#1 -- Keep your supplies close at hand. Whether you’re traveling by plane, train, or automobile, make sure your diabetes supplies are easily accessible. If you’re flying, be sure to put all of your supplies in your carry-on bags. Back-up insulin should also be kept in your carry-on, because checked baggage can be exposed to extreme cold, or heat that can spoil insulin, and ruin glucometers. If you're using a device to keep your insulin cool, be sure it is a cold pack, and not a freezer pack--freezing insulin destroys its efficacy. The same rules apply for storing supplies while driving, or on a train.
#2 – Try to stick to your routine. Traveling can really throw people with diabetes off schedule, and at no fault of their own. The delay of a flight, may mean sitting on the runway for hours, or if you’re traveling out of your time zone, it may mean feeling hungry, when you should be asleep. When you have diabetes, you need to think ahead, and stick to your routine as much as possible. If you pack extra snacks for the plane, you may want to store them in an insulated bag with an ice pack. Tracey Lucier, Nutrition Educator at Joslin Diabetes Center, also recommends writing your seat number on the bag, and asking a member of the cabin crew, to store it in a refrigerated trolley. For a list of snacks, that don’t need a cooler for storage, check out the list at right.
#3 -- Get documentation. Carry a note from your doctor, stating that you have diabetes, and need to have your medication with you at all times. If you’re going to a country where they speak a language other than your own, translate the note into that language. Make a few copies of the note, and distribute to those traveling with you, so you will have documentation at all times.
#4 -- Inform airport security you have diabetes. When flying, remember to put your diabetes supplies in a quart size plastic container that is separate from the other non-diabetes liquids you’re bringing on board; this way, screeners can immediately separate diabetes medications, from other liquid items in your carry-on baggage. Sometimes it is helpful to carry your insulin bottles, or pens in their original packaging, to prove the prescription is your own. Lastly, always check out the Transportation Safety Administration’s website.
#5 -- Always be prepared to treat low glucose. When you travel, you may disrupt your normal routine for both eating, and dosing insulin; you may also be sightseeing, or increasing your physical activity in general. Because of these changes, you need to be prepared for low glucose whenever it strikes, so pack plenty of glucose tablets—these are usually the best because they won’t melt, explode in heat, or leak, and become sticky.
#6 -- Investigate the food you eat. "If you take mealtime insulin, do your best to figure out the carbohydrate grams in the foods you’re eating so that you take the right pre-meal insulin," advises Lucier. She also recommends doing some research on local foods before your trip with websites such as Calorie King or Nutrition Data. These sites allow you to search for the nutrition information for foods you may not know a great deal about prior to your trip. In addition, test your blood glucose before, and after meals to see how new foods are affecting your control. It's crucial to keep your glucose numbers in check to avoid problems.
#7 -- Increase your stash of supplies. You may be traveling to Hawaii for only a week, but it’s wise to pack diabetes supplies as if you were staying twice as long. Check out the list at left for what you should bring. If you're using a pump, should also remember to bring extra supplies. Andrea Penney, RN, CDE, suggests asking for a back-up loaner pump for your trip in case there's a problem with the one you're wearing. "Simply call the pump company [you use]. You might have to leave a credit card number as a deposit, or you may have to pay a 'rental fee'. The arrangement differs with each company."
#8 -- Consider time zone changes. If you’re wearing an insulin pump and will be traveling to a location that is in another time zone, be sure to adjust your insulin pump’s clock to reflect the change. If you have questions about how to handle the change, be certain to speak with your diabetes care team before hand.
#9 -- Test your blood sugar. Travel can have all sorts of effects on diabetes management. For example, when en route to your destination, you may be sitting for prolonged periods of time. Keep in mind that the lack of activity may prompt your blood glucose levels to become elevated; conversely, sightseeing, and other physical activity may lower glucose. Because of the changes in your schedule, it is very important to test glucose before and after meals. If you're unsure how to correct for highs, ask your healthcare team for more information.
#10 -- Tell others that you have diabetes. While it may not always be comfortable, it is important to tell the people with whom you are traveling that you have diabetes. Let them know what you have to do to stay healthy, and active on your journey, and what they should do in case there is an emergency. Always wear a medical identification bracelet when you’re traveling (although you should be wearing one all of the time anyway)—and be certain that it states you have diabetes, if you take insulin, and if possible, list an emergency contact number. If you’re bringing your cell phone with you on vacation, be sure to enter a contact in your phone book entitled, "Emergency Contact"—many first responders are trained to look for this in a cell phone in the event that you are unable to communicate due to an emergency situation.