It is important to think through your trip. Research your destination carefully and think through the practicalities of how long you plan to be away, and what kind of activities you plan to take part in – will you be more or less active than you normally are at home? And what about food, do you easily adapt to other foods or will you have a hard time finding something you like to eat?
- Visit your GP or diabetic advisor in good time to sort out your supplies and equipment –
- A letter from your GP confirming you are a diabetic, and why you have needles in your possession, would be a good idea!
- Make sure you get a prescription for your medication, enough for the trip and a bit more.
- Purchasing a diabetic identity bracelet gives some travellers the piece of mind they need when travelling, as does having medications listed for emergency situations.
- Immunisations and anti-malaria medication are usually safe for the diabetic, and should be discussed with your doctor.
- Insurance is best sorted out as soon as possible and the wise traveller will shop around. It is important to mention your diabetes as a pre-existing condition. Ask at Diabetes UK if you need help in finding a good policy. Excellent guides can also be purchased at Diabetes UK, giving you specific country prescription regulations. As well as good insurance, you will also need an EHIC if you are travelling within Europe.
Travelling with Insulin
- When you travel by air it is not always necessary to order “diabetic meals”. Check your carbohydrate intake regularly and, if required, top-up with snacks on the journey.
- When travelling by air don’t be afraid to ask a flight attendant for more food or a slice of bread if you need it. When you are about to eat on a flight, don’t take your insulin until you see the food coming down the isle – all kinds of things can cause a hold up or delay in it getting to you!
- If you are travelling into unknown territories, take plenty of snacks, especially if you are backpacking and are unsure of your final destination details. The journey might take longer than you planned, and the McDonalds you thought would be on every corner, might not be there!
- Always keep your insulin with you at all times. Insulin should always be carried in your hand luggage, out of direct sunlight or freezing conditions – such as an aeroplane hold! If your insulin comes in U-100 check the conversion rate in countries where it comes in U-40 or U-80. It will be essential in this situation to get new syringes to avoid dosage mistakes. Travel to tropical regions of the world will require you keeping the insulin in a cold pack, or in a cool place, maybe next to a cold water bottle.
- Heat will affect the rate at which insulin is absorbed. In the heat, insulin is absorbed quicker. It is therefore important to monitor your levels in hot weather and adjust your diet as required.
- In a cold climate insulin is absorbed slower. Also if you find yourself cold and shivering it is possible to use up energy and lower your blood sugar levels. Monitor your blood sugar levels in extreme conditions and never let your insulin freeze.
- Adjust your insulin times when you reach your destination – you will have already discussed this with your diabetic adviser but just to remind you:
- When travelling WEST lengthen the gap between insulin doses or add extra food with an extra dose until adjusted. When travelling EAST shorten the gap and reduce dosages. Always check your blood sugar at regular intervals when you cross time zones, as you might need to adjust your dosages. Remember perfect control might not be possible in the first few days, but keep working at it.
Arriving at your Destination
Finally arriving at your destination is a very exciting time – make sure you have pre-booked a hotel for the first few nights if you are backpacking, so that you have time to readjust to your surroundings before setting off.
It is inevitable that on some days you might not feel yourself, either because you are adjusting to different food, or because you have caught a local stomach upset which has left you a little green! Traveller’s diarrhoea is often a case of “when” rather than “if” in most tropical destinations, and careful attention should be given to food and water. It is important to monitor your blood sugar levels carefully while you are sick. Maintain a good level of carbohydrate content in your diet and don’t delay seeing a doctor if the problem continues or if you are worried about your condition.
Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional. Please discuss your travel health requirements with your regular family doctor or practice nurse.