It is true that living with diabetes is a daily trip of exercise, medication, blood glucose testing, eating on time, and the rest that you do each day. However, all that having been said, diabetes that you control can go with you around the world (or much of it).
Having traveled south and north of the border, to the Middle East, and to Europe and returned home never worse for the wear, I can attest to the fact that with preplanning you can minimize the chances of becoming ill while away from home.
What this basically means is that you must think ahead and anticipate any diabetes related risks in the country where you will vacation. What this means is that you must know the medical facilities of the countries you expect to visit.
Third world or developing countries are more likely to present problems than more Westernized countries. Some spas or resorts in foreign countries are isolated and have only nurses available. Cruises may not have the most modern of medical facilities on board and you are miles from a modern hospital.
The physician may not be trained specifically in the area that you need, and may have been trained in a country whose accreditation may be very different than those with which you are familiar. What you pay for your accommodations may also infringe on your treatment if you need it. Staff in a luxury hotel are more apt to speak your language, have a physician on call, have back-up personnel to help, etc. With sensible precautions you will enjoy a trip that is a list of memories just waiting to be enjoyed.
Before you decide on any trip and certainly, before you get on the plane, train, or cruise ship, make sure that you see your physician to make sure your diabetes is well controlled. If you need some work in this area, a really good trip may will be the motivation to get you in control.
If you are going to certain countries you will want to discuss immunizations that are necessary before you land there. Do this early so that if you have a reaction to a vaccine you will have plenty of time to get over it before the date of departure.
A little time and thought will make your trip easier and set your mind at ease. With your health care team or physician, make up a treatment folder with all of your medical history. Make sure that you include not only your name, but that of your physician and emergency phone numbers.
In this folder have a copy of your travel itinerary, a detailed description of your medications and how you manage your diabetes as well as any other diseases. Make a list of all medications you take, what they are for, and how much and when you take them. Also bring a prescription for extra medications, including your diabetes meds, just in case yours disappears. If you are to be gone for a while you may want a list of the most recent laboratory tests that you take.
Have a list of hospitals in the cities that you will visit. These can be found through the ADA here in the US or the International Diabetes Federation in Brussels, Belium. To find out a list of English-speaking foreign physicians you can contact the International Association for Medical Assistance to Travelers in Lewiston, NY.
Make sure you have a medical ID bracelet or necklace. Don’t remove it. Carry a note written on your physician’s prescription pad stating that you have diabetes and are carrying syringes and insulin for that reason. Some of you wrote in and asked about the chance of being stopped because you have these in your carry on luggage or purse and were worried. My response is that most drug runners or users wouldn’t have illegal paraphernalia so easily accessible.
As you are getting your clothes together, also get together the medication you will need to pack and then get more. Pack more than you will need, just in case. There are places in the world where you may not be able to get the exact brand of medication that you use or it may take an interpreter some time to get to a pharmacy, so a word to the wise should be sufficient. Pack your medications and supplies in an suitcase that you keep with you. Do not check your meds.
You will need:
- Enough medication and insulin for the trip and extra vials in case one breaks. In the US insulin comes U-100 and in other countries it may come U-80 or U-40.
- Blood testing supplies. I always change batteries in my glucometer before I leave so that I know it will work. If that’s not enough for you to sleep well, pack extras.
- Make sure you also pack medications like anti-diarrhea, antibiotic, antibiotic creams, Band-Aids, pain killers, and glucagon.
- Pack a supply of food such as crackers, cheese, fruit, glucose tablets and juice just in case your flight is late and your meal is delayed. For very long flights, I tend to pack a sandwich. If you read my article on France in October, you know that I was served M&Ms; as part of my diabetic meal, so
- I take it for granted that those who pack these meals just are not always educated about what my needs are. If you’re carrying fruit and going out of the country, it will have to be eaten before going through customs or declared and left with the customs officials.
- If you have room, add some water to your bag. This again, is just in case your flight is delayed and you are sitting on a plane on a runway for a few hours. You may or may not be able to get water.
- My last thought is that you may want to bring your cell phone with you if you stay in the US or if you can afford to use it and have service abroad. We took ours on this last trip and never used it. I did have to stop my husband from calling to see if our dog was happy at the boarding facility, but then, she was probably worth a call from France.
Before you leave the country make sure you will be staying someplace where you can store your insulin. Very low temperatures or very high temperature can change the potency of your insulin. It does not have to be refrigerated but it does need some protection. Don’t leave your insulin in a cold trunk or in your pocket in a very warm environment. There are wonderful insulin carriers that can keep your insulin cool for at least 24 hours while traveling or on the go.
Do make sure that you don’t sit still during a long trip. Get up and stretch, walk around and if you in a car or bus, get out when you can and get that circulation going.
If you are traveling by air remember to order special meals. Don’t order low-carb meals as they may be too low in calories. Some people are concerned about sending their insulin through the X-ray machines at the airport.
The ADA says that this is rarely a problem, but if you have a problem with this, ask to have it hand inspected. If you inject insulin on a plane, do understand that you in a pressurized environment and you will have to be careful when measuring your insulin.
Don’t take your insulin, until you see your meal being placed down in front of you. With a special order you may be first or last to be served. Take your blood glucose levels frequently to make sure that you are in control. Jet lag can effect these readings.
People also ask us about crossing time zones. If you take instant acting insulin and carbo count, the insulin you take before meals will be easy to compute. Talk to your doctor about the base line insulin that you take at night and about what time to take it.
The day will be shorter as you fly East so you will need less insulin, the opposite is true if you are flying West. Change your watch the next morning when you arrive so that you stay on the same time during the night. Know how many hours you lose or gain so that you can make decisions with your doctor and you won’t have to be concerned.
When you are in a foreign country, do know where the American Consulate is in case you have a medical emergency. Every phrase book that I found had a translation for “I have diabetes” in the language you will need.
It took almost a day to get from the middle of the country to the south of France. Travel takes time so when you arrive, take it slow for the first day. Plan your activities around your needs for food, insulin or meds, exercise, and lost sleep.
Watch your blood glucose levels and check them often to make sure you get on your new time schedule with few or no bumps. Depending on the country you are visiting, watch out for the water and ice cubes. Pack the most comfortable shoes you have and never try to break in new shoes. If you get a blister or cut don’t let it go. Watch your limbs daily.
Now that I’ve given you all of this information, here is the most important thing that I can think of and that is, after you’re re all prepared, go and have a good time. No, I am wrong. Go and have a fantastic time.