KARACHI, Aug 22: Due to the tightening of security at airports, people with diabetes intending to travel by air have been strongly advised to carry a note from their doctor explaining why they need to take medication on board, or a diabetes ID card that displays their photo and is signed by their doctor.

The diabetics can alternatively have a prescription with their name on it and that a spare set of diabetes equipment must be carried in case of loss or damage.

The Diabetic Association of Pakistan and WHO Collaborating Centre, Karachi, on the basis of guidelines provided by the Diabetes UK and American Diabetes Association (ADA) here on Tuesday further said that all diabetes equipment should be placed in a clear plastic bag during the journey.

It was stressed that check-in staff and cabin crew should be made aware of the need to carry diabetes equipment and food or drink.

People with diabetes were urged to take double the amount of medication they expect to use on their travels. This was said to be because they might need to increase their dose in case of illness.

“Up to 50ml of insulin -- usually enough for a few weeks -- is allowed on board a plane,” the advisory stated mentioning that if any more insulin was needed, it had to be stored in the hold.

DAP sources maintained that their advice based on information from insulin manufacturers had always been to avoid storing insulin in baggage which went into the hold, as travelling at altitude may cause the baggage to freeze, which would damage the insulin.

Insulin manufacturers were said to have suggested that in the current emergency situation, insulin that had to go in the hold should be placed in an airtight container (such as a flask) in the middle of suitcase.

“Alternatively, if an airtight container is not available, wrap it in bubble wrap, then in a towel and again place it in the middle of your suitcase,” they said.

“On arrival at their destination, the individuals concerned must examine the insulin for crystals and discard the insulin if any are found.

“The diabetics are strictly advised that even if it looks okay, they should test their blood glucose levels more frequently and if the levels appear abnormal, then the insulin ought to be discarded as it may be damaged and ineffective.

“Before travelling, try to find out where you can get further supplies of insulin at your destination, in case of emergency,” they were advised.It was also stressed that though under normal conditions, insulin could safely pass through X-ray machines at airport terminals. The diabetics, however, needed to be particularly careful in case the insulin remained in the path of the X-ray longer than normal, or if it was repeatedly exposed to X-rays as this could affect the stability of the insulin.

Travellers with diabetes having concerns about X-rays could request hand-inspection. Also, insulin never should be placed in checked baggage. Passenger baggage stored in cargo holds was subject to powerful X-rays. It also could be affected by severe changes in pressure and temperature.

They have been therefore suggested to inspect their insulin before injecting each dose, while doctors must be consulted if anything unusual was noticed about the appearance of insulin or insulin needs were noticed to be changing.

For general diabetes management, people with diabetes have been asked to carry starchy carbohydrate foods, such as biscuits, and soft drinks as diet cola and water, on board the aircraft. These must be purchased after going through customs.—APP