Traveling with diabetes comes with its own unique baggage, but you can navigate the challenges and keep your wanderlust alive.
“I counsel patients to plan for success, while preparing for the unexpected,” says Dr. Rajesh Garg, an endocrinologist and director of the Comprehensive Diabetes Center at the University of Miami Health System. Here are his suggestions for diabetic travelers.
First things first. See your doctor to make sure you’re healthy enough to travel.
“A stable treatment regimen is helpful when traveling. It takes one to three months to optimize treatment, so plan accordingly if your blood sugar levels are not stable,” says Dr. Garg. Ask your doctor for an extra prescription and a letter describing your condition and why you travel with diabetic supplies. Discuss your plans, activities, and destinations. Understand how to adjust your insulin dose and meal schedule based on time zones. If you are visiting a developing country, ask about travel vaccines. Some take four to six weeks to become effective; others require a series of shots.
Next, note the nearest pharmacy, walk-in clinic, and emergency numbers at your destination. The International Association for Medical Assistance to Travelers has lists of English-speaking doctors.
Don’t have a medical ID bracelet yet? Now’s the time to get one.
You might also want to purchase travel insurance in case you need medical care while away. If you are going to fly, pack your own meal or order one that suits your meal plan. Also, read up on airport security and carry-on regulations for diabetics. A TSA notification card helps travelers with disabilities get through security quicker. Most importantly, set a medication reminder alarm on your phone, especially if you will be crossing time zones.
Yes, there is an app for that.
Download the appropriate travel app that notifies you of gate changes and flight delays. BG Monitor, a health app for diabetics, supports U.S. and international units of glucose measurement, calculates carbs, and determines when you need to adjust your insulin. “If buying insulin overseas, pay attention to different units,” says Dr. Garg.
Pack for success
If flying, pack medication in your carry-on luggage—cargo hold temperatures aren’t insulin-friendly. Speaking of carry-ons, yours should include:
- All diabetes supplies, extra glucose meter batteries, extra medicine in original packaging
- An extra pair of diabetic socks, if doctor recommended
Keep a smaller bag at your seat that contains:
- Glucose tablets
- Snacks (nuts, raw vegetables, fruit, cheese and crackers, peanut butter)
- Hand sanitizer to use before checking blood sugar
- Over-the-counter medicines such as antibiotic ointment, anti-nausea medication, glucagon, antidiarrheal medication
- If your feet swell or your flight exceeds four hours, wear compression stockings to prevent blood clots and stroll the aisle every hour or two to promote circulation
On the go
At home or away, always protect your insulin, equipment, and test strips from excess heat or cold. “Insulin exposed to temperatures above 90 degrees Fahrenheit is less effective and may spoil,” Dr. Garg explains. Traveling by car? Bring an ice chest for insulin and keep it away from direct contact with ice. Portable coolers that plug into the car charger are an easier option.
If flying, ask TSA officials for a manual inspection, since X-ray machines may damage insulin pumps and glucose monitors. When boarding, tell the flight attendants you have diabetes. air bubbles before reconnecting,” Dr. Garg says.
If you are in a foreign country, learning a few key phrases, beyond the common courtesies, makes travel easier. Learn how to say, “I’m diabetic,” “Where is the nearest hospital or clinic?” and “Where is the closest pharmacy?”
When you get there
You could pursue a packed itinerary, but it’s healthier to pace yourself, especially in hot climates.
“Hot weather can make the insulin absorption faster and thus, necessitate a decrease in insulin doses. Test your blood sugar and adjust insulin and meals regularly,” says Dr. Garg. Avoid the mid-day sun, stay hydrated, limit alcohol and caffeine, and apply sunscreen (sunburn affects blood sugar). It’s fun to stroll barefoot on the beach, but resist the temptation. Protect your feet at all times.
To eat healthy on the road, get creative with your meals:
- Replace a burger bun with a lettuce wrap
- Skip the tortillas and rice when ordering fajitas
- Fortify salads with chicken, fish or beans and hold the croutons and dried fruit
- Power up with protein-packed egg dishes
- Substitute nuts, fruit or yogurt for processed snacks
- Avoid all-you-can-eat cruise ship buffets; request the healthy “spa” menu
“Traveling with diabetes requires effort," says Dr. Garg. "However, today’s technology makes it easier. Keep in touch with your doctor via electronic communications and keep up a healthy routine and you should be good to go.”
Nancy Moreland is a contributor to UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. Her articles have also appeared in the Chicago Tribune.