Vacation planning

I am going on my first vacation since “cyborging up” in 2020 and my first vacation since Covid. I have a Dexcom and a Tslim. I have a couple of days where I will be ocean swimming (probably 2 or 3) and also using a hot tub. Problem? I have no idea what to do about my devices with the salt water and the heat. I won’t be doing any activities alone. so, no concern about adverse effects and not having someone there. I just lost my job and health insurance so paying $400+ to speak to the CDE about this isn’t happening. I will have to see the endo and pay out of pocket. That will be well over $2000 between labs, office visit and meds. Probably more like $2500+ and that’s hoping my pump and Dexcom supplies hold up for 3 months. I won’t have insurance until mid to end of February. Anyway, I want to go into the endo office with an idea of what my options should look like. I also would like to hear good solid travel advice since I will be out of my country for 2 weeks. I already requested a refrigerator in my room for meds.

Be very careful with hotel refrigerators. Some have been known to freeze insulin, which can destroy it. Maybe keep a small cup with water in it to keep check? Does anyone have a better suggestion?


Insulin does not need to be refrigerated if you will only be gone for 2 weeks. When I go on 3 week trips, I bring along 4 weeks of insulin and do not refrigerate. In the past I used Frio bags for longer trips of up to 6 weeks but got lazy over time and just leave insulin unrefrigerated and have not had any issues with insulin going bad in many different climate environments. The manufacturers recommend about 28 days depending on the insulin but that seems more to cover themselves legally rather than how long the insulin actually lasts before degradation. On my trips I use Humalog for bolus and in the old days levemir and lantus for basal but no longer use anything but Humalog in the past few years.


An understated warning! I agree with @CJ114; there’s no need to refrigerate your travel insulin. I don’t ever risk travel refrigerators; lots of downside and very little upside. I would, however, avoid leaving your insulin in a car on a sunny day.

Definitely pack more insulin and supplies than you typically use for your planned two-week trip. I would double the supply quantity – but that’s just me. Diabetes supplies tend to be light and small. Extra supplies won’t harm you. Murphy’s law does apply to diabetes travel supplies – anything that can go wrong will go wrong!

When I travel, I usually go through some episodes of misplacing or even losing some critical supplies. A few years back I misplaced my RileyLink (a key component of my Loop system) for three days and it turned out that my back-up RL didn’t work – Murphy laughed!

I would split up your supplies into at least two different travel bags. That will help offset the risk of one of your bags getting lost or stolen. Always carry with you enough supplies to treat your diabetes for at least three days. The “I’m just going out for an hour, no need to pack along my D-kit” is not a good plan – Murphy again.

Also pack some long-acting insulin and pens/syringes to cover possible pump malfunctions. Most of all, enjoy your trip!


If you do a hot tub, make sure your dexcom is on your arm and out of the water.

I tried it a couple of times and the sensors go whack pretty soon after. They are supposed to be waterproof, but the heat and the chemicals will loosen that up fast.


I’m gonna triple the hotel fridge warning. You only make that mistake once, because it’s such a doozy. As a kid vacationing in Florida, we lost ALL my insulin to the fridge. I had to go to the hospital for my overnight injection until the pharmacies opened the next day and the vitals could be replaced.

Missy people disconnect their pump for swimming, and just plug it back in occasionally for a correction and/or basal booster. Highly recommend you set up a basal profile for 0 u/hr if you’re going to go this route, to avoid the beeping.
It’s rated for submersion at 3 feet deep for 30 minutes, so you don’t have to take it off if you’re not planning on actually being underwater a lot or just wading in the water, etc. Hot tubs are fine, too so long as you’re not keeping the pump submerged.

Be aware, though, that the warranty does NOT cover pumps that are lost/stolen. (It should be added to your home/renters insurance for cyber here) So you take a great risk leaving it unattended on the beach or something. Try to make sure it’s always locked up safe if it’s not attached to you.

Tandem also has a pump loaner program for traveling. They will actually send you a second pump sealed in a box that you can have on hand just in case of emergencies. At the end of your vacation, you send the pump back still in the sealed box. If you do have some sort of catastrophic failure, they’ll instruct you to open the sealed box and put the spare pump into service and return the failed pump instead. You’re on the hook for the value of the second pump, though, should you not be able to return one. I.e., if it’s lost or stolen, so keep that in mind if you choose to go this route.

I highly encourage you to travel with your backup plan, too, if you don’t go the loaner pump route. What would you do if you were stranded in a strange place without a working pump and/or insulin options? That might be an emergency vial/pen of long-acting insulin, syringes with the intention of just injecting your short acting insulin every few hours, or maybe an old insulin pump and supplies…

Also remember that the Dexcom reads wonky when it’s wet. Mine reads really high. Since I restart my sensors anyway, I’ve gotten really good at popping the transmitter out (by prying something thin and flexible between the sides of the sensor and transmitter). Then I can dry any water in there and the readings go back to normal. It dries on it’s own eventually, but this technique fixes the problem way faster.

I hope you enjoy your vacation!

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I wrote this blogpost a long time ago back when I was using an Animas pump. However, I would still use the Untethered Regimen if I were to go on a beach vacation. Much safer IMO to keep your pump out of the pool and ocean and not run the risk of it being stolen out of a cooler.

I also agree with the other posters to avoid hotel refrigerators. I am a big fan of Frio packs. Not only do they keep your insulin coolish, they provide padding to help prevent breakage.


I did have that happen once but I thought it was because I put the insulin on the top shelf right under the tiny little freezer. I have not used a mini fridge since, only a Frio. I have a Frio for pens not vials.

OK very interesting info. I think I would rather disconnect from the pump while in the water. I guess I will have to research how to set up a basal profile for 0 u/hr. My endo and CDE refuse to teach me to make changes to my settings.

I do have Treciba pens for a back up plan if I have a pump failure issue. I can bring them, just in case.

I can pop my transmitter out. NP. Thanks for the info.

Very interesting read. I went and looked up the original article from 2004 and also reviewed some medical journals on the topic. I had not heard of this but it could solve the problem of being off pump for 6 hours at the beach and I could leave the pump in my room. NO fear of cooking the insulin or of losing the pump.

I have had great success doing that and actually have some of my best numbers when I add a basal injection to my pump regimen. It is probably a guess as to how much basal you want to take by injection and how much to let the pump keep doing. In general if you are very active with swimming, etc. you probably only need 50-60% of your basal injected. Then at meals and night, you can put your pump back on for boluses and for more of your basal. If I were going away from the hotel for the day, especially on a boat, I would be sure to take a pen with fast-acting insulin for meal and correction boluses if needed. Frio makes pouches specifically for pens and they are big enough to toss some extra pen needles into.

Also I forgot to mention in my previous post. If you use Frio, just know that it works by evaporation and don’t keep them in waterproof or airtight pockets of your backpack or tote bag.

I always used Lantus for this because it was what I had. For best results, I injected 2 times per day. Tresiba would work great also and you would only have to inject once a day.

I wrote quite a few posts about the untethered regimen. Here is the link to one more post which talks about the advantages and disadvantages.

Thanks. I don’t think I would use the untethered regimen long term. I have really good control with my pump. My last 2 A1Cs were 5.6 But, It could be a viable option for vacation. I have a Frio for pens but not for vials. I guess I could pick one up. Yes I have Tresiba. My cat has Lantus.

The Dexcom sensor is 100% waterproof. The receiver or your phone is not. You want to keep your fancy new Tslim out of saltwater. Take some syringes and switch to shots for the periods when you are going in and out of water? Your pump history will tell you your typical basal and bolus doses. Don’t store your insulin in a car, but you are fine having it unrefrigerated in the shade on the beach or a hotel room for weeks.

You say you just cyborged up last year so I’m a little surprised you aren’t more confident about unhooking for brief periods.

A little more concerned that you don’t have insurance. Most involuntary separations will give you a chance at paying for COBRA. While many (most?) practices have strict practices on not accepting new patients without insurance, most will be able to offer an “uninsured discount” to existing patients undergoing a carrier change or transiently uninsured. The major lab companies will too. The insulin companies have discount card/coupon plans (which some of us even with insurance have leaned on.) But you have to ask! Back in the 90’s I went many years uninsured but my diabetes care was way lower tech back then.

I get a very real “bump” in Dexcom readings during a warm shower but I don’t think it’s because the Dexcom is wet. I think it’s a change in interstitial fluid balance inside me. I would NOT recommend taking a transmitter out just because it’s going to get wet. The Dexcom sensor and transmitter are 100% waterproof (note the “vents” in the sensor - that part is SUPPOSED to get wet when you are in the water!)

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No, I mean what I said. I’m a sucker for long, hot baths, and keep a meter in the bathroom for exactly this reason, because Dexcom spikes and becomes untrustworthy. If anything, the baths make my actual BG drop if I have insulin on board, not spike as Dexcom reflects.

I’m most definitely not alone in this either, as Dexcom told me it was a known issue. They told me it was because of water under the transmitter and that it should resolve itself in less than an hour, as soon as the water dried. Which is why I took to just popping out the transmitter to physically dry it myself, rather than wait all that time for it to dry on it’s own. The false high resolves itself within a few readings once it’s dry…

I don’t leave it out as t reply suggests. It’s only out for a moment while I dry it.

So you would rather wait 2 hours for the sensor to restart, rather than have a bump during the (presumably shorter) bath?

For me the bath bump is very reproducible. And for me it recovers almost the instant I get out of the bath. But I can’t ever imagine removing and restarting the transmitter for such a minor blip.

You don’t have to restart it, do you? Just remove, dry, reinsert?
I have not actually have this problem, I go in hot tub, sauna, bath, swim, shower. . . Maybe a bit up or down (seems random, possibly more up if warm and more down if swimming especially if I have insulin on board and haven’t taken extra carbs).

No, I don’t restart it. I just pop it out, dry it, and pop it back in. It’s never been an issue. I suppose if it tries to scan at that point, it might confuse the sensor and briefly give the “- - -”, but I’ve never seen it. It’s become a regular part of my drying off regiment.

I don’t have this problem with quick showers and whatnot. It’s only when the sensor is submerged for lengthy times.

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I have had the pump for 11 months. I only disconnect to shower (about 10 minutes per day). For me, a “long shower” might result in hearing the 15 minute alert to resume insulin. Being a critical care travel nurse, I have been working 50-60 hours per week with Covid and have not been to the beach at all since getting my devices. This will really be my first time unhooking. I also don’t have any diabetics in my family and don’t know anyone else with a pump. I only met with the CDE twice. Once to set up the pump and the second time I have no idea why. The endo told me I had to but the CDE didn’t show me anything When I started asking specific questions about settings, what they were/meant and how to properly adjust them, he refused to discuss it stating that he didn’t want me to touch anything.

And, my contract just got canceled. The hospital I was at was just purchased. I was supposed to be there until mid January then go on vacation for 2.5 weeks followed by a mandatory quarantine by my company because I’m going out of country. If I take an assignment now, I have to cancel the vacation. Assignments are 13 weeks. So, I just lost insurance a week ago . No cobra info received yet.

I will have to call my endo next week to see what can be done there. I have discount cards for my insulin but they are only for discount copay if you have commercial, non government insurance. Weird but true. Not too worried about that. I think I have enough insulin vials for about 4 or 5 months. Since I lost 85 pounds, I use half the insulin I used to. I have a little over 3 months worth of pump supplies and exactly 3 months with Dexcom supplies. I just started my new transmitter.

The good part about what I do is that I can set up a new contract before I go on vacation and start as soon as quarantine is over. Insurance starts on day 1.

OK, thanks for all that background! I can certainly see why you need a vacation!

I know that a lapse in insurance coverage isn’t as bad today as it was say 10-20 years ago when being uninsured a single day turned diabetes into an uninsurable pre-existing condition. That said, from the little I know employment law in my area, if you were terminated by the new owners then you likely have insurance coverage through the end of the month and an option to buy COBRA before then. And if you lost insurance purely because of corporate tumult you usually can get fast-tracked (no waiting for enrollment period) into any obamacare plan you choose.

Maybe your current insulin discount card requires you have private insurance, but all the insulin companies have plans to help folks without insurance too. Again with a recent job loss you may be fast-tracked into a super-discount or free insulin program. Every insulin brand has a website and they strongly encourage everyone who just lost insurance/job to call as well.

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