Common Health Issues

Travel Tips for Managing Diabetes

• By Rich Health Editorial Team
• November 12, 2021

Whether you are camping or dining in the most elegant restaurants of the world, traveling brings on its own set of challenges. It is difficult enough keeping your blood glucose levels under control when you are at home with all its conveniences and following your regular routines. But when you travel, everything can be thrown out of whack. Not only do you have to plan for emergencies, worry about what to do if you run out of supplies, and deal with upsets in schedules, changing time zones, and altered exercise patterns, you also have to worry about eating right and keeping your blood glucose under control. The key to any successful trip, whether for business or pleasure, for a weekend or a month, is to plan ahead.

 

DIABETES TRAVEL TIPS MANAGEMENT

 

Before You Travel with Diabetes

Before leaving on any trip, talk to your doctor about any special precautions you might need to know about. If you are taking a short trip 100 kilometers away to visit your best friend, you may not get out of your routine all that much and may not need to take any special precautions. But if you are taking a long trip, especially if you are crossing time zones or visiting another country, you may have to prepare more carefully. 

 

 

If you are going on an extended trip, traveling far from home, or visiting another country, make sure to schedule a visit with your doctor. Your doctor should examine you to make sure you are keeping your blood glucose levels under control. If you have any complications of diabetes, such as heart problems, these should be assessed to make sure it is safe for you to travel. 

 

If possible, schedule this visit well in advance of your trip. This will give you time to get your diabetes under control, if necessary. If you will need any immunizations, you can take care of them at this time. Immunizations can sometimes leave you not feeling well and this can affect your blood glucose levels. If you take care of them in advance, you will have time to regain control of your blood glucose.

 

 

You will also need some papers from your doctor: a letter and your medical prescriptions. This is especially important if you are traveling far from home. The letter should explain how your diabetes is being treated. For example, it should state whether you are taking any oral agents, insulin shots or using an insulin pump, and it should list all the supplies you currently use, such as insulin, lancets, test strips and syringes. This letter can be useful should any questions arise through customs or if you need to seek treatment anywhere in your travels. The letter should also list any allergies you have or any foods or medications to which you are sensitive. It should also mention any complications or other medical conditions that affect you.

You should also have prescriptions for insulin or any oral agents you might be taking for diabetes. Don’t rely on the prescriptions alone for obtaining supplies should you run out. Pack enough at the beginning to last you through your entire trip. But should you lose your bags, or some emergency occurs, you will have prescriptions available to get replacements.

 

The rules for getting prescriptions filled may vary from country to country. Make sure that you know the rules before you go. Whether you are traveling around the block or around the world, wear a medical identification bracelet or necklace that identifies you as someone with diabetes. If you are traveling to a foreign country, ask for a “Diabetes Identity Card” written in the language of the country or countries you will be visiting. Also, learn to say “I have diabetes” and “sugar or orange juice, please” in the language of the country you will be visiting.

 

What You Should Pack for Your Diabetes Trip

If you are a seasoned traveler, you may be used to packing light. This is okay when it comes to clothes and accessories, but when packing your diabetes equipment, it’s better to have and not need than need and not have. When packing your insulin, medications, and blood testing supplies, always pack at least twice as much as you think you’ll need. Put half of your supplies in your carry-on bag and the rest in your regular suitcases. This way, if your bags are lost, you will still have an adequate supply to last you until you find your bags or replace your supplies. Keep your carry-on bag close by at all times, whether you are traveling by car, plane, train, boat, bike, foot, horse or camel. Your carry-on bag should contain the following items:

 

• Blood and urine testing supplies, including lancets, test strips and meter
• Extra batteries for your blood glucose meter
• All oral medications
• Any other medication or medical supplies you may need, such as glucagon, antidiarrheal medicine, antibiotic ointment, antinausea drugs, or medication for any other conditions you have
• All the insulin, syringes, and/or infusion sets you will need for the trip (if you use a pump you may still want to pack some insulin syringes as an emergency backup)
• Your diabetes identity card or other form of identification that indicates where you can be contacted while you are traveling, as well as your home address
• A snack of crackers and cheese or peanut butter, fruit, a juice box, and some form of fast-acting carbohydrate to treat hypoglycemia

 

When you pack insulin, pay special attention to how you store it. You don’t want it to get too hot or cold. If insulin freezes or is stored at temperatures below 2°C, it may aggregate, or clump together, and become inactive. Also, keep insulin out of direct sunlight or in places that may get too hot. Insulin spoils if it is stored at temperatures greater than 30°C. In general, if the temperature is comfortable for you, your insulin will be okay too. 

 

However, be careful about leaving it in the glove compartment or trunk of your car, or in a backpack or cycling packs that are exposed to direct sunlight. These can get quite hot. Instead, store your insulin in an insulated travel pack that will keep your insulin cool without freezing it. Also, make sure to keep your insulin with you when traveling by plane, bus or train, since the temperatures of luggage areas could harm your insulin.

 

When buying insulin overseas, be aware that insulin can come in different strengths in different countries. For example, an insulin with U-100 means there are 100 units of insulin in every cubic centimeter (cc) of fluid. When you use an insulin syringe, you are probably used to a U-100 syringe. 

This ensures that you deliver the right dose for your strength of insulin. In some countries, insulin may come as U-40 or U-80 solutions, which are more dilute than what you may be used to. If you use one of these insulin, you also need to buy a matching U-40 or U-80 syringe. If you use a U-100 syringe for U-40 insulin, you will end up injecting less insulin than you need. To avoid this, make sure your syringe matches your insulin strength. Ask your doctor how to make any adjustments in dose for any other insulin strength you may have to buy.

 

Eating on the Run on Your Diabetes Trip

If you are flying or taking a train and eating en route, make sure to request a special meal in advance. You can request a special meal that is low in sugar, fat, or cholesterol. You should request your meal at least 2 days before you fly. A convenient time to do this is when you are making your seat reservations. Meal service is often slow on airlines, so make sure you see the cart coming down the aisle before you take your shot of insulin. Carry an extra snack with you in case your meal is delayed. Also make sure the flight attendant knows that you have diabetes. This could help expedite service if you are in need of a quick glass of orange juice or snack.

If you are flying in an airplane and need to inject insulin, be aware that the cabin is pressurized. Be careful not to inject air into the insulin bottle. In a pressurized cabin, this can make it difficult to move the plunger and you may end up injecting an inaccurate dose of insulin.

 

When traveling across time zones, be aware that some adjustments may be needed. If you are driving, this will probably only require a minor adjustment. But if you are flying across several time zones, it could make a difference. In general, remember that travel eastward shortens your day. 

If you use insulin, you will probably need less insulin and perhaps an extra snack. Discuss your plans with your doctor or diabetes educator before your trip. Bring your travel plans and itinerary with you. Your doctor or diabetes educator can help you make any required adjustments in your eating and insulin schedule. Don’t forget to test your blood glucose level while you are traveling, especially if you are crossing time zones. If you are flying, test your blood glucose soon after you land and when you get settled into your lodgings. If you have jet lag and don’t feel very well, it may be difficult to judge whether your glucose is too high or too low. Testing is the only way to know for sure.

 

Once you arrive at your destination, take it easy for a few days. Test your blood glucose levels more often than you usually do. Plan your activities around your insulin and meal schedule. Don’t forget to take along snacks when hiking or sightseeing. Don’t assume you can find food wherever you go. Try to experience the foods that will give you a sample of the local flavor, but avoid those foods you know will upset your stomach. When traveling in some foreign countries, you need to avoid the local tap water, even ice cubes. Rely instead on bottled water.

The most important thing to keep in mind is that diabetes need not interfere with your adventure. It just takes some advance planning and preparation. Once you integrate diabetes into your daily routine, whether at home or traveling, you are free to experience the world and all its pleasure.

 

Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

Navigating Travel with Diabetes by R Mullin, D Kruger et al