Do You Need a Travel Letter for Diabetes? The TSA Doctor's Note, Explained

Here is the short answer: no. TSA does not require a doctor's note, a prescription, or any documentation at all to bring diabetes supplies through airport security. Not for insulin, not for pumps, not for CGMs, not for syringes.

I fly with Type 1 diabetes, a Dexcom G6, and an Omnipod 5, and I have never once been asked for a doctor's note. Not by TSA, not by anyone at any airport, domestic or international. It has simply never come up.

That does not mean a travel letter is useless. There are specific situations where having one makes life meaningfully easier. This guide covers what TSA actually requires, when a letter earns its place, exactly what it should contain, and the simple habit I use instead.

What TSA Actually Requires (No Letter Involved)

TSA's published screening procedures for diabetes mention exactly two things you need to do:

• Declare medically necessary liquids before screening begins, and place them in a bin separate from your other belongings.
• Notify the officer about any insulin pump, glucose monitor, or medical device attached to your body.

That is the complete list. Documentation appears nowhere in it. If an officer ever questions your supplies anyway, which is rare, stay calm and ask for a supervisor or a Passenger Support Specialist. That resolves it.

What I Do Instead: The Original-Box Habit

Since nobody has ever asked me for a note, I don't carry one for domestic trips. What I do carry is simpler: at least one of everything in its original pharmacy box.

If I'm bringing three vials of insulin, one of them stays in its original box with the pharmacy label showing my name. Same for my Omnipod 5 pods and Dexcom G6 sensors. The rest can go in whatever organizer I like.

This is not required. Nobody has ever asked to see it. But a pharmacy label with your name on it answers any question before it gets asked, it costs nothing, and it takes zero extra space since you're bringing the supplies anyway. Think of it as quiet insurance.

When a Travel Letter Is Actually Worth Having

There are trips where I'd get the letter. If any of these describe yours, it's worth the effort:

• International travel. TSA rules stop at the US border. Security and customs in other countries can be stricter about syringes and injectables, and a letter on official letterhead bridges any language barrier.
• Large quantities of supplies. A month of pump supplies looks different on an X-ray than a weekend kit. Documentation smooths that out.
• Traveling with a child who has diabetes. You're carrying someone else's medication through security, which invites more questions than carrying your own.
• Glucagon kits and other injectables. Anything beyond the standard insulin-and-syringes kit benefits from a line on a doctor's letter.
• Peace of mind. If having the letter means you stop worrying about security, that alone is a good enough reason. Anxiety is a real travel cost.

What a Good Travel Letter Contains

A good travel letter fits on one page. Anything longer won't get read at a checkpoint. It should include:

• ☐ Your full name, matching your passport or ID
• ☐ Your diagnosis (Type 1 or Type 2 diabetes)
• ☐ An itemized list of what you carry: insulin types, pump model, CGM, syringes, lancets, glucagon
• ☐ A statement that these supplies must remain with you at all times, in the cabin, and cannot go in checked baggage
• ☐ Your doctor's name, practice, and phone number, on official letterhead
• ☐ Signature and date

Ask your endocrinologist or primary care doctor at a regular appointment, and give them at least two weeks of lead time. Many clinics already have a template for this. Tandem's own user guide recommends carrying a letter from your healthcare provider explaining the medical need for your pump and supplies, so this is standard advice, not overkill.

The Free Backup: TSA's Notification Card

There is one more option that costs nothing and takes thirty seconds. TSA offers a printable notification card for travelers with medical conditions and devices. You hand it to the officer before screening to discreetly communicate what you're carrying.

It doesn't exempt you from screening, and it isn't a substitute for declaring your liquids out loud. But for anyone who finds the verbal declaration awkward, it's a quiet way to get the same information across.