Diabetes Advocates

Air Travel with Diabetes

Air travel passengers these days are subject to flight delays, crowded planes, and long security lines. For those of us with diabetes, there is often added scrutiny and possible personal discomfort when encountering TSA agents unfamiliar with the myriad of medical devices and supplies we carry.

Diabetes education opportunities can happen anywhere; a TSA screening before a flight is not an optimum time. Being prepared and knowing your rights can help ensure a fast and painless navigation through security. Here’s how:

BEFORE YOU FLY

If you have questions about the screening process, you can call TSA Cares toll free line at 1-855-787-2227. They’re open Monday through Friday 8 a.m. – 11 p.m. EST and weekends and Holidays from 9 a.m. – 8 p.m. EST. They will answer your questions and even coordinate checkpoint support with a Passenger Support Specialist to assist you (or your family member). You must call at least 72 hours in advance for checkpoint support. This is a new program comprised of TSA volunteer employees. Their role is to assist the passenger and get them through screening and on to the gate.
From the TSA Blog: PSS’s are Transportation Security Officers, Lead TSOs and Supervisors who have volunteered to take on the responsibility of assisting passengers who may need a little help at the checkpoint. They receive additional training involving scenarios such as resolving traveler-related screening concerns and assisting travelers with disabilities and medical conditions.

Print out the Disability Notification Card for Air Travel. This is a fillable PDF form that you can discretely hand to the TSA screener to let them know you have diabetes/wear an insulin pump/wear a continuous glucose monitor (CGM), etc.
Put all of your diabetes supplies that you carry into clear plastic zippered bags. This will expedite the screening process, as you’ll need to separate them at screening from the rest of your carry on items.
Understand the 3-1-1 rule (and the exception) = TSA allows one zippered clear plastic bag for liquids in 3.4 ounce (100ml) bottle or less (by volume) per passenger. If you have medication that is more than 3.4 ounces (100ml), it must be declared before the screening and it will require additional screening. (The TSA cautions us about “reasonable quantities” for the length of your stay, so be prepared.) It’s recommended that you keep the liquid in the original bottle with the prescription label on it.

KNOW YOUR RIGHTS AND TSA POLICIES

It behooves all air passengers with diabetes to become familiar with TSA policies that impact us. TSA.gov has particular sections which we feel should be reviewed before traveling:

External Medical Devices (At this time, the TSA has not formally created a policy for continuous glucose monitors (CGMs) but would fall under the category of external medical device.)
Traveling with Children has a section regarding children under 12 years of age and medical conditions.

Please be cognizant that neither you nor your supplies and devices are exempt from screening (or additional screening) by showing the Disability Notification Card or telling a TSA screener that you have a medical condition.

BEFORE THE SCREENING

Prepare

Have your Disability Notification Card ready to hand to the TSA agent if you wish to use it.
Decide your choice of screening: imaging technology/metal detector or patdown.
Gather your supplies to declare. You have the right to request hand screening of your supplies or place them on the X-Ray belt.

Declarations

You must declare your diabetes supplies (including freezer or gel packs) before the screening. These can go through the X-Ray machine or you can ask that they be inspected by hand. (This is your right to ask.)
Freezer or gel packs are permitted through screening and are treated like a liquid if they are slushy or partially frozen. Frozen or not, they may be subjected to additional screening.
Any liquid or gel more than 3.4 ounces will require additional screening and you may be asked to open the container for inspection. If you do not want the container opened, you must inform the TSA officer before the screening. According to the TSA website: “Additional screening of the passenger and his or her property may be required, which may include a patdown.

Let the TSA agent know if you are wearing an insulin pump or CGM and express your choice of screening: imaging technology, metal detector, or a thorough patdown. You are not required to remove your pump or CGM sensor. The pump or CGM will be subject to additional screening and the passenger will have an explosive trace detection hand sampling during screening after holding the device. (You have the right to choose your method of screening of yourself and your insulin pump and/or CGM.)

SCREENING

If you choose imaging technology or a metal detector:

Be aware that you may still be subjected to a patdown if the alarm sounds. To help avoid the alarm, remove all metal jewelry, metal accessories, and pocket contents. The TSA also suggests avoiding clothes with a high metal content. Pumps and sensor filaments will not normally set off an alarm.
Pumps and CGMs will have additional screening (and the hands holding the devices will be swabbed) after you step through the imaging technology or metal detector.

If you choose a patdown (or the alarm has sounded on imaging technology/metal detector):

You will be screened by a TSA agent of the same gender. If you do not wish to have the screening conducted in view of the security line, you can request a private screening. You will be escorted to a private area with the screening agent and an additional TSA employee. You can bring a companion to be present during the private screening.
It’s helpful to point out to the TSA agent where the device is attached to the body or where a sensor resides. If that area is hidden by clothing, the agent will pat down and around that area. No agent should ever ask you to lift a piece of clothing or reveal a “sensitive body part”. If this happens, request a Passenger Support Specialist or TSA Customer Service Manager immediately.
Pumps and CGMs will have additional screening (and the hands holding the devices will be swabbed) after a patdown.

WHAT TO DO IF THERE IS AN ISSUE

There have been instances in which a passenger with diabetes has had issues during a screening. Some TSA agents, despite training, are unfamiliar with insulin pumps and continuous glucose monitors (CGM). If you feel that you are being asked to subject yourself (or a family member) that is not within the TSA’s right, you have the right to the following:

Ask for a Passenger Support Specialist during the screening. They are your TSA employee advocates at the security area.

Ask for a TSA Customer Service Manager onsite. If there are not Passenger Support Specialists available, you have the right to request a Customer Service Manager.

If you feel that your issue was not fully resolved onsite, you should file a claim after the screening has been completed. While it may not help you, filing a complaint will help travelers with diabetes in the future. All claims are assigned a specialist and are resolved within 90 days, with those incidents found to be “unlawful discrimination, harassment, or retaliation” addressed through training or additional measures.

Many Diabetes Advocates have shared their viewpoints, experiences, and suggestions to the TSA regarding security screening with diabetes. Take a moment to check their opinions and personal anecdotes here:

Christel Marchand Aprigliano