Wil Dubois

Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and smart guy Wil Dubois in New Mexico.

This week, Wil is taking on the topic of international travel challenges for those of us dependent on insulin. So buckle up for Wil's take on this topic.

{Got your own questions? Email us at AskDMine@diabetesmine.com}



Diane, type 2 from British Columbia, writes: I will be traveling overseas, my first trip since starting insulin. I’m looking for tips on keeping insulin cold while traveling, and whether there is a problem with airline security taking insulin on board the plane?

Wil@Ask D’Mine answers: Bon Voyage! Rest assured that traveling with insulin is pretty much the same as traveling without insulin. As to keeping insulin cold, that’s not really necessary. It’s only necessary that it not get hot.

Here’s the deal: While your main stash of insulin should be kept at fridge temp, insulin in active use only needs to stay in the room temperature range. For Basaglar, Humulin R U-500, Lantus, Levemir, Toujeo, and Tresiba (the most likely type 2 insulins) room temperature is defined as being below 86° Fahrenheit, or 30° C for you and the rest of the world.

So that means, depending on where you are going overseas, you may not need any sort of cooling apparatus whatsoever. Iceland in the icy winter months? Pack your pen with your toothbrush and forget about it. On the other hand, if you’re going to Ethiopia—home to the hottest average temperature on Earth, well, that’s another story. There, the year around average temp is 93.0° F (33.9° C), so just walking down the street will cook unprotected insulin.

Now what?

Well, there are a gazillion ways to keep insulin not hot, including icepack-powered insulated containers of all shapes and sizes and battery powered mini coolers, (Note that the innovative but pricey ClimaPak by Kewl Innovations has gone the way of the Dodo Bird) but my preferred way of keeping insulin happy in harsh environments is the Frio.

The Frio is a wallet that comes in a range of sizes and colors (see our video product review). They work via the magic of evaporative cooling. Each Frio has an inner wallet and an outer wallet. The inner wallet is filled with pixie dust, or some other magical substance. Soaking the pixie dust in water turns it from rough-edged rock-hard crystals into a soft gel. As the gel starts slowly drying out again, a process slowed by the outer envelope, the evaporation lowers the temperature inside the Frio where your insulin is nestled. 

How cold is it inside the Frio? According to the Frio folks, 25° C. For USA readers, that’s 77° F., well below the 86° recommended for our basal insulins. Frios will even work in Ethiopia. In the summer. On a hot day.

No ice required. No power or batteries required.

The Frio works for about two days, depending on the humidity. That’s heaps longer than an ice pack, and the Frio can be “recharged” simply by soaking the inner envelope in water again.

As an added benefit, Frios can also help keep insulin from getting too cold when the mercury travels the other way.

Oh dear. That did sound a bit like a commercial, didn’t it? But it isn’t. I’m not on Frio’s payroll. Quite the opposite. I pay them. I’ve used Frios for many years, as do most of the traveling insulin users I know.

Now, on to the airport… Oh. Wait, I almost forgot something. We’ve mainly been talking about active pens. What if it’s a long trip requiring the use of more than one pen? Then what? Those are supposed to be kept refrigerator cold, right? Well, depending on the brand of insulin, an active pen lasts between 28 and 56 days. And that’s once its been “opened” by piercing it with a pen needle. Take whatever number of pens you need (plus a one pen reserve in case your trip unexpectedly lasts longer) and I think you’ll find that you’ll use them all up before they go “bad.”

Of course, if there’s a fridge at your destination(s) go ahead and put your spares in it.

OK, now on to the airport. If you just packed your insulin in your checked luggage, you’d be problem free. No security issues. But if you do, a whole new set of potential hassles replaces the airport security hassles.

Now, some experts worry about pressure and temperatures changes in airliner cargo hold and strongly advise PWDs to be sure to put their insulin in their carry on luggage. I’m not so sure about the cargo hold issues, but I agree with the insulin carry-on advice for a more pragmatic reason: Luggage, sometimes, gets lost.

So I think you should carry your insulin with you. 

I travel a lot, and I’ve never once had an issue with airport security relative to my insulin. In fact, most of the time they don’t notice it or comment on it, and I don’t even bother to put my insulin into my one-quart zippy bag that’s supposed to hold all my liquids. I guess insulin pens either don’t look suspicious on X-ray, or security folks see them so often that they know an insulin pen when they see one. I don’t think you’ll have any problems, unless Al-Qaeda makes an insulin pen bomb, in which case all of us who travel with insulin are screwed.

Still, to be on the safe side, ask your doctor for a letter on his office letterhead that briefly describes your condition and your need for insulin. The letter should include the name of your insulin, and it never hurts to mention that you will die quickly without it. Probably not true, but it gives the letter more weight.

My doc forgot to date my original letter back in 2003 so I’ve carried it with me ever since, as my Letter of Marque, but in all those years I’ve never once needed it.

And if your doc is super busy, there are also a number of “stock” letters that can be downloaded from the Internet, modified to include your brand of insulin, and then you just need your doctor’s signature, or a reasonable facsimile of it.


Happy travels. With insulin.


This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.
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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.