Backup Plans When Diabetes Technology Fails Abroad

Technology fails. It just does. I’ve had pump occlusions, CGM sensor errors, PDM malfunctions, and phone app crashes all while abroad. Each time was stressful, but having backup plans made them manageable problems rather than emergencies.

Here’s how to prepare for and handle technology failures while traveling.

What Can Go Wrong

Insulin Pump Failures

CGM Failures

Other Tech Failures

• Phone dies (CGM data loss)
• Chargers break
• Batteries unavailable
• Software updates cause issues

The Essential Backup Kit

For Pump Users

Always carry:

For CGM Users

Always carry:

Manual Dosing: When You Need It

If your pump fails completely, you need to transition to multiple daily injections (MDI).

Converting Pump Basal to Long-Acting

Basic formula: Total daily basal units ÷ 1 or 2 doses = long-acting dose

Example: If your pump delivers 24 units of basal per day:

• Once daily: Take 24 units of Lantus
• Twice daily: Take 12 units of Levemir morning and evening

Important Adjustments

My MDI Backup Protocol

1. Immediately: Note when pump stopped
2. Calculate: Hours since last basal delivery
3. Correct: Bolus for missed basal if significant
4. Long-acting: Take full dose at next logical time
5. Monitor: Check BG every 2-3 hours initially

CGM Failure Protocol

When your CGM stops working:

Immediate Steps

1. Don’t panic. You managed diabetes before CGM.
2. Switch to fingerstick testing
3. Increase testing frequency:
   • Before meals
   • 2 hours after meals
   • Before bed
   • Middle of night (especially first night)
   • Before driving

Testing Schedule Without CGM

This is more than you’re used to, but it’s temporary.

Specific Failure Scenarios

Scenario 1: Omnipod Failure

The situation: Pod screams, occlusion, or PDM error

Action plan:

1. Remove failed pod
2. Apply new pod if you have supplies
3. If no pods left, switch to backup insulin pens/syringes
4. Contact Insulet for replacement (may take time abroad)

My experience: I’ve had pods fail in remote areas. Always carry backup pens and know your MDI doses.

Scenario 2: Tandem/Medtronic Pump Failure

The situation: Pump displays error, won’t deliver insulin

Action plan:

1. Follow pump’s troubleshooting steps
2. If unresolved, disconnect and switch to MDI
3. Contact manufacturer (difficult from abroad)
4. Consider local pump supplies if using common infusion sets

Scenario 3: Dexcom Transmitter Dies

The situation: Transmitter battery depleted or malfunction

Action plan:

1. Start fingerstick testing immediately
2. Use backup transmitter if you brought one
3. Can sometimes find Dexcom supplies at international hospitals
4. Manage manually until replacement obtained

Scenario 4: Phone With CGM App Dies

The situation: Phone breaks, lost, or battery dead

Action plan:

1. Use Dexcom receiver if you carry one
2. Check Dexcom Follow on another device (need WiFi)
3. Fingerstick testing if no receiver
4. Consider cheap backup phone with app installed

Prevention Strategies

Before Your Trip

During Your Trip

Emergency Supplies You Can Find Locally

If you’re caught without backup in most countries:

Usually Available

• Human insulin (NPH, Regular)
• Syringes
• Glucose meters and strips
• Lancets

Sometimes Available

• Rapid-acting insulin analogs (Humalog, NovoRapid)
• Long-acting insulin (Lantus, Levemir)
• Pen needles

Rarely Available Abroad

• Specific pump supplies
• CGM sensors and transmitters
• Omnipod

This is why carrying backup is so important.

Communication and Documentation

What to Have Written Down

Keep a physical copy (paper) of:

• Your current insulin doses (basal and bolus)
• Correction factor
• Carb ratio
• Target blood sugar range
• Emergency contact numbers
• Insurance information
• Doctor’s contact info

When you’re stressed and technology has failed, having written reference is invaluable.

Contacting Manufacturers From Abroad

Realistically, getting manufacturer support abroad is difficult. Self-reliance through backup supplies is better than depending on support.

The Mental Game

Technology failure feels like losing a safety net. Acknowledge that.

Coping Strategies

1. Remember: You can manage without technology
2. Accept: Numbers might be less perfect temporarily
3. Focus: On safe ranges, not perfect ranges
4. Plan: Take concrete steps to resolve the situation
5. Connect: Reach out to diabetes community online for support

My Technology Failure Kit

What I actually carry for a 3-month trip:

This adds weight and takes up space. It’s worth it.

Learning to Trust Myself Again

When my pump failed in Bali, the first thing I felt was betrayal. I’d come to depend on this technology so completely that I’d almost forgotten how to manage without it.

Those three days on manual MDI while waiting for replacement supplies were humbling. My numbers weren’t great. I was checking my blood sugar constantly. I felt like a newly diagnosed diabetic again.

But I did it. I didn’t die. I didn’t end up in the hospital. I managed my diabetes the old-fashioned way, and while it wasn’t as smooth as my usual setup, it worked.

Now I view my technology as a luxury, not a necessity. The pump and CGM make management easier and my numbers better. But I know I can survive without them if I have to. That knowledge is worth more than any backup device I carry.

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