Saturday, November 24, 2001

Before September 11, supplies used by diabetics such as sharp-pointed syringes, lancets, and insulin-pump infusion sets were not a security concern at the nation’s airports.
But that all changed after the deadly terrorist hijackings, when the Federal Aviation Administration drastically tightened security.
“In my eight years with the American Diabetes Association, these devices had never been an issue. I never heard of them being used to challenge boarding” by a passenger, said Jerry Franz, vice president of communications for the ADA.
But recently “I’ve heard from people who’ve been quizzed about their insulin pumps, which are picked up by metal detectors,” said Dr. Joe Prendergast, president of the Metabolic Center in Atherton, Calif.
Others have been hassled about syringes or insulin pens, which administer insulin automatically, said Mr. Franz.
The insulin pump is a small mechanical device, about the size of a pager, that delivers insulin to the body by way of a thin plastic tube called an infusion set.
The latter connects the pump, worn outside the body on a belt-holder or a pouch, to a plastic needle inserted beneath the skin.
“The pumps are loaded with a clear liquid [insulin], and the patients tell me they’ve had to explain to airport security what the fluid is. I guess there’s concern it might be nitroglycerine or anthrax,” said Dr. Prendergast, known on the Internet as Dr. Joe, in a telephone interview.
He said security personnel in British airports have been far more intrusive. “They are convinced they can recognize insulin by its smell, so they actually smell the fluid in the pump,” he said.
Mr. Franz said the ADA has also received complaints from people who encountered difficulties with airport security due to the fact that they have traveled with devices such as insulin pumps, insulin pens or syringes.
However, neither he nor FAA spokesman Paul Takemoto said they have heard of any diabetic being denied passage on a flight because of equipment that was carried.
Immediately after the terrorist attacks, the FAA banned sharp objects such as knives, box cutters, metal scissors, ice picks, straight razors and metal nail files from being taken aboard planes. There was resulting confusion among diabetics and seeming uncertainty by both the FAA and airline personnel as to how pointy objects diabetics use to inject insulin or test blood-sugar levels would be treated.
John Hughes of Woodburn, Ore., an insulin-dependent diabetic who uses an insulin pump, found out when he called the Portland airport. “They said, ‘Without a doctor’s note, we won’t let you through,’” Mr. Hughes told the magazine Diabetes Interview.
Nearly a month after the deadly hijackings, the FAA came out with new regulations dealing with the sharp objects used by millions of diabetics to keep their blood-sugar levels stable.
The new regulations allow diabetics to take such supplies aboard flights but require additional evidence of their medical condition.
And, contrary to what Mr. Hughes was told, the FAA says: “Prescriptions and letters of medical necessity will not be accepted [as the sole evidence] because of forgery concerns.”
The FAA now says passengers may board planes with syringes and insulin-delivery systems only if they can produce a bottle of insulin having a “professional pharmaceutical pre-printed label” that identifies the medication and the manufacturer’s name.
Those who test their blood-sugar levels but do not require insulin may bring lancets aboard for finger-stick testing. However, the lancets must be capped, and the patient must have a glucose meter featuring the manufacturer’s name embossed on it, according to the FAA.
“The FAA also told us that individual airlines and airports can make their own regulations” in addition to those imposed by the federal government, which means there can be further restrictions, said Mr. Franz.
He advised diabetics to call their airline at least one day in advance of a scheduled flight to find out its policy with regard to medicines and supplies.
If a passenger is barred from boarding a flight because of a diabetes-related difficulty or other problem, Mr. Franz said the person should contact the FAA grounds security commissioner at the departing airport. The security commissioner should be able to resolve the problem, he said.
Lisa Anderson, director of customer advocacy for Southwest Airlines, said in an interview that Southwest has a system called Medlink in which doctors intervene to resolve differences over health issues.
Because of the long waits at airports following the terrorist attacks, diabetics who take insulin or oral medications to reduce blood sugars need to come prepared with additional food. Products such as peanut butter crackers or peanut butter sandwiches are recommended, because they can help stabilize blood sugar levels.

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