Q: Our 13-year-old child is going to visit his grandma in a different state for a few weeks and will travel solo on a nonstop flight to get there. My mom is well-trained in type 1 diabetes care -- that's not what I’m worried about. It's the flight itself! The airline has a very detailed plan on how to handle children flying solo, but nothing about how to handle a child with type 1 diabetes. The flight is four hours. Is this a bad idea, or can we make it work?
A: Every year, thousands of kids safely fly solo to destinations around the world -- and among these young jet setters are many children with type 1 diabetes. To figure out if your son should be one of them, think about how mature he is right now with handling his diabetes. Since you can’t expect flight attendants and other airplane personnel to be trained in administering type 1 care, is your son ready to be in charge of his diabetes for four hours with minimal adult supervision? How willing and able is he to follow through with certain care tasks, including blood sugar checks and responding to highs and lows? How has his blood sugar been lately? And finally, are you confident he knows how and when to ask for help?
Some parents opt to buy an extra ticket to have an adult caregiver on board for the flight, especially if this is a child’s first time on an airplane. However, if you feel confident in your son’s ability to take care of himself, he may be ready for takeoff, with just a few extra steps.
The most critical part of the trip-planning process is meeting with your child’s diabetes care team. Bring the specifics of the flight with you (i.e., takeoff/landing times and total trip length from your home to Grandma’s house). Using this information, your diabetes educator can help you time meals and snacks and possibly modify insulin requirements on the day of the trip in order to keep your son’s blood sugar as stable as possible.
While you’re there, also request that someone from the team write a medical clearance letter for your son to carry with him. This basic letter from a medical professional simply explains your son’s diagnosis of type 1 diabetes and why he must carry certain medical items with him. Presenting this letter may make passing through security a much easier task.
Next, get in touch with the airline to learn about their policies on children flying solo. Speak to someone directly to explain your child’s situation, and what kind of help he may need. Some parents make a “what-to-do” sheet for the child to pass to the flight attendant after boarding. This can be a rundown of emergency directions and other information, including what time he is supposed to check his blood sugar (if he falls asleep, for example, it’s reasonable to include a request for the flight attendant to wake him up so he doesn’t miss his check). If you plan to create this kind of list, let the airline know to expect one.
Now comes the fun part -- packing! For easy access, pack all diabetes supplies, including your son’s glucometer and testing strips, insulin, snacks, and juice and other low blood sugar supplies in a sturdy carry-on bag. If your child doesn’t have some form of visible diabetes identification, such as a medical alert bracelet, get one for him to wear while he travels.
In light of current airline safety regulations, it’s best to make sure any prescribed medication (including insulin) is in its regular prescription packaging. Also be aware that people with diabetes can bring more juice than the normal limit of 3.4 ounces of liquids. The American Diabetes Association has a complete list of up-to-date safety regulations here.
When the day of the flight arrives, get a gate pass so you can stay with your son until he leaves. In addition to following the meal plan and insulin regimen you planned with the diabetes team, it’s a good rule of thumb to have your child check his blood sugar right before takeoff (and adjust accordingly), and then check again about halfway through the flight, or with whatever frequency your diabetes educator suggests.
While you may be worried about a low, don’t be surprised if your son’s numbers actually run a little high. Sitting still in the plane, feeling nervous and excited, and dry air on the plane can all contribute to numbers edging up. Make sure your son knows he can request water on the flight in order to stay hydrated. On the other end, instruct Grandma to meet him at the gate and to be sure he got off the plane with all his gear!
Will waiting for a call that your son arrived safely make these the longest four hours of your life? Possibly. But once you both get the hang of it, traveling solo really can be a fun adventure for your child -- and further proof that diabetes should not limit how exciting and adventurous life can be.
--Paula Jameson, A.R.N.P., M.S.N., C.D.E., is the diabetes program coordinator at the Florida Center for Pediatric Endocrinology, Diabetes and Metabolism at the Florida Hospital for Children in Orlando.
How Other Parents Deal
“When my son and his father came back from a trip they took together, I was on airport pick-up duty. I made sure I packed a big snack and brought all my son’s supplies with me just in case he was running low or couldn’t get to his supply kit right away to test. Good thing I did! He ate the sandwich I brought before even giving me a hug!”
-- Karen L., Los Angeles, mom of 18-year-old David
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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