By Shana Cunningham, MSN, RN, MLDE, BC-ADM, CDE and Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDE, FAADE
Summer is an exciting time to travel and explore new areas. The opportunity to travel — even for a short excursion — allows one to expand one’s knowledge and explore the world’s beauty. Day trips may include a relaxing day on the beach, hiking the Grand Canyon, walking the National Mall in Washington, DC, or visiting your favorite amusement park. Day outings are especially fun because you get to immerse yourself in an area for adventure, relaxation, or enjoyment with family and friends. You may have a particular destination in mind or on your “bucket list.” Having diabetes should not stop you from having fun and visiting new places. However, planning and preparation are necessary to safely enjoy your day trip.
The first step is deciding on a destination. After you decide where and what you are doing for the day, do your research. As you prepare, questions will come to mind.
• Are you going to a park, lake, ocean, beach, theme park, or museum?
• What are you going to do?
• Will you be swimming, surfing, hiking, horseback riding, exploring, or just reading and relaxing?
• What is the weather?
• Will most of your time be spent outdoors or indoors?
• If you’re planning outdoor activities, what is the area terrain like — flat, hills, mountainous? What is the highest altitude?
• Does your destination have park rangers, lifeguards, medical/facilities?
• What are your options for storing supplies (climate-controlled area), food, beverages, and personal needs?
• Is food available?
Answers to these questions can help you plan your day trip, maintain optimal blood glucose control, and recognize how the environment might impact your blood glucose levels and/or your diabetes medications/supplies.
• Discuss your day trip plans with your diabetes care provider to see if changes to medication dosages or timing are required.
• Be sure to wear your diabetes identification.
• Avoid traveling alone; know your surroundings. If you take a cell phone, program in an emergency contact and directions should an emergency situation arise.
• If your day out requires strenuous activity, check with your diabetes care provider before participating. Overall, it is important to remember the general principles of diabetes self-management: healthy eating, being active, self-monitoring, taking your medications as directed, problem-solving, and reducing the risk of complications such as high and low blood glucose.
Healthy eating is critical to blood glucose control. Pack healthy foods and be aware of food options at your destination. Attempt to stay on your usual eating schedule, and avoid missed or delayed meals. If you take your food with you, store it properly to avoid getting a foodborne illness. Most perishable foods should be kept out of the “danger zone” (temperature between 40 and 140 degrees) to avoid bacterial growth. Pack foods that require refrigeration with frozen gel packs in a cooler or insulated bag. Remember to keep your food in airtight containers. Your next best option is to pack non-perishable foods.
If you are eating out, controlling portion size is key. One way to practice portion control is using the plate method: non-starchy vegetables should cover half of your plate, a quarter of your plate should be filled with a starch or grain, and the remaining quarter of your plate should hold a protein.
• Cereal/energy Bars
• Trail mix
• Peanut (or another) nut butter
• Canned or pouches of tuna and chicken
• Dried fruits
• Small pieces of fresh fruit (apple or orange)
• Pumpkin seeds
• Dry cereal
• Low-sodium/low-fat turkey jerky
Hydration is essential, so pack plenty of water for the day. Common causes of dehydration include increased sweating, high blood glucose related to increased urination, or visiting an area with higher altitudes. Always drink safe, treated water, and avoid drinking untreated water from streams, lakes, and creeks. Freeze several bottles of water, so you have cold refreshing water throughout the day, or carry an empty water bottle to refill throughout the day with clean water.
Being active is good for your health. Everyone should do some form of daily activity. Try to avoid sitting for prolonged periods of time, even at the beach or lake. Purposely walk around to explore the scenery. If your trip includes a lot of activity, make sure you have the proper footwear and clothes. Consider wearing clothing made of moisture-wicking and quick-drying fabrics. Listen to your body and take rest breaks when needed.
Self-monitoring is vital when you have diabetes. Bring extra test strips and lancets with your meter. A good tip is to take double the amount of testing strips you think you may need. Protect your meter/strips from harmful temperatures, extreme heat, cold, or moisture by keeping them at room temperature. For specific guidelines, check with the manufacturer of your meter/supplies. Make sure your meter is fully charged before leaving home, and pack an extra battery.
Continuous glucose monitor (CGM) sensor users know specific activities can affect CGM function. Check with your CGM manufacturer about using your equipment during extreme sports, altitude changes, and amusement park thrill rides. Increased sweating and water activities can affect the adhesion of your sensor. If you plan to wear your sensor, bring extra supplies.
If it also important to stay aware of your normal state of being. If something does not feel right, check your blood glucose and then ask yourself if you need to rest, eat something, drink water, or seek medical attention.
If you need to take your oral medications during your day trip, keep your pills in an air-tight container. Take what you need for the day, plus one extra pill for an unexpected travel delay. Most medication labels recommend storage in a cool, dry place and keeping them away from excessive heat and humidity. Remember that insulin in use does not need to be refrigerated, but it is sensitive to and can ruin in extreme temperatures. If you will be outside for an extended period in very hot or cold weather, use an insulated cold (not frozen) travel pack or gel pack to store your insulin. Take extra insulin, syringes, or pens needles with you in case your insulin gets broken or misplaced.
Insulin pump users should talk with their provider and diabetes educator for general directions on what to do during their day out. When people are more active than usual, they need less insulin, so you may need temporary basal dosing. If you plan to do any extreme activities or sports, contact your insulin pump manufacturer for recommendations about how to avoid damaging the pump. If in doubt, you may want to consider disconnecting your pump and using an alternative (prescribed) insulin delivery source for the day. Finally, remember to take extra alcohol pads, infusion sets, reservoirs, cartridges, pods, batteries, and anything else you need should a complete change out be necessary.
Increased activity, heat, sweating, and dehydration can all impact your blood glucose control. When a person is more active, hot, and sweating, that person’s blood glucose level can often drop, causing hypoglycemia (or low blood glucose levels). Be ready to treat hypoglycemia with a source of glucose. Glucose tablets or gels are ideal treatment options and are stable in extreme temperatures. Four to five glucose tablets (15 to 20 grams of carbohydrate) are appropriate treatment for hypoglycemia. Take your glucagon kit and make sure one of your travel companions knows how to administer it. Pack urine ketone strips in case you have high blood glucose readings or become ill.
You also need to protect your skin and feet. Take proper fitting shoes that are broken in. Wearing a new pair of shoes is not ideal during a day trip because they may create blisters or sores. Always wear shoes during your trip and change into a new pair of dry shoes if necessary. Protect your skin from extreme sun, heat, and chilly weather. Apply sunblock every two hours, after swimming or sweating, and use insect repellent.
• Use sun block as directed.
• Avoid direct sunlight, especially during peak hours; limit your hours in the sun; wear a wide-brimmed hat and sunglasses.
• Stay hydrated.
• Wear water shoes; avoid walking barefoot on the sand.
• Hike with at least one companion.
• Stay on the path and tell others where you’re planning to go.
• Wear hiking boots or shoes.
• Call ahead to Guest Services to see if the park has any special accommodations for children with diabetes.
• Research food options before your visit.
• Find the First Aid Stations and restrooms when you first arrive.
During the planning stage, you may find it helpful to make a list of items you might need during a day trip. You can customize it to your diabetes treatment plan and needs as well as to various destinations.
When you have diabetes, it pays to be well prepared when you take a trip, even if just for a day. A little planning can go a long way toward reducing travel-related stress. That way, you can focus on enjoying yourself and having terrific day-trip adventure.
Want to learn more about staying healthy with diabetes this summer? Read “Summertime: Hazardous for People With Diabetes?” “Summer Portion Control: From Beach to Barbecue,” and “Planning an Active Summer.”
Source URL: https://www.diabetesselfmanagement.com/about-diabetes/general-diabetes-information/summer-day-trips-with-diabetes/
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