Travelling with Diabetes

Blog

by Melinda D. Maryniuk, MEd, RD, CDE

People with diabetes can enjoy travel and adventures of all kinds! Long-distance flights, cruises, hikes… everything is possible with a little planning.  This guide will help any person with diabetes plan ahead to reduce the risk of any health-related problems and fully enjoy the trip!

Before You Go

  • Talk with your healthcare provider. If you’re planning a big trip, it may be recommended that you go to your doctor’s office for an overall medical check-up and “clearance” for the trip at least 1-2 months before you depart.  
  • Ask if any vaccines or booster shots are needed. Keep a copy of your up-to-date health records with you, including immunization dates. 
  • Obtain important travel documents. Be sure to get written prescriptions for all your diabetes medicines and supplies in case you run out while on the road. In addition to getting necessary documents such as a passport and visa, ask for a “diabetes travel letter” from your provider stating the following:
    • That you have diabetes
    • That it is necessary for you to carry certain medicines and equipment (such as syringes, insulin, glucose meter, lancets)
    • A list of any allergies
    • Contact information in case of emergency.
  • Talk with a diabetes educator and dietitian. This is a great time to schedule an appointment to review a variety of topics including: your sick day plan, reducing risks of foot problems, adjusting medicines based on time zone changes, and tips for sticking with your meal and exercise plan while travelling. 
  • Learn a bit of the language. If travelling to a foreign country, it is helpful to have translations of some basic phrases written down on index cards or even on your smartphone or tablet such as:
    • I have diabetes. I need some help.
    • May I please have some sugar or fruit juice or soda?
    • My blood sugar is too low. I must have something to eat. 
    • Where may I buy medicine?
  • Break in your walking shoes. Allow plenty of time to adjust to new walking shoes or hiking boots.  Wear soft, cushioning socks that can wick away moisture and help keep your feet dry.  If you’ve been having trouble with your feet, it may be time to consider therapeutic shoes (covered by Medicare).
  • Learn more about special situation travel. Having diabetes should not hold you back from doing anything.  However, let your provider and educator know if your travel plans include any more unusual or higher risk travel adventures such as being at very high altitudes (where blood glucose meters may not be as reliable) or scuba diving (to minimize any risk of hypoglycemia).
  • Contact your health insurance company. Determine if you need any extra coverage in the event of an emergency.  You might also consider travel insurance in case you have to unexpectedly cancel the trip.  In that event, it is helpful to have the letter from your provider indicating your medical clearance for travel

Departure and Travel

  • Review the suggestions in the “Diabetes Travel Checklist” for packing. Based on your own experiences, add those items you find helpful.  Keep a copy of the checklist in your luggage so it’s easy to review when you pack to come home. 
  • Pack extra diabetes medicines and supplies. It’s always best to have more than you think you need.  Make sure you know the generic name of your medicines – as they may be called by a different brand name in another country.  Consider bringing a second meter as a back-up. 
  • Keep your diabetes supplies in your carry-on bag. If you are checking a bag, make sure all of your medicines and diabetes supplies stays with you.  Keep your diabetes travel letter and prescriptions with you as well.
  • Use an insulated cool-pack for insulin. While keeping insulin at room temperature is fine, it may be safest to avoid temperature extremes by keeping insulin and other injectables in an insulated cool pack (such as Medicool or Frio cool). 
  • Going through security checks. Be prepared to have your Diabetes Travel Letter handy in case your supplies get questioned.  If you wear any devices (pump, CGM) let the TSA agent know and ask for a pat-down. 
  • Expect the unexpected.  Travel delays are common.  Have enough food with you to cover more than you think you need.  Bring a meal (such as a sandwich and fruit) as well as some snacks. 
  • Managing long distance travel. If you are changing time zones, no adjustments in medicines are needed if it is less than a 3 hour time change.  However, for longer trips, you’ll be changing the dose and timing of your medicines based on the advice from your provider or educator.   It will just take a couple of days to get on to your new schedule.  While travelling to your destination, it is also important to:
    • Stay hydrated. Drink water.  Avoid alcohol.
    • Check your glucose more often with your meter. This is especially important when changing time zones.
    • Get up and move as much as possible. Even leg lifts and short walks in the aisles help.

Enjoying Your Trip

  • Check blood glucose more often. You may find with changing time zones or even different schedules, activity and meal routines that there is more variability in your blood glucose.  Don’t be too hard on yourself but do your best to keep it close to target. 
  • Be kind to your feet. Chances are, you’ll be walking more.  Take extra care to inspect your feet at the end of the day and make sure your shoes are completely clear (no small stones) before putting your feet back in.  You may need to change your shoes half-way through a long day of walking to reduce blisters. 
  • Safe sharps disposal. Just as when you are home, disposing of syringes and lancets in a safe way is important.  If you use syringes, you may want to bring a needle clipper to make syringe disposal easier. 
  • Keep to your routines. As much as possible, follow your meal and exercise plan.  Make some compromises.  For example, instead of eating every meal out purchase foods from a grocery store for breakfast of lunch.  It can take extra effort to get enough fresh veggies and fruit when you travel – but it is also a great way to discover local markets.  Use resistance bands to do stretching and strength building exercises in y our hotel room (or better yet, choose a hotel with a gym!)
  • Seek medical care before you might need it. In the event of an emergency – would you know what to do?  Instead of wasting time figuring out where to go or who to call, it’s good to have a plan in place and a phone number to call.  Chances are high you’ll never needed it – but better to be prepared!
  • Stay rested, hydrated – and enjoy! Don’t forget to drink plenty of water and get 7-8 hours of sleep!  

Diabetes Travel Checklist

  • Diabetes medicines and supplies (pills, insulin, syringes, pump supplies)
  • BG Monitoring supplies (meter, lancet, lancing devices, log book, alcohol wipes, extra batteries)
  • Ketone checking (ask your provider if this is needed)
  • Diabetes Travel Letter
  • Prescriptions for medicines (generic names) and supplies (such as syringes)
  • Medical identification (wallet card, bracelet or necklace)
  • Insulated travel bag/cool pack (for medicines if needed)
  • Needle clipper (for removing syringe needles) and sharps disposal plan
  • Snacks (such as nuts, granola bars, dried fruit)
  • Carb counting information for regional foods
  • Exercise clothing; resistance bands, step counter or fitness tracker
  • Hypoglycemia treatment (glucose tabs, for sure; ask your doctor if glucagon is needed)
  • Phone numbers /websites for diabetes supply companies (pump, meter, CGM, etc)
  • Phone numbers of your home medical team as well as contact info for a medical group in the area you are travelling to (if possible)
  • Medical ID stating you have diabetes
  • General first aid kit (including medicines for motion sickness) and a diabetes sick day plan
  • Moist towelettes / hand sanitizer
  • Clear ID labels on your luggage (so it can be returned to you if it gets lost!)

Additional Information:

The Diabetes Travel Guide.  2nd Edition.  Davida Kruger.  American Diabetes Association

https://www.amazon.com/Diabetes-Travel-Guide-Davida-Kruger/dp/1580402364

Travel Cool Packs

Medicool, Inc
www.medicool.com

Frio Cooling Products

www.wisechoicefrio.com

MEDport

www.medportllc.com

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