Airport security

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Pumps vs. Privacy
Enhanced airport security gives pump wearers no choice but an invasive new pat-down examination

By Robert S. Benchley

As difficult as airport security has become, the Transportation Safety Administration (TSA) is making it more complicated—and potentially more embarrassing—than ever to get through the long lines, especially for insulin pump wearers. The reason is the new, more invasive screening procedures that took effect on October 28, 2010. TSA has begun installing advanced scanners using backscatter X-ray technology to provide a fairly revealing full-body image. Although you look somewhat like an alien on the screen, even a small piece of paper left in your pocket can be seen. But so can your breasts, genitals, and other body parts. The image quality isn't great, but the idea of strangers seeing through their clothing is what gives so many travelers the creeps.

Yes, you can opt out of being scanned and request a physical pat-down and visual inspection of your pump. You have always had this option, but here too the procedures have changed. The new "enhanced" airport security measures permit a same-sex screener to make a much more probing examination, and no part of you is off limits.

These new procedures have travelers up in arms. The American Civil Liberties Union has received hundreds of complaints, and several lawmakers in Washington have proposed bills to mandate a certain level of dignity for air travelers. Talk show hosts have picked up the theme in their monologues, and NBC's Saturday Night Live ran a mock TSA public service message spoofing the enhanced pat-downs.

For travelers with diabetes, however, it isn't quite as funny, especially if they wear an insulin pump. Although the new airport scanners use a low dose of radiation—less than the average cell phone call—most pump manufacturers have historically told patients not to subject the units to any type of radiation. It can potentially affect the accuracy of insulin dosing and, depending on the manufacturer, may void your warranty. That's why those who may take along a spare pump are generally advised to request a hand check of their carry on bag. With the conventional walk-through metal detectors (and hand wands) at airport security checkpoints, you are not exposed to any radiation. Pump wearers have often said nothing to screeners because most of the units, especially models made of plastic, didn't set them off. With the new technology, they have no choice but to request the enhanced pat-down. If you have any questions about airport security and your pump, contact the manufacturer, as your owner's manual may now be outdated.

The TSA has traditionally accommodated travelers with diabetes in other ways—exempting them, for example, from the three-ounce limit on liquids when they take medication on board (the scans will not affect your insulin). According to TSA, insulin, syringes, blood glucose meters, lancets, and test strips can all be taken through the checkpoint once they have been screened. You should notify the security officer if you are carrying any of these supplies with you. Regular travelers also report that screeners recognize pumps if they happen to set off a metal detector.

The conventional advice to travelers with diabetes still pertains: Show up early. Carry a note from your doctor about your condition and your need for the supplies you are carrying. And, some travelers would suggest, if the airport security you are traveling through doesn't yet have the new scanners, say nothing.

The public outcry over the new procedures has been so great that TSA Administrator John S. Pistole issued a statement that said, in part: "We are constantly evaluating and adapting our security measures, and as we have said from the beginning, we are seeking to strike the right balance between privacy and security. This has always been viewed as an evolving program that will be adapted as conditions warrant." In short, cross your fingers and stay tuned.

Reviewed by Susan Weiner, RD, MS, CDE, CDN. 05/12.