World travel with type 1 diabetes using continuous subcutaneous insulin infusion


  • Alexander R Charlton University Hospitals of Leicester
  • Jessica R Charlton University Hospitals Of Leicester



type 1 diabetes, travel, insulin, climate, altitude, flight, continuous subcutaneous insulin infusion, CSII, airport security, metabolism, physiology, glucose


Living with type 1 diabetes and using continuous subcutaneous insulin infusion (CSII), the authors travelled together for four months through 11 countries. Travelling with type 1 diabetes presents various added challenges. Personal experience of the challenges faced by the authors in relation to their diabetes are discussed along with the ways they were able to overcome these challenges. A review of general aspects one may encounter when travelling with type 1 diabetes and CSII follows. This provides an insightful overview for individuals living with type 1 diabetes intending to travel as well as healthcare professionals involved in providing care to those with type 1 diabetes intending to travel.


Gill GV, Redmond S. Insulin treatment, time‐zones and air travel: a survey of current advice from British Diabetic Clinics. Diabet Med 1993;10(8):764–7.

Chandran M, Edelman SV. Have insulin, will fly: diabetes management during air travel and time zone adjustment strategies. Clin Diabetes 2003;21(2):82–5.

Kerr D, Martinez J. Time zones [online]. 2015. Available at: (accessed 3 May 2019).

King BR, Goss PW, Paterson MA, Crock PA, Anderson DG. Changes in altitude cause unintended insulin delivery from insulin pumps: mechanisms and implications. Diabetes Care 2011;34(9):1932–3.

Chee YL, Watson HG. Air travel and thrombosis. Br J Haematol 2005; 130(5):671–80.

Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen PW. Cardiovascular risk factors and venous thromboembolism. Circulation 2008;117(1): 93–102.

Tashima CK, Fillhart M, Cunanan A. Jet lag ketoacidosis. JAMA 1974;227(3):328.

Spence C. Tasting in the air: a review. Int J Gastronomy Food Sci 2017;9:10–5.

Pavela J, Suresh R, Blue RS, Mathers CH, Belalcazar LM. Management of diabetes during air travel: a systematic literature review of current recommendations and their supporting evidence. Endocr Pract 2018; 24(2):205–19.

de Cássia Sparapani V, Jacob E, Nascimento LC. What is it like to be a child with type 1 diabetes mellitus? Pediatr Nurs 2015;41(1):17–23.

McGhee K. Diabetes and air travel: ensuring security, promoting dignity. Int Airport Rev 10 February 2017.

Nassar AA, Cook CB, Edelman S. Diabetes management during travel. Diabetes Manage 2012;2(3):205.

International Airport Review: Rachel Humphrey (2016). Held in an airport for 2 hours because my son had an insulin pump [online] (accessed 2 May 2019).

Civil Aviation Authority ( 2019. Available from: (accessed 21 August 2019).

Diabetes UK. Using diabetes technology at the airport. 2019. Available from: (accessed 21 August 2019).

Moore K, Vizzard N, Coleman C, McMahon J, Hayes R, Thompson CJ. Extreme altitude mountaineering and type 1 diabetes; the Diabetes Federation of Ireland Kilimanjaro Expedition. Diabetic Med 2001;18(9):749–55.

Brubaker PL. Adventure travel and type 1 diabetes: the complicating effects of high altitude. Diabetes Care 2005;28(10):2563–72.

Fink KS, Christensen DB, Ellsworth A. Effect of high altitude on blood glucose meter performance. Diabetes Technol Ther 2002;4(5):627–35.

Giordano B, Thrash W, Hollenbaugh L, et al. Performance of seven blood glucose testing systems at high altitude. The Diabetes Educator 1989; 15(5):444–8.

Moore K, Thompson C, Hayes R. Diabetes and extreme altitude mountaineering. Br J Sports Med 2001;35(2):83.

de Mol P, de Vries ST, de Koning EJ, Gans RO, Bilo HJ, Tack CJ. Physical activity at altitude: challenges for people with diabetes: a review. Diabetes Care 2014;37(8):2404–13.

de Mol P, de Vries ST, de Koning EJ, Gans RO, Tack CJ, Bilo HJ. Increased insulin requirements during exercise at very high altitude in type 1 diabetes mellitus. Diabetes Care 2011;34(3):591–5.

Mohajeri S, Perkins BA, Brubaker PL, Riddell MC. Diabetes, trekking and high altitude: recognizing and preparing for the risks. Diabet Med 2015;32(11):1425–37.

Driessen SO, Cobelens FG, Ligthelm RJ. Travel-related morbidity in travelers with insulin-dependent diabetes mellitus. J Travel Med 1999;6(1):12–15.






Special Commentary