When Frank*, a 56-year-old professional living in Boston, boarded a flight to Las Vegas for a speaking engagement in the summer of 2006, he was certain he had prepared adequately for his voyage.
Having lived with diabetes for 32 years, he made especially sure to have his insulin handy on the flight. And as so happens with many who live with diabetes, the inactivity of the flight caused Frank's blood sugar to rise.
He took his insulin. But he forgot to have a snack before leaving the plane. The sudden activity when the plane landed caused his blood sugar to drop dangerously low -- and that's when his trip took a drastic turn for the worse.
"I don't remember getting off the plane," he says. "The next thing I remember, I was being transported very, very fast, with my hands handcuffed behind me, in a wheelchair."
Only after he was taken to the police station in the airport, where he received glucose pills for his hypoglycemia, would he fully realize what had transpired.
"I finally learned what happened," he says. "I had gotten off the plane and wandered into the security screening lines. The security officers saw me wandering around, and they perhaps tried to talk to me, but I was not responding.
"They called the cops, who tried to subdue me," he continues. "But I'm a big guy -- 6-foot-3. It didn't work, so they Tasered me. Well, I didn't respond to the Taser either, so they Tasered me again."
All told, Frank counts himself lucky. Aside from some small burn marks on his back from the Tasers and lingering numbness from the handcuffs, he suffered no lasting ill effects from his experience. And though he believes he was treated roughly, he did not file suit against the airport or the police.
Frank's experience, fortunately, represents an extreme case of what can go wrong when traveling with diabetes.
"It is fairly easy to travel safely with diabetes," says Dr. Larry Deeb, clinical professor of pediatrics at the University of Florida and immediate past president of the American Diabetes Association, who says cases like Frank's are exceedingly rare.
"People with diabetes shouldn't be afraid to fly," he notes, adding that proper preparation is key. "People with diabetes can travel safely and can go anywhere they want to go safely if they prepare for it."
"First and foremost, people with diabetes need to prepare ahead and anticipate what they might need," he says.
For those who rely upon a strict schedule to control their diabetes, the realities of travel could pose challenges.
Deeb says that those with diabetes must also bear in mind that air travel -- especially during the holiday season -- is often fraught with unexpected mishaps.
"Things may be stressful, you may miss a plane, or you may be stuck on a plane," he says.
"One of the issues is all of the extra supplies people need to take with them to manage their diabetes," Wolpert says.
According to ADA guidelines, this should include two blood glucose monitoring devices -- packed in separate bags -- with extra batteries; insulin lancets, test strips and syringes; and, for insulin pump users, pump supplies, extra batteries, and insulin and syringes in case of pump failure.
Emergency snacks are also a must, and everything should be kept close at hand.
"Everything goes in carry-on; don't check anything," Deeb says.