For some people, insulin requirements increase during travel, and for others, they decrease. Time zone changes seem to make the biggest difference for me. A couple of hours may not matter much, but international travel resulting in eight hours time difference or more tends to upset my insulin clock as well as my internal sleep clock. If you use insulin, more frequent and careful monitoring is, once again, the key to good control when traveling through different time zones. If you are traveling east, your day will be shorter and you may need less insulin; if you’re traveling west, your day will be longer, so you may need more. It’s a good idea to consult your doctor about insulin adjustments before your trip, preferably with your travel itinerary in hand. (For more about planning for international travel, click here.)
Disposing of sharps responsibly is as important on the road as it is at home. Some airport and airplane restrooms have sharps containers, and some hotels offer a complimentary sharps container for guests who use them, but most do not. Whether you use sharps at a gas station, on a cruise, in a public restroom, or at your seat on a plane, train, or bus, never leave them in a wastebasket or seat pocket; someone could get stuck later. When taking a plane, I often pack a larger sharps container in my checked luggage to use after arrival and, in the meantime, use a bottled water container with a screw cap as a quick fix. A bottle is easily attainable, is made of clear plastic so that sharps can be identified by anyone who handles it after your departure, and can be closed tightly to maintain safety. Syringes, needles, lancets, and monitoring strips fit inside easily but are difficult to remove because of the narrow opening.
Eating while traveling
It is important to try to maintain your normal diet and to continue monitoring carbohydrate intake while traveling, but many people allow themselves a bit more freedom when on vacation. Sometimes the amount of control you have over food choices is limited during travel by your accommodations, restaurants, family environment, or other factors. While some restaurants and hotels can easily accommodate low-fat, vegetarian, or other specific diet requirements, having such choices available is never a guarantee, especially outside of the United States. In the course of trips to some remote developing countries, I have literally been at the mercy of those responsible for meal preparation, and my options have been very limited. In those cases, I made the best choices possible, estimated the carbohydrate count (and then added 1/3 to 1/2 the total if I didn’t have a good idea of the ingredients), and checked my blood glucose level after meals. Again, careful and frequent blood glucose monitoring will help determine the effect of different foods on your blood glucose level.
That said, in hotels, restaurants, or cruise ship dining rooms, do not ever be afraid to ask for choices from your personal meal plan, even if what you want is not shown on the menu. (The worst the waiter can say is “no.”) Airlines can usually accommodate special meal requirements, although requests should be made at least two days in advance of the flight. Buffets, parties, and group meals are often more difficult to manage, so I either plan what I will eat at the buffet or party before the meal, bring something with me that fits my plan, eat early by myself and enjoy the company without eating, or do a combination of these things.
You should always have snacks on hand that can be used to supplement or replace a meal if necessary. Cracker and cheese packets, trail mix, granola bars, and fruit cups all travel well, pack easily, and will hold the appetite until other choices are available. I usually pack enough snacks or emergency rations to replace or supplement several meals and then replenish my stores when possible. For example, one small box of cheese and crackers has six or eight snacks, a box of protein bars or granola bars has 12 or 24, dried fruit comes in various package sizes, and fruit cups have four packs per box. All of the above can fit into a container the size of shoebox and would last for two weeks even if needed twice a day every day.