Traveling With Diabetes

Diabetes is all about maintaining consistency, and that consistency can be a little challenging when we’re traveling. I should know — I’ve traveled quite a bit for my professional life, and I’ve lived with Type 1 diabetes since I was 15. I’ve logged a lot of hours on the road, a fair number through the air, and an occasional few on the rails. And in that time, I’ve discovered firsthand some of the major pitfalls that can impact someone traveling with diabetes and created my own “travel guide” for successfully taking diabetes on the road.

Travel ready
I’ve got a packing list for just about every travel situation I might find myself in. I have a go-to list for what I need to bring when I’m traveling by van for music performances on the road (these are usually three- to seven-day trips with a lot of drive time — somewhere in the neighborhood of four to five hours a day, typically — and late nights since we’re usually performing until around 1 AM most nights). I’ve got another list for air travel, which is once in a while for music, but more often a more relaxing visit home to see family or a vacation for leisure. I keep these on my phone so that I don’t have to “reinvent the wheel” every time I travel, and that’s proven to be a very useful idea — and prevented me from leaving without something essential but easy to overlook, like extra test strips.

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Most of the items overlap, and most of them aren’t particularly related to diabetes. Clothes, toiletries, toothbrush, towel, and so on — these are the items on any travel list. For diabetes, I always make sure I’ve got insulin, extra insulin, a tester, extra test strips, some form of readily available sugar that can stay within reach for the duration of my trip, a copy of a prescription for my insulin that can be shown to TSA workers as proof that what I’m carrying is medically necessary (though the TSA has never once stopped me for insulin — I’m guessing they see a lot of it and probably know it by sight right away), and perhaps most important of all, glucagon!

The glucagon (a hormone that works against the action of insulin) was something I had gotten a little lazy about, and I almost paid a VERY heavy price for that! I was on a road trip for music, and had eaten a VERY late meal after a gig the night before. It was a time I would never have eaten at home, and a quantity that’s just a bad idea for that late at night (taking a large dose of insulin right before sleeping is asking for trouble!). Overnight, my sugars dropped, and the next morning I was slipping into serious hypoglycemia. My bandmate saw me shaking, and wasn’t able to find the glucagon — because I had forgotten to pack it! By sheer luck I was able to wake up, but it was a very close call and a clear reminder of how important that item really is to ALWAYS have with you! In fact, this incident was the final straw before I formalized my list so that I wouldn’t have to rely on mere memory ever again — it’s just too easy to forget something essential!

Travel is about new experiences, but you CAN keep your balance
There were a few factors that lead to a potentially horrible outcome in that glucagon story. The glucagon wasn’t packed, and we’ve covered that one. But the precipitating event was my late, late meal where I gave myself a large dose of fast-acting insulin right before sleeping, and then proceeded to test once before bed without waking myself up midway through the night to double check. That was bad decision-making all around. I ate that large meal because I thought, “hey, I’m on the road, in NYC, and there’s a good pizza spot around the corner,” giving myself tacit permission to do something I would have thought twice about if I were at home.

Looking back, I see a few lessons learned from that experience. First, I realized that there is a dangerous line we often tell ourselves when we’re traveling. We use the “I’m on vacation” line to justify doing things we know we shouldn’t. In this case, I used that logic to justify a large meal way too late. I could have had a salad, with a very small dose of insulin, or even just one small slice of pizza, again with a small dose of insulin. That would have made a lot more sense, as that smaller insulin dose would have presented far less danger of producing the kind of dramatic low that I suffered.

The second major mistake I made was assuming that my pre-bed number (which happened to be 121) was all I needed. That number was probably the absolute PEAK of what I had just eaten, and my sugars proceeded to tank! Since then I have adopted a policy of testing overnight, every two hours if needed, when I find myself in a situation where a late insulin dose can’t be avoided. There aren’t many of those incidents, but when they happen, I don’t play around with them anymore!

Diabetes CAN travel
In the end, diabetes isn’t a reason to avoid travel. There are a few extra challenges, and we have to be aware of some things that other people don’t have to worry about. But it’s all workable, as long as we remember our essentials and take those extra steps (like testing a few more times when our routine changes). So get out, enjoy the road, and see the world!