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Saturday, February 07, 2009

Travelling With Type 2

Up-dated 3rd April 2018. Please advise me in the comments if amendment is needed.

Air travel

Travel by air has become a bit more complicated since 9/11. I was travelling through the USA on my first rtw trip in March 2003 when the Iraq war started. Security went nuts and within a week we missed a flight from St Louis to Atlanta because we spent two hours in security. TSA took a long time to find a way to secure air travel without grossly inconveniencing passengers. However, after the initial over-reaction things have settled a bit now.


Hypo protection

For the possibility of lows, I just carry jelly beans. Simple and not bulky, which is important these days for carry-ons with many airlines strictly enforcing size limits.

Mid Air Snacks.

Making some snacks up in advance is best because you can choose exactly what they are. You aren't restricted to the over-priced limited range available at the airport. I usually make up a small sealed plastic container of mixed nuts and raisins. It keeps well, can be kept in a pocket or purse for a quick nibble to stave off hunger and gives a good mix of protein, fats and carb. If that is not possible, I seek out something suitable in the air-side shops. Things like beef jerky (check the carb count), nuts, cheese-'n-crackers or similar. Not for meals, but for those times when you need something to nibble on during a long flight. I don't try for very low carb, but a mix of carbs, protein and fat, including about 5-10 gms carb in a snack.

I never go on a flight without sufficient for two or three snacks in my carry-on. It may be scheduled as a one-hour hop. But, after the first time you've waited three hours in the gate lounge and then sat in a delayed plane on the taxi-way for several hours without food, air-conditioning or information you realise that travelling in those conditions without snacks is not wise. It may only ever happen to you once, but that will be too often if you don't have food available every few hours.

In-flight Meals.

This is becoming a hypothetical subject, but there are still a diminishing number of Airlines that provide meals in cattle class.

Never, ever, ring in advance to advise that you have diabetes and wish to have a "diabetic" meal. If you do, be ready to eat a meal that will commence with a bread roll, followed by a main of low-fat starch, with sides of starch, washed down with fruit juice, followed by a piece of fruit and a dessert of low-sugar rice pudding or similar.

Instead, I have a standard procedure. I wait until the initial boarding rush is over and I can catch the attention of the steward. I advise the steward that I have diabetes that I manage with a strict diet. Then I patiently nod and smile through the set "you should have advised us in advance so we could have provided a special diabetic meal for you". I apologise for not doing so and request a look at the menu of the day. I then choose the least bad choice. Failure to do this means you are risking no choice at all when they run out of the beef casserole and you find that pasta and rice is the only choice left. On two notable occasions, when there were no remotely acceptable choices, the senior steward suggested that I might prefer something from the business class menu. You get a different class of service on Qantas and Air New Zealand.

For longer flights I carry a cooler pack with me. This thing wandered around the world twice with me:


It doubles as my carry-on for medications and other things I need to get at quickly. Most airlines will allow something like that as a second carry-on, but check if your airline has a one-bag limit.

I often prepare a salad the night before, usually with some cold cuts or similar, and pack it in an appropriate small plastic lunch container. The dry food will get through the TSA security, but liquids won't; I haven't tried a freezer brick through security since those rules changed, so I would transfer the food from the fridge to the pack as late as possible. After passing through security buy a cold drink which can also act as a cooler for the insulated section. If you don't want to pre-prepare you can nearly always buy a prepared salad, or jerky or something similar on the "air" side of security.

Don't try to get drinks through airport security - they will probably be confiscated. Buy your cans or bottles after the security check if you need them; I usually have a coffee instead. On board, I have never travelled on an airline that did not provide water or diet soda on demand, sometimes free.

Medications and Diabetes Supplies

When I fly I always carry a letter from my doc listing my ailments and medications. I have only rarely needed that letter, but on those rare occasions it saved me a lot of stress and hassle. For diabetes supplies read the current rules on the TSA web-site - they apply to all US airports and many overseas airports also use them as a general guide. 

This is a copy of the US TSA rules as at 3rd April 2018:
heck or Carry-on
If you are being treated for diabetes or some other medical condition and have concerns about TSA’s screening process, please contact the TSA Cares Helpline. Travelers or families of passengers with disabilities and medical conditions can call the helpline toll free 855-787-2227, prior to traveling with any questions about screening policies, procedures and what to expect at the security checkpoint.
Helpful information for diabetic travelers:
  • Diabetes related supplies, equipment, and medication, including liquids, are allowed through the checkpoint once they have been screened. Passengers should declare these items and separate them from other belongings before screening begins.
  • Accessories required to keep medically necessary liquids, gels, and aerosols cool are permitted through the screening checkpoint and may be subject to additional screening.
  • Liquids, gels, and aerosols are screened by X-ray and medically necessary items over 3.4 ounces will receive additional screening. A passenger could be asked to open the liquid or gel for additional screening. The TSA officer will not touch the liquid or gel during this process. If the passenger does not want a liquid, gel, or aerosol X-rayed or opened for additional screening, he or she should inform the officer before screening begins. Additional screening of the passenger and his or her property may be required, which may include a pat-down. You have the option of requesting a visual inspection of your insulin and diabetes associated supplies.
  • Passengers who have insulin pumps can be screened using imaging technology, metal detector, or a thorough pat-down. A passenger can request to be screened by pat-down in lieu of imaging technology. Screening can be conducted without disconnecting from the pump. However, it is important to let the officer know about the pump before the screening process begins.
  • Regardless of whether passengers are screened using imaging technology or metal detectors, insulin pumps are subject to additional screening. Under most circumstances, this will include the passenger conducting a self pat-down of the insulin pump followed by an explosive trace detection sampling of the hands.
  • Be sure to let an officer know if your sugar is dropping during screening or if you need medical assistance.
Also, note that the 3-1-1 gels and liquids rule is eased for Medications. That was a very useful tip explained to me by the TSA supervisor at DFW. It helped that I had my letter from my doc, but items not on the doc's list such as mosquito repellent, antiseptic and similar were also allowed.

Road Trips

When possible I prepare exactly the same snacks as I do for an air trip and carry the cooler pack on board. That gets a lot of use in the car, because there will always be a bottle or two of diet soft drinks, a bottle of wine and some cheese, crackers or similar. I add a couple of freezer bricks to keep things cold and fresh. Each night I put those in the room fridge, if it has one, or ask the hotel staff to keep them in the restaurant freezer. I've never had that request rejected but I have occasionally forgotten to collect them in the morning. No big deal, they only cost a couple of bucks. I also store small containers of olive oil for salad dressing or cooking oil, vinegar, salt and pepper in the side pockets.

If the accommodation I am using has cooking facilities I always prefer to cook my own simple breakfasts. While on the road it is easy to pick up some eggs, maybe an onion, mushrooms, cheese (or whatever you like) to make a simple omelette or scrambled eggs in the morning.

I look for diners and Mom and Pop restaurants when I'm on the road. The sort of place where I can get bacon and eggs for breakfast, or they will listen when I ask them to hold the fries and double the salad.


Hotel breakfasts can vary from wonderful buffet choices to disastrous "continental" breakfasts of a tired croissant and grey cold imitation coffee. They can also be incredibly expensive, with minimum prices in the restaurant or high extras and tips on room service. I refuse to pay $20+ for some watery scrambled eggs and a coffee. If the hotel choice is OK or I can cook my own, wonderful. If not I have a standard routine on arrival at a hotel.

I ask at reception where the nearest diners, cafes and restaurants are and for recommendations. At an appropriate time after I check in, usually after dinner, I take a walk around the district. If I arrived by car I will have already been watching for restaurants as I drove in. I use the walk for exercise and also to check out an appropriate place for breakfast. It is rare that there are no diners or similar within a reasonable walk - which also doubles as my morning exercise.

Eating Out

When I am travelling with my wife, eating out is much simpler. On two trips around the world with her we left a reputation behind us as Aussie cheapskates because, wherever we went, we would order one main course and a spare plate for the two of us. It took some cheek, but we didn’t put the weight back on. We also saved some cash, but that was a bonus, not the intention. Where it wasn’t possible because of language or embarrassment of others, we would order a main course and a side salad or starter – just to get the plate – then mix between the two. This allowed me to leave the high carb items for my non-diabetic wife.

We often found that we still left food on the plate, even when we shared. The food is actually the smallest cost in running most restaurants; many chefs provide enormous serves to attract customers.
When I travelled alone, it was more difficult. I, like many, was raised in an environment where waste was frowned upon - waste not, want not. As a post-WWII child I was taught to clean my plate before leaving the table.

It takes discipline to break the habits of a lifetime and leave over half the food on the plate when you know you are paying for it. But if you eat it, you will pay much more eventually. Specify that you absolutely, definitely do NOT want chips/fries. Many restaurants add them automatically.

For dinners, when travelling alone, I found the method I used most often was to order an appetiser and a side salad instead of a main course. If that was too small I would order a second appetiser. That led to some marvellous and delicious meals; often the appetisers are more varied than the main course and aren't accompanied by piles of potato, rice or fries.

My most common lunch when travelling is "Soup of The Day". But be a little careful of thick "cream" soups; they will often be thickened with cornstarch, flour or potato. In 2006 I happened to be wandering through Germany in Spargelsuppe season. Bliss.

I'm sure I'll recall other tips after I post this, so I'll probably return regularly and up-date it.

Bon Voyage
Cheers, Alan
Everything in Moderation - Except Laughter.


nonegiven said...

These days you can use Google maps to choose a motel based on which restaurant chains are nearby. Many chains aren't open for breakfast. I recently chose one because there was an iHop in walking distance so I could have fried eggs for breakfast. (They put pancake batter in their scrambled eggs and omelets.)

Anonymous said...

When I packed a small cooler and ice, I had my small bag of ice confiscated by TSA. However, I was told I could get ice at the fast food drink counters after proceeding through security.

Alan said...

I don't doubt your story on ice. You may have had a TSA person from the class of ’03.

I noticed on my most recent trip last April that there was a marked improvement in attitudes in the TSA staff I met. On that trip I passed through security at NYC, DFW and HNL. When I had a problem at DFW, with a non-standard zip-loc bag for my liquids (they don’t sell quart bags in Oz) the DFW TSA supervisor was very helpful and pleasant.

Only once did I come across one of the class of '03. That was the group for which the selection criteria included the thickness of their muscles, especially the one between their ears.

RK said...

Great article! A comment on "cold-packs" and TSA security. I have went through security numerous times at US airports with a small lunch bag cooler containing insulin cartridges and a cold pack with no issues. Actually queried TSA at my local airport, they advised medication no problem. Also informed me I should carry a prescription copy in case I was questioned.

I have a rather large laptop case and place the small lunch cooler in a middle compartment. It runs through x-ray without a problem so far. Although now that I made this statement, next flight I will get hauled off for frisking like a common criminal....LOL