Travel and diabetes
Travel and diabetes
People with diabetes can travel just the same as people without diabetes. But, you will need to do some formal planning to make sure travel plans include management of diabetes.
Key points to remember about travelling with diabetes
- make sure travel plans include management of diabetes
- have a review by your diabetes team about one month before travel
- make sure you take enough diabetes supplies
Preparing for travel with diabetes
People with diabetes can travel just the same as people without diabetes. You will, however, need to do some formal planning to make sure travel plans include management of diabetes.
When travelling it is important to think about:
- length of journey
- possibility of delays
- timing of insulin
- availability of carbohydrate food
- access to medical services and diabetes supplies
- care of insulin and diabetes equipment
- customs regulations in different countries
- changes in type of foods
- changes in activity levels
- changes in medication and sleep routines
- prevention and management of sickness away from home
- carrying letters from your diabetes team in case they are needed at customs or security check
Have a review by the diabetes team before travelling
It's a good idea to have a review by your doctor and diabetes nurse about one month before travel. This is especially important for overseas trips. They will assess blood glucose levels and make any needed adjustments to treatment. The diabetes team will supply appropriate letters and give advice about coping with time zone changes. You can also discuss other issues such as insulin adjustments for activity changes, flights and overseas medical facilities.
Letters and contacts you need when travelling with diabetes
Ask for a copy of your most recent clinic letter which summarises medical information about your child in case you need to seek medical advice away from home. For overseas trips and domestic flights, ask for a letter stating that you will be carrying supplies such as insulin and syringes, as well as fluid and food for hypoglycaemia treatment. This is so you avoid any problems at customs or security inspections.
Ask your doctor about suitable diabetes services at your destination. Your diabetes team can provide contact names, addresses and phone numbers for most parts of the world. Make sure you have the contact phone, fax number and email address of your usual diabetes team in case you or others need to contact them about your child.
Check immunisations before travelling with diabetes
Make sure your child is up to date with immunisations and has any special immunisations they need for travel to particular countries. Allow at least 2 months for this in case your child needs special immunisations - your family doctor will be able to give you advice about this.
Get travel insurance before travelling with diabetes
Buy travel insurance well in advance. As the insurer will usually require information from your doctor, you need to allow enough time for this process.
Check with the airline about meals on the plane when travelling with diabetes
Find out from the airline or travel agent when approximate meal times are scheduled and whether extra snacks are available. It is best not to ask for a 'diabetic diet' as this is often low in carbohydrate and not the type of food children like. Ask for a children's meal or normal meal and if there is not enough carbohydrate ask for more or use some of your own food.
Make sure you have enough supplies when travelling with diabetes
Make sure you have enough supplies, such as:
- insulin pens
- blood glucose meter and spare batteries
- blood and urine test strips
- diabetes Medic-alert bracelet or neck chain
- insulin pump supplies
It is a good idea to have a spare blood glucose meter as a backup. The insulin, GlucaGen™ hypokit and blood glucose meter need to be protected from extremes of temperature. If these are likely to occur on the trip, use an insulated container or packing.
If you are travelling with an insulin pump, make sure you have a supply of insulin pens as a backup in case of pump failure.
Make sure your child is wearing a diabetes ID necklace or bracelet, such as Medic-alert.
During the trip, you need to divide essential diabetes equipment between 2 separate hand luggage bags in case one is lost. Don't pack supplies in your luggage in the cargo hold as they may be exposed to extreme temperatures or get lost at the airport.
Prepare in case of sick days when travelling with diabetes
Prepare a kit for sick day management.
Revise information on sick day management and hypoglycaemia management.
Take supplies of easy-to-eat carbohydrate for treating hypoglycaemia as well as enough extra carbohydrate in case of delayed meals. For a long flight always have enough carbohydrate foods for 2 to 3 meals. Be prepared for long and unexpected delays. Carry supplies of bottled drinks and water if allowed, although there are limits on carrying liquids on some overseas flights.
For trips to countries where English speaking is uncommon, it may be a good idea to have medical letters translated into the local language and also some translations for important requests. For example, "I need to find a doctor", "I need sugar quickly". Making contact with the New Zealand consulate may also be a good idea for longer stays or in the case of any difficulties.
Food and hygiene issues when travelling with diabetes
Like all travellers in overseas countries, you need to be extremely cautious with food hygiene. In countries where water supplies and general hygiene is suspect, drink only bottled water, avoid ice cubes and salads and avoid street food sellers and market stalls.
Make adjustments for overseas flights and time zone changes when travelling with diabetes
Insulin adjustments for flights crossing time zones need to be individualised, taking into account:
- the duration/length of the flight
- number of hours of time zone changes
- timing of meals, snacks and stopovers
- usual pattern of insulin doses
- time of arrival at destination and plans for that day (for example, sleeping or being active)
- never stop insulin on flights
- do extra BGL testing
- keep one watch on local departure time and one on destination time
- set an alarm or arrange to be woken to avoid oversleeping on the plane or after arrival
- be prepared to give extra doses of rapid or short acting insulin whenever BGL is above the target range
- be prepared for unexpected hypos
- carry plenty of additional carbohydrate in case there are delays, late meals and so on
- higher BGLs are more likely during flights because of inactivity
- low BGLs are more likely if care is not taken to avoid more than the usual overlap of long acting insulin doses, or if less food is eaten because of sleeping more than usual
- you don't need to make significant adjustments for predominately north-south travel with less than a 2 hour time shift (for example, Pacific Islands or Australia)
- talk to your diabetes team if you are using an insulin pump as there are specific guidelines on how to manage the pump for takeoff and landing