By: Clay Wirestone
Are you ready for a challenge? Then let’s take a trip together–just me, you, and diabetes. Another travel season is upon us, with all of the challenges and frustrations that it entails for those with type 1 and type 2 diabetes. It might not simple or easy to manage, but it should be rewarding if we handle it right.
Here are 12 tips to get you ready for your vacation, business trip, or quick weekend away. It might not cover every possible contingency, but once we get through the list, you should be well on your way to a (relatively) stress-free adventure.
1.) Visit your doctor. Yes, taking a vacation is supposed to be about getting away from your ordinary surroundings. But the savviest diabetic travelers start their planning early, and that means seeing some familiar faces. Meet with your doctor or healthcare team and let them know your plans. Listen to any special advice they might have-everyone’s case is different. You might need immunizations or other special treatments, too.
2.) Get a letter. At that doctor’s appointment, make sure to get a letter from your physician that outlines your condition and your basic treatment plan. This can come in handy with airport security, or if you’re visiting another country and need to access healthcare services there.
By the way, that documentation should also include emergency prescriptions for your most important medication and supplies. You’ll never know when you might need them, and being over-prepared is far preferable to being under-prepared. Hopefully, though, you won’t ever get to that point, because you’ll follow our next recommendation.
3.) Pack more supplies than you’ll need. Even with spare prescriptions, you don’t want to go without your necessary medications or supplies on the road. If you’re a type 1, for example, you need to bring sufficient insulin and test strips. Not having them could lead to big headaches at best and serious troubles at worst. The same goes for oral medications for type 2s.
How much extra should you pack? Boston’s Joslin Diabetes suggests taking twice as many supplies as you would actually need. It also notes that insulin pump users may want to contact their pump manufacturer and see if they can obtain a backup pump for the trip.
4.) Prepare for airport security. Listen, no one loves going through airport security. But for people with diabetes who use insulin and insulin pumps, it can be even more of a hassle. Make sure to package your supplies separately so Transportation Safety Administration staff can see them easily. And tell your screeners if you’re wearing an insulin pump–airport scanners can potentially cause problems with the devices, according to Columbia University’s Naomi Berrie Diabetes Center. You might want to opt for a pat down instead. Whatever the case, don’t be caught by surprise when standing in line at the airport.
5.) Take note of time zones. Here’s something you might not have thought of–you’re used to a regular schedule of insulin injections or medication. Going halfway around the world could mean the loss (or gain) of many hours. According to a paper published in the journal Clinical Diabetes back in 2003, this can mean a real adjustment for people on multiple daily injection regimens. Pump users can simply reset the time on their devices, although close monitoring of blood sugar is still recommended.
Specific advice is hard to make here because everyone’s case will be different. But the paper suggests talking this over with your healthcare provider, and studying your itinerary to figure out how much time you’ll gain or lose. That will allow you to make a plan in advance. And don’t panic–if you’re gaining or losing only a couple of hours, the adjustment is minimal.
6.) They do insulin differently there. Not all insulin is sold at the same concentration in every country you’ll visit. You’re probably familiar with the label U-100 on your insulin vials; that simply means that each milliliter of fluid contains 100 units of insulin. But according to the Mayo Clinic, “outside the United States, insulin may come as U-40 (40 units of insulin per mL) or U-80 (80 units of insulin per mL). If you need to use these types of insulin, you must buy new syringes to match the new insulin.” It’s a simple enough change to make, but it could land you in big trouble if you aren’t aware of the difference.
7.) Don’t overheat! Here’s another tip for insulin users: Make sure to keep your insulin insulated and protected. It’s very easy, especially if you’re headed somewhere tropical, for your insulin to get way too hot. It can then lose its potency, making it difficult to dose correctly. So invest in an insulin cooler other protective device. Generally speaking, a single vial of insulin isn’t going to turn into seltzer water if it gets hot for a short amount of time. But if you’re carrying a lot of insulin with you, and your schedule is uncertain, make sure you can protect that medication.
8.) Can you find a doctor? Now it’s worst-case scenario time. What would you do if you’re in a foreign country or other unfamiliar locale and need urgent medical attention? Do you know how you’d find a doctor? Do you know how you’d find a doctor with knowledge of type 1 or type 2 diabetes? And will that doctor be able to speak your language?
Thankfully, there are people who can help. The Mayo Clinic recommends the International Association for Medical Assistance to Travelers, which can get you a list of English-speaking overseas healthcare providers. You can visit the group online at iamat.org or call (716) 754-4883 for information. If you end up having an emergency, you can also try the American consulate in the country you’re visiting or local medical schools.
9.) Check your blood sugar often. People with diabetics most often think about their blood sugar levels in connection to diet and exercise. And that’s what causes our levels to fluctuate most of the time. But travel can complicate things immensely. Our diet and exercise will likely be different, to some degree. But we will also be dealing with the stress of catching (or missing) planes and making our ways in unfamiliar surroundings. Stress affects blood sugar, too. Don’t forget the time zones mentioned earlier, and the possibility of heat damage to your insulin.
In other words, travel can mess up your blood sugar levels in myriad ways. So make sure you know what that number is at all times. If you don’t check regularly, do so. If you do check regularly, check more often. And if you’re on a continuous blood glucose monitor, make sure to check it against fingerstick numbers regularly.
10.) Watch the food. Trips can be amazing opportunities to sample new and delicious kinds of food. But don’t let that sampling–a very real pleasure–turn into extra portions. Remember that good diabetic control often relies on restraint.
And according to the Joslin Diabetes Clinic, you’ll also want to do some basic nutrition research. Chances are you haven’t looked up how many carbohydrates exotic foreign dishes contain, so why not tackle that before the trip? With such knowledge in hand, you won’t be fiddling with a carb-count book or your smartphone while ordering that stunning, sophisticated dish.
11.) Be open about your disease. No one likes to run around and tell everyone about his or her diabetes. It’s embarrassing, it makes you the focus of unwelcome attention and it just seems tacky. But it could end up being a lifesaver, especially if you’re in an unfamiliar place and around a lot of unfamiliar people. If they don’t know and you end up having problems with your blood sugar level, you might not be able to communicate at the moment when your need is greatest.
This also means you should carry identification with you that details your disease and medication. That could take the form of an ID bracelet, a wallet card, a fob on your keychain or even a tattoo. You never know when they might come in handy.
12.) Don’t be limited! The final message of this list is not to let this list freak you out or deter you in any way. One of the amazing blessings of modern life is that we’re able to do and see things that previous generations of people with diabetes only dreamed about. We can climb mountains. We can participate in extreme sports. We can do all the things we want to do.
We just have to be smart about it.
A Final Note:
People with diabetes know how this disease can pull them in different directions. On one hand, diabetes management is often easier on a tight schedule. But on the other hand, so many treatment breakthroughs–tiny blood glucose meters, insulin pumps–make it easier to vary that schedule and try new things.
And so it is with travel. We’re pulled to explore new things, because so many of our treatments make it easier than ever before. But we can easily go too far–not planning well enough or far enough in advance. The solution is to find a happy medium, a balance between getting ourselves ready and allowing enough spontaneity to make the trip truly worth remembering.
It’s not an easy task, but the rewards are significant. Just like dealing with diabetes itself.