TRAVELLING WITH DIABETES
There’s no reason why having diabetes should stop you traveling anywhere in the world. There are plenty of reasons why you should be prepared before you leave, though. Being stranded in a small village without insulin is any Type 1 diabetic’s idea of a nightmare! Make sure it doesn’t happen to you, by taking into account these factors (yes, it is a long list, but better to be safe than sorry, don’t you think?)
1. Before You Leave
A few hints and tips to ensure the trip is as smooth as possible, and you don’t have any panic attacks:
• Make sure you have adequate supplies of all your medication, including twice as much insulin, syringes or pens, needles or tablets as you’ll need, and all your blood glucose monitoring equipment - strips, lancets and (very important) a spare battery for your meter. Trying to track down the exact right battery when you don’t speak the language could eat up valuable fun time.
• Pack some extra carbohydrate in your hand luggage, both to counteract any low blood sugars (something sweet like juice or sweets) and to stop the gap in between meals if you get hungry (something like savoury biscuits). You don’t know how easy it will be to get food in a hurry, so it’s best to be prepared.
• When you next go for a check-up with your diabetes doctor, ask him or her for a letter with a contact number and address, confirming that you need to carry needles and syringes on you at all times.
• Remember that diabetes increases vulnerability to infections, so try to be extra healthy before and during your trip – drink lots of water, eat well, and do moderate exercise.
• Get all the recommended immunizations, at least 6 weeks before you go, so that any side-effects can have worn off. Also choose a suitable malaria medication for the regions you’re visiting.
• Get yourself a diabetes identity card or jewellery, if you don’t already have one. Medic Alert – www.medicalert.com - is the leading personal health record repository, and is recognized worldwide. What does that mean? All your necessary information stored in their database, and an instantly recognizable way to show that you’re diabetic and on insulin.
• Register (for free) to become a member of the International Association of Medical Assistance to Travellers at www.iamat.org/. You’ll immediately have access to a network of doctors around the world who can give you competent care. The organization supplies you with a list of these doctors and their contact details, no matter where in the world you are.
• Learn a few useful phrases in the language of your destination (things like, 'I have diabetes, please give me something sugary to eat’ will come in handy in an emergency).
2. Carrying Insulin
Insulin is a sensitive beast, who likes conditions to be just so. Best you obey these rules:
• Insulin should always be kept out of direct sunlight and kept cool. Avoid carrying it in the outside pockets of backpacks, as these are often in direct sunlight, and remember that a closed car on a hot sunny day gets boiling hot, fast.
• This isn’t just a precaution. Insulin loses its effect if it’s stored above 25deg C (77deg F) for a long period of time. It’s fine for up to a month at that temperature, but no more. Even more important, insulin is inactivated fast at temperatures above 35deg C (95deg F), so if your insulin happens to reach those temperatures, toss it out.
• To guard against this, it’s helpful to get a small cooler bag for storing insulin.
• On the other end of the scale, insulin should never be allowed to freeze. When you’re traveling by air, make sure you keep your insulin in your hand luggage, as the cargo hold of a plane at high altitude can get to well below freezing.
• How do you know if your insulin has been compromised? Rapid and short acting insulin should always be clear. If it looks cloudy, brownish, or has bits floating around in it, the insulin has been heat damaged and should be discarded immediately.
• Lastly, if you’re travelling with someone else, split your insulin between both passenger’s hand luggage, in case one of the bags gets lost. It’s best to do this after you’ve gone through security (see below).
3. Getting through Airports
When you’re diabetic, it seems impossible that others might not know what insulin is, and how important it is to have on you at all times. Funnily enough, most of the world doesn’t know a thing about it! Help them out with these tips:
• At security checkpoints, expect to be stopped and questioned about your medication. People carrying vials of liquid with needles attached can’t just waltz through security any more. Leave yourself extra time to get through security so you don’t get stressed out.
• Make sure you label all medication properly and be sure the name on the medication matches the name on the plane ticket – this will often mean leaving your insulin in its original packaging and taking it out once you’re on the plane.
• Bring your prescriptions from your doctor for all the supplies you need on the plane. The name on the prescription should match the name on the ticket, so they know that you need everything you are carrying.
4. Making Adjustments
It’s not only different food and different amounts of exercise that can affect your blood sugar (although it’s wise not to discount the amount of legwork needed to be a tourist!) Bear these tips in mind too:
• Insulin is often absorbed faster in warmer climates. Frequent blood glucose monitoring is vital to ensure that you’re adjusting your insulin dose accordingly.
• Heat and excitement can significantly affect your blood sugar levels. The more often you check blood sugars, the more easily you’ll be able to anticipate and avoid any problems.
• If you’re usually in front of a computer all day, you’ll need to cut down your insulin for an active trip. Alternatively, if everyday life sees you racing around and now you’re going to be lying on the beach all day, you’ll need more insulin to achieve the same blood glucose results.
5. Precautions
One or two words on what to do while you’re away:
• If you’re going on an adventure trip (as opposed to a luxury first-class trip) it’s safer for those with type 1 diabetes to travel with a companion who has some knowledge of the condition, and can recognize a low and know how to help if you get ill.
• If by some unfortunate chain of events your supplies and back-up supplies get lost or stolen and you need insulin in a hurry, the first place you should head to is the emergency room of a local hospital. They’ll usually be able to give you enough medication to sort you out until you can make other arrangements, like visiting the local Centre for Diabetes (see this list under Diabetes Resources for where to go in each of the countries we’re visiting).
• Don’t be adventurous when it comes to food, unless you’re willing to pay the price of unusual blood sugar responses, and possible stomach ailments. Diarrhoea and vomiting is never fun, but it’s more of a problem for type 1 diabetics as it messes up your blood sugar. Don’t be a dare devil – stick to plainer food and ensure you’re well and healthy enough to enjoy your trip.
