The timing of this piece is pretty perfect — I’m typing it on my iPad at a coffee shop in Niwot, Colorado, the little town where I grew up. I live in Philly now, and flew in just last night! This particular trip is a combination of work and leisure — I’m here to play a concert, but I extended the visit so that I could see family and spend some extra time in my beloved home state while I’m here. And after 20+ years of traveling for music as someone with Type 1 diabetes, I can tell you there are certainly challenges — but they don’t have to stop you from seeing the world! So without further ado, let’s break down a few of the challenges of traveling with diabetes, and figure out how to handle them. In no particular order, here they are.
I wear a continuous glucose monitor (CGM), so I typically need to spend at least a little extra time explaining to the TSA agents what it is and letting them give me a brief pat down of the spot where it sits on my abdomen (and occasionally a full pat down). Additionally, the extra sensors, insulin pens, insulin pen needles, and other diabetic supplies I carry will usually mean my bag is pulled for the hand inspection. The moral of this story? Just know that traveling with diabetes should mean you arrive at the airport about 30–40 minutes earlier than you think you need to, because you are likely to spend a little extra time with TSA (and for the record, I’ve yet to encounter anything but friendly and professional TSA folks, and certainly don’t begrudge them the extra time they take with me — it is their job, after all!).
Traveling across time zones isn’t easy for anyone — the body has to readjust the internal clock and everything can get a little “wonky.” When insulin is in the picture, it gets a little trickier. We time our basal insulin to match the rise and fall of our needs. Particularly if you use an insulin pump, you might have a very precisely set basal rate that fluctuates throughout the day and night. When the time zone shifts, the body needs to catch up, and it can create a little “turbulence” in blood glucose control. Even if you simply take a single long-acting basal shot (as I do), you’ll still see that after a long flight, that morning surge you’re used to is suddenly happening 6 hours earlier, or 6 hours later. It can be frustrating, and there’s no easy fix. But here are a few things you can remember.
• First, it’s OK to have some numbers outside the ideal range for a few days. Unless you’re surging to dangerously high or low numbers, let go and just do what you can. Hit 180 after the meal when you usually peak at 140? That’s really OK, and after a few days your body WILL adjust. If you decide to aggressively pursue that 180, you might actually do more harm than good! If you send yourself too low, you trigger a big swing in glucose, and now you’re only adding to the imbalance. So expand your range for the first 3–4 days after traveling to significantly different time zones — your body will catch up!
• Second, try adjusting that basal rate gradually, and start a few days BEFORE you fly. Nudge your routine over by an hour each day, so that when you leave you’re already shifted over a bit, and then finish adjusting those last few hours the first few days you’re in the new location. What you DON’T want to do is simply change it by 5–6 hours all at once!
Finally, traveling is stressful. Even if it’s a fun trip (like this one is), the act of traveling — going through security, bustling through the airport, cramming yourself into the 4.6 inches of legroom the airlines provide you, and all the rest of it is stressful. I notice a bit of a surge nearly every time I’m about to board a flight. It’s usually because I’m dealing with all the logistical stuff above, AND because I’m genuinely excited and happy about traveling — remember, excitement for something positive is actually no different from negative stress as far as the physiological response of the body. That bit of extra adrenaline will push blood glucose up a little bit. So I usually give myself a few extra units before I board to make sure the surge isn’t severe enough to throw everything off.
Onward and upward
Traveling with diabetes can be a challenge, but it certainly doesn’t have to stop you. The list presented here isn’t a complete rundown, and if some of our readers are veterans of the skies, perhaps you could add some of the tricks you have figured out to make traveling with diabetes easier. It’s a big world out there, and we should all see as much of it as we can!