A few weeks before I was diagnosed with type 1 diabetes, I spent my winter break studying abroad in Benin, West Africa. When family and friends would ask me about my trip, I would often say I was glad I got to travel to Africa before I had diabetes. I thought traveling internationally now that I had diabetes would be much more challenging. Thinking back on my experience in Africa, I wondered how I would have kept my new prescription of insulin cool and safe. It seemed to me that my new diagnosis was in some ways limiting. Although I still considered myself someone who loved traveling, I wasn’t sure many international trips would be in my future.
My first trip abroad with type 1 diabetes
A year after I was diagnosed, my best friend invited me to visit her family in Costa Rica. I was honored to be invited to visit her hometown and excited to meet her family and friends. Although I still felt hesitant about diabetes and international travel, I decided that I would not let fear stop me. I knew traveling with diabetes would be a different experience. I did a quick Google search, and the two tips that appeared most frequently were to give yourself extra time in the airport and to pack double the amount of supplies you think you’d need. (After now having diabetes for a few years, my biggest takeaways from my experiences of traveling are always carry glucagon with you and bring a back-up supply of insulin — more on that below.)
On this trip to Costa Rica, I learned my lesson to expect and plan for the unexpected. My doctor recommended I bring glucagon, pump supplies, and insulin pens and needles just in case. Originally, I was going to only bring pump supplies because I had recently started on the pump and did not see myself wanting or needing to go off it for any reason. But as I found out, when you are in a new environment, adapting to a different schedule and being more carefree about your diabetes routine, things tend to go wrong.
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We were at the beach and decided to take a walk to check out the landscape. While I was walking, I started to feel low, and my Dexcom alerted that I was dropping rapidly. I looked down at my pump and realized that I had 12 units of insulin on board. I’m still not sure if my pump malfunctioned or if I wasn’t paying attention and gave myself the 12 units instead of a bolus for 12 grams of carbohydrate. Either way, it was not a good place to be. Thankfully, I had brought my glucagon to the beach with me and was able to give myself the glucagon shot and prevent myself from passing out.
During the aftermath of this event, I discovered that glucagon is not readily available in every country: My friends brought me to the nearest emergency clinic, which was still about a 45-minute drive from where we were. By the time I got there I was feeling fine, but it was a good idea to check in with a doctor. What I learned is that had I not had my own glucagon with me, this small clinic would not have been able to help me. They would have had to transport me to a hospital in the capital city to get access to glucagon. The doctor told me it is not available as a prescription, and only large hospitals have access to it. For the rest of the trip, I switched back to insulin pens until I went home and could talk to my doctor and the pump company. Having the pens with me meant I did not have to stress about finding insulin in a foreign country.
I hope this story reminds you to be prepared. Although scary situations can arise, diabetes should not stop you from enjoying a vacation. Traveling with diabetes can be tricky, but it’s not impossible. It just takes a little more planning. Below is a list of my top type 1 diabetes and travel tips!
Type 1 diabetes and travel tips
1. Allow more time than you think is necessary at the airport. One-and-a-half time the amount you’d normally need is a good rule of thumb. This way you can get through security smoothly and have extra time to problem-solve any challenges.
2. Pack twice as many supplies as you think you might need.
3. Bring extra insulin and, if you are on a pump, a backup method of delivering insulin.
4. Carry glucagon with you always! Make sure the people you are traveling with know how to administer it.
5. Bring extra test strips even if you are on a CGM (continuous glucose monitor). Pack ketone strips as well.
6. Pack extra batteries and an extra pump charger.
7. Also bring an extra CGM sensor and transmitter.
8. Carry a medical ID card or wear medical ID jewelry.
9. Bring a doctor’s note explaining that your diabetes supplies need to stay with you.
10. On a related noted, keep your diabetes supplies in your carryon luggage — don’t put them in your checked luggage.
11. Include some wellness routines in your journey. Try a new fitness studio or explore a new city by foot.
12. Bring your own food and eat light on travel days, which will help lower your need for insulin. This helps avoid a blood glucose rollercoaster mid-flight.
13. Take an image of all prescriptions and keep them in your phone (or ask your doctor for extra prescriptions to bring with you).
14. Find out where there is a nearby pharmacy at your destination. Have prescriptions with national chains that are open later and more often.