I’ve always been a pretty good traveler. I simply checked the weather at my destination and packed accordingly. Easy. Then I learned that I had diabetes, and suddenly even weekend trips required an intense amount of additional preparation.

But now I’ve got it down almost to a science...almost.  I do a fair amount of domestic travel, so I’m used to the routine at the airport security check.  Wearing an insulin pump and continuous glucose monitoring system (CGMS) means I usually “beep” going through the scanner.  I always anticipate the “pat-down” and I budget my time accordingly.  I’ve learned to cope.

A recent trip turned out to be a little different.  My wife and I planned a trip to Italy for a few weeks of down-time.  Because of the length of the trip and the fact that we were going “across the pond,” I knew that a little additional planning was in order.  

I made sure that I had extra insulin, meds, syringes (in case I had problems with my pump), extra test strips, etc.  I even packed extra batteries for my pump and picked up an insulated baby bottle caddy with built-in, freezable, blue-ice packs so I could keep my extra insulin cool between refrigerators.  I wear a MiniMed pump, so I went to the Medtronic-MiniMed website to make sure I had a number to call in case of issues abroad.  (There’s a Medtronic office in Rome, by the way.)  I was completely prepared for this trip.  

(As timing would have it, I was due for an infusion set/site change very close to our arrival in Rome.  I had planned ahead and had all my supplies with me in my carry-on luggage.  Important note: Never put your supplies in your checked-in luggage—your luggage may not make it with you, and the plane’s cargo bay may experience temperature fluctuations!)

So, after a great flight and a drive in a hired car from the airport to our B&B, our change of scenery was complete. We were ready to set off to do some sightseeing…and cappuccino drinking, of course!   

Now, Rome’s a walking town!  The city has great mass transit, but Italian cuisine isn’t what you'd call low-carb, so extra walking helped balance out what, for me, was a higher than usual carb load. (Pump wearers: Depending on the amount of walking you do, you may actually have to adjust your basal rate down a bit to avoid lows.)  We struck the perfect balance of walking-pasta-walking-doppio macchiato-walking-tiramisu-walking…you get the point. All things in moderation, of course: You don't have to eat the entire plate!

A couple of days into our trip, and things were going great!  We’d made plans to rent a car and drive south to Salerno, on the Amalfi Coast, for a few days, then on to the Isle of Capri by way of jet-boat.  (Springtime on the Amalfi Coast is magnifico!) The amazing pasta notwithstanding, the exercise from walking and tight monitoring had kept my BGs in check. Our vacation thus far had been fantastic.

Assault and Battery

On the morning of our drive to Sorrento to catch the boat to Capri, following my usual routine, I did a quick BG check before breakfast.

What was that?!

There was a new icon on my meter—one that I hadn’t seen in a while: the battery icon!  My meter's battery was about to give up the ghost.  Remember, I’d packed for every contingency imaginable, even extra pump batteries—everything except for my BG meter battery. (And I had two extra in my kit…at home)

There was no way that Ravello, the village we were in, would have a 3-volt Li CR2450 battery. I figured we’d head on to Sorrento; surely we’d find one there.  I made a quick call to MiniMed's help line to confirm that the standard camera-type battery was fine--that no particular medical device battery was needed.  Josh at the help line was awesome.  He even looked at Medtronic’s Italian website to see if there was a satellite office outside of Rome.

Sadly, there wasn't.  We decided that if we couldn't find the battery in Sorrento, we’d have to head back to Rome.  Well, can I tell you that what should have been a quick drive through town to the marina wound up being no fewer than five or six tours of Sorrento, with stops at every conceivable electronics, camera and housewares shop looking for the elusive Li CR2450.  Finally, success!  Five euros later, we were back on track to the marina and the continuation of a vacation we won't soon forget.

I could go on about what a great vacation this was, but the point of my story is to remind those living with diabetes to make a thorough checklist and really plan for all contingencies when you travel.  My MiniMed pump and CGMS have always worked flawlessly—but the key to their working is cross-checking results with a BG meter—something we here the United States may take for granted.  Next time I travel, domestically or abroad, not only will I have that extra battery, but a back-up meter as well.  What was a beautiful trip could have had a less-than-beautiful alternative ending!  

(By the way, my average BGs on the trip were 122—not shabby! You can live with diabetes and have pasta, too. You just gotta plan appropriately.)

How to Plan for Your Trip

Nine Basic Things to Do

1. Know your health—are you physically able to travel? Notify your physician of your travel plans and destination—he/she may want to make changes or adjustments in your medications and give you recommendations.
2. Make sure you’ve got enough medications and supplies for the trip—plus a few extra days, just in case. If you need additional medications, have your physician call in to the pharmacy (and give it enough time to fill the prescriptions).
3. Brief your travel companion(s) on your needs, if they're not familiar with your diabetes.  Deputize them as your assistants, just in case.
4. Have your emergency contact numbers handy (your doctor, pharmacy, pump support line).  Find out where you can get supplies/medications while traveling, should a need arise.
5. Wear your medical ID bracelet while you’re traveling. Heck, you should always wear it.  You do have one, don't you?!
6. Make sure someone at home has your travel itinerary and contact number(s).
7. If you don't have an international cell phone, consider a cheapo pay-as-you-go phone while overseas.  Make sure your contact at home has that number--and knows the international dialing prefixes.
8. Become familiar with culinary differences you may encounter. Will there be any special considerations you have to make?  It’s pretty easy to get sugar substitutes just about anywhere nowadays, but I usually bring a small box of Splenda with me, just in case.
9. Make a master checklist of everything you will possibly need:
   • Medications with pharmacy labels intact. Remember that dosages overseas can be different.  Some countries use U-500 insulin; should you need to get meds while traveling abroad, be extremely careful about dosages!
   • Glucometer (with back-up battery)
   • Back-up glucometer (with fresh battery)
   • Supplies: syringes, lancets, test strips, Keto-sticks, alcohol prep pads, coding solution)  Note: If you’re traveling overseas, plan on having a doctor’s order/prescription for “sharps”/syringes. (Have syringes on hand in case of pump damage, malfunction or failure. It’s pretty rare, but it can happen.
   • If you’re on an insulin pump, contact the pump company to see if you can borrow or rent an extra one while traveling.  
   • Make sure you’ve got extra pump batteries
   • Snacks. Make sure you have healthy snacks and some quick-acting carb snack, should you go low.
   • Rapid-acting glucose tablets for when you’re on an airplane, I don't recommend the liquid—it’s just another hassle at the security check.
   • Think about having a Glucagon pen in case of emergency, and make sure that your travel companions know how to use it.
   • Have a temperature-controlled container for extra insulin. The best thing I’ve found is a baby bottle travel pack. (Guys, you can get black ones.)  Some come with built-in blue ice, and the entire thing can be frozen in advance of your trip.  
   • Hand sanitizer or wipes.

On Travel Day:

You may need to adjust your eating and insulin schedules. Hopefully you’ve discussed this with your doctor or nutritionist.

Keep all your diabetes-related supplies and medications with you in your carry-on.  DO NOT CHECK THEM WITH YOUR LUGGAGE!

Leave a little early for the airport. You may get the pat-down at security, especially if you wear a pump. Chances are great that you’re not the first they've seen with a pump. But if you are, be a good ambassador and use the occasion as a “teaching moment” for the security specialist.  It might make it easier for the next passenger who comes along with a pump or device!

Check your sugars more often while traveling—your regimen is different, which may affect your BGs.

Enjoy your trip—you’re now well prepared!