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    Nancy Klobassa, R.N., and Peggy Moreland, R.N.

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  • May 5, 2009

    Blog: Be prepared for traveling with diabetes

    By Nancy Klobassa, R.N., and Peggy Moreland, R.N.

9 comments posted

It's spring and the school year is almost over. Many of us are thinking about travel plans this summer. Unfortunately, you can't leave your diabetes behind.

Whether you go camping or cruising, you can go anywhere and do almost anything. It just takes a little planning ahead to handle traveling with diabetes.

My son, who has type 1 diabetes, has been to Ukraine and Russia. Diabetes doesn't stop him from travel, but he has to plan carefully before going overseas. Here are some travel tips from the National Diabetes Education Program:

Plan ahead

  • Immunizations: Find out what is required for where you're going, and make sure you get the right shots, on time.
  • Visit with your healthcare provider for a checkup four to six weeks prior to your trip to make sure your A1c, blood pressure, and cholesterol are in a good health range before you leave.
  • Ask your healthcare provider for a prescription and a letter explaining your diabetes medications, supplies, and any allergies. Carry this with you at all times on your trip. The prescription should be for insulin or diabetes medications and could help in case of an emergency.
  • Wear a diabetes medical identification. The identification should be written in the languages of the places you are visiting.
  • Time zones: Make sure you'll always know when to take your diabetes medicine, no matter where you are. Remember: eastward travel means a shorter day. If you inject insulin, less may be needed. Westward travel means a longer day, so more insulin may be needed.
  • Carry enough food to cover the entire flight time in case of delays or unexpected schedule changes.

Pack properly

  • Take twice the amount of diabetes medication and supplies that you'd normally need. Better to be safe than sorry.
  • Keep your insulin cool by packing it in an insulated bag with refrigerated gel packs.
  • Keep snacks, glucose gel, or tablets with you in case your blood glucose drops.
  • If you use insulin, make sure you also pack a glucagon emergency kit.
  • Make sure you keep your medical insurance card and emergency phone numbers handy.
  • Pack a first aid kit with all the essentials.

When flying

  • Plan to carry all your diabetes supplies in your carry-on luggage. Don't risk a lost suitcase.
  • Have all syringes and insulin delivery systems (including vials of insulin) clearly marked with the pharmaceutical preprinted label that identifies the medications. The FAA recommends that patients travel with their original pharmacy labeled packaging.
  • Keep your diabetes medications and emergency snacks with you in your seat — don't store them in the overhead bin.
  • If no food is offered on your flight, bring a meal on board yourself.
  • If you plan on using the restroom for insulin injections, ask for an aisle seat for easier access.
  • When drawing up your insulin, don't inject air into the bottle (the air on your plane will probably be pressurized).
  • Prescription laws may be very different in other countries. Write for a list of International Diabetes Federation groups: IDF, 166 Chaussee de la Hulpe, B-1170, Brussels, Belgium or info@idf.org or www.idf.org.
  • Insulin in foreign countries comes in different strengths. If you purchase insulin in a foreign country, be sure to use the right syringe for the strength. An incorrect syringe may cause you to take too much or too little insulin.

Road trips

  • Don't leave your medications in the trunk, glove compartment, or near a window as they might overheat. Medications can be kept in a cooler.
  • Bring extra food along in case you can't find a restaurant.

General traveling tips

  • Stay comfortable and reduce your risk for blood clots by moving around every hour or two.
  • Always tell at least one person traveling with you about your diabetes.
  • Protect your feet. Never go barefoot in the shower or pool.
  • Check your blood glucose often. Changes in diet, activity, and time zones can affect your blood glucose in unexpected ways.

Emergencies happen. While in Ukraine, my son had appendicitis and had to have an emergency appendectomy.  Because of the different strength insulin in Ukraine, he was allowed to use his own insulin. What have been your experiences when traveling with diabetes?

- Peggy

9 comments posted

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  • August 3, 2009 9:23 a.m.

    marymartha, Thanks for the question. Since most rapid acting insulins are good at room temperature for 28 days; prefilling the insulin cartridges makes a lot of since, specially when traveling. I contacted one of the major insulin pump companies and asked your question and this is what they told me. "We do not recommend prefilling insulin cartridges because there is a lubricant on the cartridge that can break down when insulin is added and in worse case senario, can cause problems with the piston in the pump that delivers the insulin and it may be possible to get a "No Delivery Alarm." The representative said that it would be OK to prefill one extra syringe. since the cartridges are to be changed every 3 days. Thanks again for the question, I learned something new too.

    - Nancy and Peggy

  • July 23, 2009 3:57 p.m.

    I am just starting on the pump and need some advice about carrying an extra set of infusion supplies in the event of an unexpected change out. Can I pre-fill the cartridge and carry that and change it out every 30 days? Or can I use the remaining insulin left in a cartridge that was not used in a previous pump application, as long as not too old? Hope you can help!

    - marymartha

  • May 22, 2009 2:41 p.m.

    Dessi, great advice! Thanks for sharing.

    - Nancy and Peggy

  • May 19, 2009 5:34 p.m.

    I was diagnosed at the beginning of last year with T1 but feel extremely lucky to have been able to keep my travel-heavy lifestyle (living abroad this year + about 15 multiple-time-zone-crossing plane trips since diagnosis and climbing an active volcano and visiting Machu Picchu, both at 8-9000 feet) . To achieve this, I follow pretty much all the advice you give here, but from experience would like to add one piece: separate all your supplies, glucose tablets, insulin (even extra meter which I also carry), etc. IN TWO PARTS WHICH YOU CARRY IN DIFFERENT BAGS! (This is assuming that you are already bringing double the amount of all you will need on your trip.) I learned this the hard way. In Chile, I had a backpack stolen from an intercity bus I took and it was the one which contained all my insulin. Since I use a pump, supplies were not such an issue, but needless to say, I still wish someone had given me this very commonsense advice - to not carry backups together with the diabetes stuff for everyday use. (It turned out insulin was sold without prescription in Chile so ultimately I managed OK, but I didn't know this until the end of the ten-hour bus ride.)

    - Dessi

  • May 15, 2009 11:47 a.m.

    Pat-It might be best if you check with your health care provider about your insulin needs and traveling. Normally, if you are on lantus one time a day, you would take it 24 hours after your last dose taking into accout the time zone change. However, since you are on a split lantus dose, it would be better to ask your healthcare provider. You can take your rapid acting insulin as you normally would with your meal.

    - Nancy and Peggy

  • May 12, 2009 10:29 a.m.

    I am newly diagnosed Type I and am struggling to get my blood sugar under control with insulin (24-hr and fast-acting). I am taking 8 units Lantus at 6PM and 5 units at 8AM and Humalog after lunch. We are leaving for Europe on 5/28 and I am very concerned about the time change. What is the best way to adapt my insulin to the new time zone? We have planned for this trip for many years and I will do better if I have a plan for the insulin dosage. Thanks!

    - Pat

  • May 7, 2009 3:45 p.m.

    Thanks, Kerrita for the updated address for the International Diabetes Federation. We will have the address corrected.

    - Nancy and Peggy

  • May 6, 2009 6:00 p.m.

    Packing some compression stockings can also help reduce the risk of blood clots in travelers who can't move around a lot while traveling. You can get them at your local drugstore (or therapeutic varieties online or at a medical supply store).

    - Amelia

  • May 6, 2009 10:18 a.m.

    Hi Nancy and Peggy The International Diabetes Federation hasn't been at that address in about a decade. Our new address is: International Diabetes Federation 166 Chaussée de la Hulpe B-1170 Brussels Belgium tel +32-2-5385511 fax +32-2-5385114 info@idf.org www.idf.org Our list of over 200 member associations in over 160 countries is available here http://www.idf.org/member_associations Kerrita

    - Kerrita

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