is…well, old, I recently ordered a new one.
The advantage: they cool with water, not ice or any other way that needs extra pre-cooling (or freezing).
Also, they’re light enogh for a longer trip, and not too big, and they come in different sizes so you can choose which one fits your needs best.
@ everyone
Insulin on a flight: Insulin (all of it!) should be kept in the bag you take into the cabin with you. It’s too cold in the cargo hold, and you can’t be sure they don’t throw your bag/suitcase/whatever. Another reason is that it happens that suitcases get lost. What do you if you are stranded abroad with most of your supplies gone?
Some people’s mental model is that the instant the insulin is out of the fridge it starts going bad.
Really insulin will do just fine at room temperature for at least a month. And it’s not that exposure to room temperature starts some McGyver countdown clock ticking - having it out for a day and at room temperature, then putting it back in really does nothing.
Others mentioned the Frio, there are some other solutions too. Do you get your insulin mail-order? The stuff they ship it in (styrofoam cooler + maybe gel packs) would be way overkill but if you can put the styrofoam cooler in your carry-on then you’re set.
As to vacation travel: the worst environment your insulin will see is a hot car or hot beach. 10 minutes unprotected in a hot car in the sun in the summertime will do far more damage to the insulin, than 12 hours at room temperature.
As to airplane and bus etc. travel: I’m super paranoid and make sure that not only do I have supplies in my carry-on but in my pockets.
I agree with you about all your isulin supplies should be taken in hand luggage. When I first went abroad after diagnosis I was told this and my mother carries half in her hand luggage and I carry the other half in my hand luggage. This is why it is important for us to take a copy of our prescriptions and a doctors letter explaining that we must not take insulin in the hold and the reason why we are carrying needles. A spare testing kit or two would also not go amiss.
I suppose everyone of us wants to come along ?
I bring a travel loaner pump , when out of country …I have never been asked to show the letter from Doc either at the airports , but always bring it along .
If a concern : thinking of pre-ordering a " diabetic meal " during the flight ? You likely would be served before everyone else !
Remember to re set your pump clock as you move through time zones …7 hour time difference for you ??? This method has been the simplest for me .More finger poking throughout the flight has always paid off for me .
I have a gadget I bring along " Bayer simplewins " , given by my Pharmacist years ago , to break of the needle part of an insulin needle . I think I recall sharp disposal units in airport washrooms ?
You mentioned , that you will require 8 x 3ml vials …you are a pumper , so my question why not use 10 ml vials ? …just asking .
I visited Greece , Athens in 1990 …ended up with food poisoning and had to see a Doctor …hope this does not happen to you !..other memories are fantastic …hope to see some pictures here .
My husband and I go to Europe quite often. I usually count the number of everything I need then add extras. How many depends on what. I will bring 5 or 6 extra infusion sets, since sometimes I have problems when first inserted. Test strips, maybe one extra bottle.
I bring a new bottle of Novolog and 1 backup–in case I drop or break the bottle. I also bring Lantus and syringes, just in case. I never refrerate the bottle of insulin I am using. Only the ones not in use are refrigerated. We have had this discussion here before and lots of people swear insulin must be cold. My endo told me never to put cold insulin in a pump cartirdge. As it warms, it may cause bubbles to appear as it condenses. The only exception to this that I make is in the summer. We set our thermostat up during the day to 85. So I keep the bottle in a Frio at that time.
Don’t worry. You will have a great time. Also, supplies are available in Europe. I take the European number for Mini Med every year, just in case. Also, you can buy test strips, insulin, etc. in most pharmacies.
I have heard many good things about Frio, but as someone else already pointed out, insulin does just fine at room temperature for up to a month. What I would be more concerned about is keeping the insulin cool during your 27 days. Greece can get really hot and you should not, under any circumstances, keep your insulin inside a hot car. I even worry about sitting on the sunny side of buses. One idea is that you could split your insulin supplies and keep one half in a Frio, and the other in the hotel. I don’t know what your expectations of hotel comfort are, but in general, European hotels are very basic compared to American hotels, so there might not be a fridge in the room. You might be able to get the hotel to store some insulin in their fridge, that way you don’t have to worry about the room getting too hot, or overheating on a bus or something.
I have to disagree with the poster who said service in Greek restaurants can be slow. I’ve been there three times in the past 6 years and this is absolutely not the case. Plus, there will ALWAYS be bread on the table to keep you going.
Bon voyage!
PS I wonder how useful it will be that ‘diabetes’ and many diabetes-related words come from the Greek…
While you probably will be eating more delicious Greek carbs than at home you will be inevitably be walking and exercising more too- so take that into consideration as well in your calculations. The vacation wine always makes me lower too.
Whatever you do DO NOT CHECK YOUR INSULIN. Checked baggage in the belly of the plane is subject to pressure and temperature changes that would not treat your expensive insulin well.
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Also checked baggage can get lost.
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Go to Amazon.com and you’ll find a lot of things for the purpose of keeping drugs cool for travel. None in my experience (including the frio) are perfect and all required supplemental ice packs (reusable ice packs that can be frozen at your hotel)
• REMEMBER delays happen- you’re trip may be scheduled for 12 hours- but plan for the worst- take extra baggies and fill them with ice at the bar in the airport if need be.
• I travel with a personal soft sided insulated lunch box –I found a very narrow one that fits perfectly in my carryon bag and also has room for snacks which I would not fly without.
• I use flexible sheets of re-useable frozen gel ice packs (can be cut to size for slipping in-between vial boxes) I put my vials in their boxes in a small Tupperware box to protect them from getting wet and lay the sheets on top and underneath.
• I do not allow security to x-ray my meds and request a hand search- having everything separate- in my little lunch box makes it much easier than if it’s packed with my clothes.
• Depending on the length of my trip I will add dry ice to my pack- DO NOT LET IT TOUCH THE GLASS VIALS!! YOU DO NOT WANT YOUR INSULIN TO FREEZE or glass to break
• I’m guessing you’ll be traveling with someone else too? It’s a good idea to split up your supplies half with them and half with you…just in case something happens to your carryon you don’t have all your eggs in one basket so to speak.
• I know you’re a pumper- but for others who are not – traveling with insulin pens which are much less fragile than vials is great.
• The comment about asking the Fight Attendant to "refrigerate" you insulin made me laugh (no offense) as a long time Flight Attendant – I can assure you that that tiny galley does not have a refrigerator! (or a microwave for that matter!)(dry ice only) Even if it did the crew cannot (legally) take your medication and store it for you. They can however supply you with all the ice you need. Take lots and lots of zip lock baggies along – invaluable for your whole trip- refill with ice as you go and definitely refill the last time you can before you leave the plane- If you ask really really nicely they may be willing to put your reusable ice sheet (take an extra so you can rotate them) on dry ice for you to keep it frozen until you land. Then switch it out for the hot ride to the hotel.
• When I’m in Europe I’ve found it quite easy to get a prescription filled. The clinic was a walk in I did a finger stick in front of the Doc- showed him my US prescription- and a note from my Dr. that I never travel without. And that was it- he wrote the script and I was out the door. The whole thing Dr. and Insulin was $50 US.
• I will say- that I remember early last year Norvo Nordisk stopped shipping insulin to Greece because they [Greek Govt] had the nerve to slash prices for their citizens and the drug companies cut off their shipments until they raised prices again- nice ‘eh?
Have a great time and make sure to let us know what worked for you!
PS
This whole “insulin does just fine at room temp” discussion is wholly dependant on the TYPE of insulin you use and generally it ONLY applys to vials that are OPEN- unopend vials should always be kept cool. Read the insert that come with your specific drug befor you out of hand believe all us ya hoos on the internet!
Wow, thanks for all the replies, everyone! It should be noted that a family member has a condo that we’ve been given the OK to use, so I will have a fridge at my disposal, and I do speak Greek, so that’s a plus I’ve just never travelled overseas since being diagnosed. As a just-in-case I’ve printed cards in Italian (stopover in Rome) and Greek stating I’m diabetic, and my travelling companions (siblings) have cards that say ‘my brother is diabetic. he requires insulin’ in Italian and Greek.
I had no idea that 10mL vials existed! I’ll have to take that up with my doc when I get back!
I’ve got my back-up pump from Animas just the other day as well as purchased a Thermal lunch box + ice packs for the flight. My required pump supplies are in my carry on while the extras are in my checked bags (all insulin is with me). If anything goes awry, I have another friend catching up with me two weeks after my departure and she can bring anything extra with her; worst comes to worst my parents can mail me additional supplies.
I hope your travel will be very nice. But it’s true European hotels are not so well. My insulin have been frozen in a hotel in france years ago!!!
Enjoy your travel Philip!
I suggest when/if giving insulin to the hotel to keep in “their” frig, you ask to see exactly where. They may be thinking the freezer rather than the frig.
I always put 4 Polar Paks, that come with mail-order insulin and then frozen in my own freezer, into a small insulated hard case. These keep extra insulin vials cold up to 5 days. To the top of that, inside the hard case, I put 3 sizes of Frios so I can decide each day what I need.
We’ve got a condo with our own fridge, good tip about the hotel fridge tho
I made it! I found some WiFi to post my reply here–my solution was an insulated lunch bag with five, 9-celled ice packs lining it, and the insulin in the centre. It kept it plenty cold for the plane trip! My issue now is running all over the country and keeping track of the supplies I need to have on me!! So far so good. I got in touch with the Novo Nordisk people and their Greek distributors gave me their numbers if I have any issues with the pharmacies being able to order it in.
I’ve adjusted my calculations for the amount of CHOs I’ve been eating over here (A LOT less) and eight vials should be plenty. Sugars stable all on the plane and all through the week.
The weather’s great and there’s ADs for insulin pumps on TV! I thought that was pretty cool!!
I traveled Europe for two months at one time with all my insulin and syringes on me - kept them cool in a frio-type case and everything was fine. When I was at a hotel and not traveling, I just kept everything in the fridge.
Another time, when traveling to Ireland, I was stopped by security in London for my syringes. Then, because I was carrying “sharp objects” I had to be escorted onto the London to Ireland flight by a flight attendant and all the other flight attendants had to be “notified” of my situation. This was a first, and luckily I did have a note from my endo saying I needed to carry these on me due to my diabetes. Seemed like a lot of nonsense to me, but I went along with it so as not to cause a fuss. This is the only time this has ever happened though.
I also had my doctor give me a list of other diabetes doctors and pharmacies all over Europe in case I lost my medications and needed a refill for any reason as I was traveling. This, of anything, gave me the most assurance!
Ι will tell you is that if I need something for the exploration of Greece can ask me and help you because I live in GREECE specifically in Thessaloniki…aaaaa, k if you have insulin or anything else you can go to any pharmacy and ask are you a measurement of insulin or whatever you need!im sorry my english is poor.I hope you will realize!!
…hope to see some pictures here .
I’ve just never travelled overseas since being diagnosed. As a just-in-case I’ve printed cards in Italian (stopover in Rome) and Greek stating I’m diabetic, and my travelling companions (siblings) have cards that say ‘my brother is diabetic. he requires insulin’ in Italian and Greek.