Diabetes and Travel
With the right preparation a short holiday or a long journey is just as feasible for people living with diabetes as it is for people without diabetes. But good planning is important in order to enable you to enjoy as many carefree days as possible.
Travelling by car or plane
If you are travelling by car there is one thing that is especially important:
- You must measure your blood glucose level prior to starting your trip and at regular intervals throughout. Your most important goal is to prevent hypoglycaemic emergencies. Fast-acting hypo-aids, such as glucose or orange juice, should always be close at hand.
If you are travelling by plane, the most important thing to remember is:
- Pack all of your diabetes supplies in your carry-on bag because hold luggage can take a different route or get lost. Also, by doing so, the temperature range for the insulin and the blood glucose test strips can be kept more stable
- In order to avoid hassles at security checkpoints or border controls, ask your healthcare professional to issue you with a medical certificate. This will certify your need to carry your insulin and diabetes supplies with you.
Be sure to take plenty of backup supplies in addition to your normal diabetes supplies. Order your blood glucose test strips, insulin pump accessories, pen needles, etc, in a timely manner from your chemist or supplier.
Adjusting your insulin dose when changing time zones
If the time difference between your home and your destination is no more than two hours, then it is usually not necessary to make any adjustments.
But other arrangements will be necessary if the time difference is considerable. If you continue to administer your mealtime and correction insulin (bolus insulin) as usual, then you must adjust how you administer your delayed-action insulin/basal insulin. In other words, if you are travelling westward, then your day will be longer, forming a gap in your delayed-action insulin/basal insulin supply. If you are travelling eastward, then your day will be shorter, causing an overlap in your delayed-action insulin/basal insulin supply. In either case, it is very important to check your blood glucose levels regularly and often.
Please ask your healthcare professional about how to adjust your treatment well before you leave for your trip.
These are some proven tips:
Considerable time differences in the case of Multiple Daily Injections (MDI) patients
- Administer your usual delayed-action insulin on the day of your departure.
- Flights heading east to west:
Bridge the gap in your delayed-action insulin supply with multiple injections of fast-acting insulin (bolus insulin) and then, upon arrival, inject yourself with a dose of delayed-action insulin that is adjusted to the local time.
- Flights heading from west to east:
Upon arrival, skip your first regular injection of delayed-action insulin. Do not resume your normal rhythm until after you administer your second injection of delayed-action insulin adjusted to the local time. Bridge the gap with multiple bolus insulin injections.
Considerable time differences in the case of insulin pump therapy patients
- If your journey involves a time difference of three to four hours, then you can adjust the clock on your insulin pump in two-hour increments per day until it is set to the local time.
- If your journey involves a time difference of more than four hours, then set the pump to administer the lowest basal rate as the constant basal rate upon arrival at your destination. Maintain this constant basal rate for approx. two to three days. Once your body has adjusted to the new time, you can return your pump to your original basal rate profile.
Changing insulin requirements
Some people who experience a lot of stress at home may be more likely to spend time relaxing whilst on holiday. Others may use their holiday to maximize their physical activity. This can affect a person's insulin requirements:
- If you are less active on holiday than at home, you will probably need more insulin.
- Alternatively, if you are more active or enjoy greater physical activity than usual, you can assume a reduction in your insulin requirements.
You will need to adjust your delayed-action and fast-acting insulin dosage accordingly. The best thing to do is to discuss this at home with your healthcare professional. Insulin pump holders are especially flexible in this regard and it's possible to set up a separate basal rate profile for your holiday; or adjust your therapy as needed using the temporary basal rate.
Also important to remember: Higher temperatures will increase your circulation. The insulin will reach your bloodstream more rapidly and take effect more quickly than usual.
Protecting your diabetes supplies against heat
Insulin and blood glucose test strips are sensitive to heat (over 30°C). Do not expose them directly to sunlight because this could damage them and/or render them ineffective.
- Special cooling bags are available to protect your diabetes supplies. (e.g. Frio cooling case).
- Once you arrive at your destination, store your insulin and test strips in the minibar in your hotel room or in one of the hotel's refrigerators.
- A small cooler is useful in the car. Be sure to leave enough space between the cooling element and the insulin and test strips when using a cooler. Your supplies should never be exposed directly to extreme cold.
- Always measure your blood glucose level in the shade.
Tips in cases of emergency
- If you are travelling with a group, at least one of your travelling companions should be aware of your diabetes and understand what must be done if you experience a hypoglycaemic emergency.
- It is recommended that you carry an emergency ID card (diabetic ID card) in English and/or the language of the country where you are travelling.
- Locate the nearest physician and/or hospital at each destination on your trip.
- Before your trip ask your insulin manufacturer whether your insulin is available in the country or countries you will be visiting - possibly sold under a different name.
- Contact your pump supplier as they maybe able to offer back up supplies free of charge whilst you are on holiday.
- Ask your insurance provider whether your policy will cover the costs of any treatments you might need while abroad.