Last month, our family vacation took us to Barcelona. Our route was POS to MIA then MIA to BCN with a duration of approximately 4 hours and 10 hours respectively. The POS-MIA route was not as much of an issue as the MIA-BCN, due in part to our 2-day stop in Miami prior to our trans-atlantic flight.

The latter route was a cause for concern for Mom, who, being a Type 2 Diabetic, would need access to her insulin within the 14+ hours of travelling (inclusive of checkin and airport transits). She uses syringes and a vial of insulin. I am aware that the insulin vials  are 10ml and therefore permissible under the ‘Liquids Rule’, however my main concern was not the insulin as much as it was the needles on the plane. 

Travellers exiting the US know that the Transport and Security Administration (TSA) can be a bit strict with their checks prohibiting sharp objects such as pocket knives but interestingly enough safety pins, tweezers and sewing needles are actually permitted in carry on luggage, according TSA’s website, perhaps medical needles are permitted?…

Just to be sure, I did some digging to find answers to the following questions:

  1. Are sharps and insulin bottles greater than 3oz allowed in carry on luggage?

    Yes. According to TSA’s website, medication (and baby formula) are exempt from the ‘Liquids Rule‘, which means quantities in excess of 3.4oz or 100ml are permitted. TSA’s Blog mentions that an unlimited amount of unused syringes as well as lancets are permitted in carry on luggage. However, in an undated document on U.S. Congressman Michael C. Burgess’ website, it states that up to 8oz of liquid or gel low blood sugar treatment is permitted.

    IMG_7217

    10ml vial of Novolin 70/30 and insulin syringe

  2. Is any medical documentation required as proof of your medical condition?

    No, but it doesn’t hurt to have it. The American Diabetes Association (ADA) recommends visiting your doctor prior to travelling to acquire a letter detailing what to do for your condition: pills, insulin,  medical devices required and allergies present. Additionally ADA also advises getting a prescription for insulin and/or pills incase you need to acquire them at your destination. Interestingly enough, TSA’s website only states to inform the officer (verbally) and suggests presenting your TSA Notification Card or other medical documentation describing your condition upon screening. Mom didn’t have a letter or prescription, just her TSA Notification Card, and there were no issues.

    The above mentioned document on Michael C. Burgess’ website states that liquid prescription medicine should bare the same name as the passenger ticket in order to be permitted. TSA’s blog however, states that labelling of prescription medication is dictated by the specific state and not required by TSA. I think it is a good rule of thumb, that in the absence of a letter or prescription from the doctor, the dispensary’s label should at least verify the ownership of the medication in question. Additionally keeping the original packaging is also recommended. To my knowledge, insulin can be acquired without a prescription in Trinidad, but it’s still a good idea to ask the pharmacist to label the patient’s information on the box.

    IMG_7188

    You can download and print your own TSA Notification Card

  3. Does TSA require the passenger to provide special disposal units for used sharps?

    Yes, according to TSA’s website. I’m not so sure if they specifically asked to see the disposal unit, but we got one on Amazon. Then again we might have found out the hard way if we didn’t… I’ve seen some Youtube videos of people who’ve used regular plastic bottles with screw caps for disposal when travelling. TSA doesn’t require an actual ‘mini biohazard bin’, but a similar hard surface container, I’m not quite sure what constitutes that criteria…. In any event, the responsible way to dispose of sharps is to utilise an appropriate receptacle that minimises needle sticks.

    Additionally, TSA’s Blog outlines that an unlimited amount of used syringes is also permitted, I guess this is based on the capacity of the disposal receptacle?…

  4. What is the best method for maintaining insulin’s correct temperature for 14+ hours?

    Insulin can be kept at room temperature (15-25° C) for 28 days, but it is advised to be kept in a refrigerator when not in use. Diabetes Canada warns against carrying insulin in checked luggage as it may be subjected to freezing temperatures in flight. The ADA also suggests that pressure in the cargo hold can also affect insulin quality. Additionally, keeping your supplies in your carry on is a good idea to avoid the drama associated with stolen luggage….

    IMG_3080

    It’s a good idea to read the information on the box, as storage temperatures and other related information varies by type and brand.

    Apart from your flight’s duration, it’s a good idea to check the temperature forecast for the destination you’re heading to. Barcelona’s temperature was between 15-23°C so additional refrigeration wasn’t necessary. The temperature in the aircraft was also around 21°C which didn’t really require the use of an insulated pack. 

    IMG_2154

    My Oria Thermometer and Hygrometer recorded an inflight temperature of 20.6°C….note the very low humidity…

    Miami and Trinidad’s temperature however, were hitting maximums above 30°C at our time of travel. To mitigate this we got an insulated pack for medical vials from our local pharmacy. I also got another unit off Amazon, but mom doesn’t really use it because it’s more bulky…Please note that these methods store the vial only, don’t forget to pack the outer box/packaging (with dispensary’s label) elsewhere in your carry on. The insulated pack should also be utilised even if temperatures are acceptable since it  provides good a cushion for preventing damage to the glass vial in your carry on.

    IMG_7216 2

    Insulated travel case acquired from our local pharmacy. It’s a tri-fold soft case design with a removable freezable pack…we swapped out the original pack (due to wear) with a freezable eye mask and it works just as well.

    IMG_7192

    Medicool Insulin Protector Case acquired from Amazon – has a removable moulded freezer pack that holds 2 vials, it also comes with a spare freezer pack – its design is more bulky, but can perhaps hold temperatures for longer

  5. Can insulin pass through the X-ray machine at the security check point?

    Yes, according to ADA’s website. However if you have concerns about it’s safety going through the scanner, TSA states that you should inform the officer before the screening process begins. This may then entail addition screening, perhaps even a pat down….

Packing Tips

  • Take double the amount you think you need – to avoid any unforeseen mishaps or travel delays
  • Pack a new vial – it’s easy to see from the information on the box that a new bottle of insulin can last longer than an opened bottle.

 

Additional Info

ADA suggests being conscious of adjusting insulin dosages when crossing timezones. Eastward travel means a shorter day and may require a smaller dose and vice versa for westward travel, this could be mentioned in your pre-travel doctor’s visit.

Here’s a really interesting article…if you’re up for reading further:

https://www.diabetesselfmanagement.com/about-diabetes/general-diabetes-information/traveling-with-diabetes/

Information on this subject is constantly being updated, so please seek the most recent advisories from official sources.

I hope this helps you or someone you know on their next flight!

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About Alina C. Dhanoolal

I have a genuine and deep seated interest in shared spaces, anything from hotels to food courts. I currently have a career in Occupational, Health and Safety and I’m exploring it’s relevance outside the workplace, and in my native Trinidad. The content for my posts are solely funded by me and bare no affiliation to the organisations described. All views and opinions expressed are therefore personal..and honest. My intention is not to discredit any company, brand or business, but rather to highlight things that may be overlooked with routine operations. I also hope that my thoughts will broaden the public interest in having their standards raised-for those that need to- and to credit those who are doing a good job.

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