Traveling makes diabetes management harder. Diabetes doesn’t take a vacation just because you do. Here are some guidelines on traveling safely from experts and bloggers. (Many of these tips have to do with insulin, but not all.)
Get your supplies together. The travel insurance company Insurancewith says, “It’s often advised for [people with diabetes] to carry a pack in their hand luggage, with everything they’d need for the journey. This would include injection pens, insulin, sensors, pumps, and spare pump batteries.” Insulin and blood sugar monitoring equipment and emergency snacks should always be readily available. If you check them in, you may not have them when you need them. Or they may end up lost.
Our blogger Amy Mercer found out about keeping supplies handy on a trip to the Bahamas. Changing planes in Atlanta, she wanted to eat, but she had no syringe for her insulin. She had used the one in her carrying case and forgotten to bring others in her carry-on luggage. Her sugar climbed to over 300 before the plane landed and she could get her insulin syringes back.
Insurancewith says bring twice as many supplies as you need. Double up on all of it. Your trip could run long, supplies could be damaged, or you could need more than usual because of the demands of traveling.
You should also consider bringing a back-up pump and monitoring equipment.
Kathleen Stanley, a certified diabetes educator and registered dietitian in Lexington, Kentucky, says “If you take insulin with syringes, think about how you’ll carry and dispose of your syringes or pen needles.”
“Padded insulin travel packs — which include handy straps for organizing your supplies, cool pack inserts, and pockets for alcohol pads and other items — are available. Portable sharps containers and needle clips also can be found online.”
It’s important to keep insulin cool but not frozen. “When you’re traveling by car,” says Stanley “fill a small plastic food container or Thermos with cotton balls to nestle your insulin vials in, secure the top, and then place it in a small cooler.”
When flying, it might be best to have two packs, in case one is lost or damaged. Make sure they can refrigerate your insulin at the place you’re going
Make sure you have everything
Our blogger Scott Coulter says it’s easy to forget things, so write them down. Keep a list on your smart device or a written one that stays with you. Having a list on his phone has prevented him from “leaving without something essential, but easy to overlook,” he says.
“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… [and] glucagon” (in case of extreme lows).
Insurancewith says it’s a good idea to bring copies of all your prescriptions, because you don’t know when you might need a refill if meds are lost.
Preparing to eat right on the road
Research where and what to eat. If you’re going to a new country, find out what food is available and research the carbohydrate content of common items. You may be able to find restaurants online and contact them or research what healthy food they have.
If you’ll be staying with friends or family, they should know about your diabetes. You probably won’t want them to radically change their food plans, but they should know your requirements.
Let people know
Let people know you have diabetes. In fact, have proof. Insurancewith says “Get a doctor’s note and keep it [with you]. The note should state what medication you’re on. If you’re traveling to a country where another language is the native tongue, have the letter translated. [Make copies] for the rest of your travelling party to have.”
A prescription for your continuous glucose monitor (CGM) or insulin pump might help if security people ask questions about those.
Speak up about diabetes. Tell security personnel at the airport, and flight attendants on the plane. You might get valuable assistance. If you don’t tell, there might be unnecessary delays getting through security.
Traveling can throw you off
Traveling can change your meal times, sleep times, activity level, and time itself, because of time zone changes. Those changes might affect how your medications fit your schedule.
Even though some change in schedule is inevitable, you should try to keep to your schedule as much as possible. Figure out how you will get physical activity, and don’t stay up all night just because the music’s good.
Diabetes UK says crossing one or two time zones on a flight won’t affect you, but four or more will. “When travelling east to west, the day is lengthened and some clinics will advise you to take an extra meal and to cover it with extra insulin. When travelling west to east, the day is shortened and the amount of insulin and carbohydrate may need to be reduced.”
Check with your doctor
Kathleen Stanley says have a plan for going off routine. “If you take insulin, talk to your doctor about developing a correction scale and having some fast-acting insulin with you in case you need it… An insulin correction scale…is a written plan to help you address [low and high sugars] as they occur… It’s tailor-made instruction from your provider on how to deal with [highs and lows] while you’re traveling.” Read her whole article here. It’s worth it.
• Stay hydrated. Always take extra water and fluids (along with snacks). Anyone can get dehydrated during a long car ride on a hot summer day or a walk on the beach, and you might not know where liquid or snacks can be found.
• On a trip, you’re likely to be more active than usual, which might make your sugar go low. Stanley says, “When you can, schedule physical outings and activities after a meal; hopefully, this prevention strategy will allow a balance of ‘energy in’ and ‘energy out’ to avoid a hypoglycemic event.”
• Vacation isn’t time to overindulge. Scott Coulter says, “We use the ‘I’m on vacation’ line to justify doing things we know we shouldn’t,” like eating a large meal late at night. Scott did that, covered it with insulin, and went very low in the night. That taught him. Diabetes doesn’t care that you’re on vacation. It still demands respect.
• Test more often. Your body will be confused by the changes in routine. Don’t assume your numbers will be steady. If you can monitor more often, you might avoid potential problems.
We’ve been having the wrong conversation in this country when it comes to health care, says Scott Coulter. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.