Traveling With Diabetes: Planning Your Trip

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People with diabetes aren’t known for packing light, and I am no exception. Just leaving the house to grocery shop has me throwing at least my glucose meter, the receiver for my Dexcom continuous glucose monitoring system, and a jar of glucose tablets into my purse.

For longer trips, it has taken me a long time to learn to travel lightly, while still packing smartly. I used to bring a gigantic bag with enough socks and underpants to outfit an army, but I’ve learned to streamline the process in the last few years. As a result, it’s always an exercise in “What did I forget?” Of course, I don’t play the “What did I forget?” game until I’m about to walk out the door, or while I’m on that anxiety-inducing ride to the airport, when I convince myself that I left my cell phone/pump/license/arm/house keys at home and I have to keep checking, repeatedly, to ensure the presence and safety of these items. (The arm is easy to check for, thankfully. I just waggle it around a bit while I search through my bag for the other stuff.)

What trip me up are the health-centric decisions. Whether I’m in Philadelphia for two days or in Dubai for a week, I bring backups of my backups. Three-day trip? Three new infusion sets, three bottles of test strips, a brand-new bottle of insulin, the in-case-of-pump-failure insulin pen, glucose tablets in case of low blood glucose, my glucose meter, and a spare continuous glucose monitor sensor go in the bag.

All this stuff does not a light suitcase make. But have diabetes, will travel, and all it takes is a little extra planning to keep the trip diabetes-friendly…and fun.

Getting ready

Two weeks or so before any trip, I take stock of what I have on hand already, to make sure I leave enough time to pick up any necessary supplies I don’t have, instead of scrambling at the last minute. (Click here for a diabetes travel checklist.)

I also locate the letter I carry from my medical team explaining that I have Type 1 diabetes and that I’m using an insulin pump and a continuous glucose monitor and am carrying supplies for diabetes in my luggage.

For trips where my husband or a friend are traveling with me, I bring a glucagon injection kit (glucagon is a hormone that causes the liver to release glucose into the bloodstream), in case of severe hypoglycemia (low blood glucose).

I also prefer to have an insulin pen or two in my bag, in case my pump has any issues while I’m on the move. And usually I request a “loaner pump” from my insulin pump company as a backup while I travel. (Many pump companies offer loaner pump programs for traveling; ask your manufacturer!) And I like to confirm that I have enough fast-acting insulin, back-up basal insulin, syringes, and test strips for the trip well ahead of time, in case I need to get new prescriptions from my medical team.

The night before I leave for any trip, I make sure I’m fully packed. That way, any last-minute, “Oh my gosh, I forgot something!” panicky moments can happen in time to find the solution. This includes packing up my medical supplies and making sure they fit into my carry-on bag. My carry-on includes my glucose meter, glucose tablets, a backup pump infusion set, replacement batteries for my meter and pump, a spare continuous glucose sensor, test strips, and any vials of insulin. I keep my spare glucose meter in my checked luggage, but everything else stays with me.

Day of travel

I try to keep things streamlined on the actual travel day. Anxiety has a tendency to wreak havoc on blood glucose control for people with diabetes, so whatever measures can be taken to keep stress to a minimum should be taken. (I keep a close watch on my continuous glucose monitor graph, because it’s almost comical to watch it spike up after negotiating my way through the security checkpoints. Almost.)

For lots of people, getting through airport security can be a real stressor, and all of the medical supplies necessary for diabetes can add to that stress. Whether you’re wearing a medical device, carrying syringes, or bringing bottles of medicine, you may be stopped and questioned by a Transportation Security Administration (TSA) agent. Here are some tips on moving through airport security safely and efficiently with your diabetes supplies:

• Keep medicines in their original packaging. The prescription labels for diabetes medicines are usually stuck to the outside of the box.

• As a general rule, x-ray machines will not harm your diabetes devices, but if you have specific concerns, check with the companies that make them. Many diabetes device companies have travel FAQs on their Web sites.

• Regarding devices and x-ray machines or scanners, you do have the right to “opt-out” and have a full pat-down from a TSA agent. (I have had this done several times and haven’t experienced any problems.)

• If you do opt for a pat-down, point out where your medical devices are on your body beforehand. TSA agents will ask if you have any “sensitive areas,” so take the time to show them where your pump, continuous glucose monitor, or any other device is connected. You also have a right to a private screening, so be sure to request one if that suits your needs.

• Wear a medical ID. Wearing medical alert jewelry is a great way to keep you safe while traveling; it can speak for you in moments when you may not be able to speak for yourself.

While you’re traveling, especially by airplane, be sure to stay as hydrated as possible. Proper hydration can help with blood glucose management, so carry a water bottle (fill it after passing through security) while traveling.

Once you’re on the plane, be sure to keep emergency diabetes supplies close by. Your spare supplies can go in the overhead bin, but keep your glucose meter and some fast-acting sugar for hypoglycemic episodes at your seat for quick access.

On the go

Once I’ve arrived at my destination, I check to make sure that my pump and my continuous glucose monitor are set to local time. When I’m traveling across time zones, I tend to change the time setting on my insulin pump as soon as the plane takes off. There’s no rhyme or reason to this, but it’s a routine I’ve developed and it works for me. As with everything, your methods of management may be different. Other people I know switch their pump time forward (or backward, depending on which direction they’re traveling) one hour every hour until it is reflecting the local time at their destination.

Then it’s time to enjoy where I am! The one thing I’m fastidious about is checking my blood glucose while traveling. Changing time zones, walking around and exploring, eating different foods, and just plain being excited about being somewhere new is enough to send my blood glucose levels into new and unpredictable patterns. I make sure that I check my blood glucose at least every two hours to make sure I stay on track and safe.

But sometimes even the best-laid plans can be thwarted by circumstance. What if you’re far from your hotel, where your backup meter is comfortably resting in your suitcase, and you realize you’ve lost your regular meter? Or what if the batteries in your insulin pump die and you haven’t brought spares? When I travel, I try to do a little research ahead of time to map out local pharmacies for those just-in-case moments.

The food in different countries can trip you up a bit, diabetes-wise, as well. Carrying a few foil-wrapped urine glucose-testing strips (such as Diastix) in your wallet can help you determine if a drink is sugar-free or not. If you’re able to pick up a guidebook about local cuisine, it may help in your efforts to determine the carbohydrate content of unfamiliar foods. When in doubt, dose your medicines conservatively, and monitor often; it’s better to be correcting a slightly high blood glucose level than chasing a low for hours.

Or what if you are traveling alone and find yourself needing diabetes assistance? If you are in a country where you do not speak the native language, write out a few key phrases on an index card and keep it in your wallet. Phrases like, “I have diabetes and I need some sugar. It’s an emergency,” or “Please take me to the nearest hospital. I have diabetes” might seem silly to have scrawled on a card in your wallet, but they can be literal lifesavers.

I may seem like a crazy person, with all the planning ahead and bringing-of-stuff. But I can’t help it: It’s the combination of my Type 1 diabetes and my type A personality. It’s part of my travel routine that I can’t deviate from. Regardless of where I’m going, all this health stuff comes along with me. It makes for a long packing list. I test the limits of airline carry-on policies. But when I travel, I’m confident that I’ve anticipated what kind of diabetes disasters can occur, and how to properly handle the situations.

Have diabetes, will travel – just not light!

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