“Diabetes Travel Well”- the art of travel with diabetes!   

We are currently working on some partnerships and links to the travel industry to take the stress out of travel. Stay tuned as we bring these links and information to you about preferred providers and contacts.

Travelling and diabetes - general tips and information  

If you have diabetes you will understand the fear of going away from home or out of your routine. Many people worry about how they will manage their diabetes in an environment that is unpredictable. How will you get meals that you can eat, when you need them? How will you manage time changes? How will you get through airport security? Will the weather impact on your blood glucose levels? And how about keeping insulin and medications at the right temperature? These and many other questions can run through your mind when thinking about travelling with diabetes. If you have not had diabetes for long and/or have never travelled since getting diabetes, these concerns can even prevent you from going away.

Having diabetes doesn't mean your travelling days are over! Like many other situations in life with diabetes, to make sure you have safe, healthy and enjoyable trip it is important to plan ahead and consider all aspects of your journey such as weather, time zones, length of transit time, access to meals, the amount of activity you will be undertaking and potential adjustment to medications and insulin. Considering how much medication, insulin, blood glucose monitoring supplies, batteries and so on and making sure you have more than enough, is also critical. Many people with diabetes travel across the world. Our own Ambassador Nathan Bassett has walked the Kokoda Trail, one of our Board Members, Fiona James has travelled alone across Europe, lots of people on our forums have travelled locally, interstate and overseas. Many of us have stories to tell and ideas about how to make the most of your time away despite diabetes.

In general you should consider the following:

Driving holidays 

If travelling locally and you are driving make sure you plan plenty of rest stops, opportunities to check your blood glucose levels and stock up on carbohydrates. Don’t drive long distances without keeping tabs on what is happening with your blood glucose. Share the driving with your travelling companions if possible. If travelling to tropical or hot regions, be aware that some people find their insulin works faster under these conditions. Keep a regular check on your blood glucose. Also make sure you have somewhere to store your insulin so it is not exposed to the heat.

Flying 

Carry a letter from your doctor – GP and/or Endocrinologist. This should include your full name, address and date of birth, that you have type 1 or type 2 diabetes and then state all the medications, insulin delivery devices (syringes, insulin pens or pumps) you use; as well as the blood glucose monitoring equipment you use, and stating that you must be allowed to carry these with you at all times. Make several copies of this letter and if travelling with other people, get them to carry copies. Keep a copy with someone at home who can get this to you if needed.

Take your original prescriptions with your name and address details, as well as prescribing doctor and carry insulin and medications in their full packaging with these details on them. Keep these with the letters.

How much to take - Always work out how long you are away for and how many doses of insulin, medication, number of blood glucose checks per day you will need to do, on a day when you might do the most. Then pack more medication, test strips, insulin, syringes, pens and other diabetes equipment than you will need for the trip. If possible, pack a spare blood glucose meter in case of loss or damage. Also pack spare batteries for your blood glucose meter and insulin pump.

If you use an insulin pump always take a back up option – syringes or pen with needles and a short and long acting insulin. Work out with your doctor, what dose of insulin to take if the worst should happen and your insulin pump breaks down. Have a plan! We can assist you with developing this plan via our Consultancy Service.

Take clearly written details of emergency contacts plus your National Diabetes Services Scheme (NDSS) card and Medicare Card.

Customs - if travelling overseas remember that customs regulations vary from country to country, so it’s recommended that you contact the Australian Embassy of the country you’re visiting before travelling to chat about your medical needs and entry to the country.

Always take hypo treatments with you - carry some form of easily absorbed carbohydrate such as juice cartons; glucose tablets/gels; or lollies with you. Pack some in your suitcase, some in your carry on bag and keep some on your person, such as in your handbag or bum bag. This way you have something with you in an emergency and if you get separated from your luggage. If travelling with someone, make sure they know about your diabetes and that they also carry hypo treatment. It may even be a good idea to carry a glucagon pen in your medical supplies, even if you have never needed this before.

Stock up on snacks - also carry other food with you, fruit, crackers and snack foods, so you have some follow up carbohydrate and access to food for snacks to prevent hypos – don’t rely on airline foods and access to foods when transiting through airports can be difficult.

Sharps – any sharps - pen needles, blood glucose monitors, lancets; and medications, should be stored in hand luggage according to manufacturer’s directions, preferably in a clear, sealable plastic bag that is available for security inspection.  You can also take a small approved sharps container for used lancets and syringes. We can assist you to locate the best option for this.

Storing insulin - if flying don't place insulin in your regular luggage, as the plane's hold is not temperature controlled and luggage may be damaged or lost. You may even choose to carry a small esky or other small bag which houses all of your medical supplies and letters making it easy to access when needed. This can include a small first aid kit with items such as paracetamol and antiseptic cream in case of minor illness or injury. We can assist you with finding the best option for this.

Insulin pumps are fine to go through all security and screening – you may find some staff at airports more touchy about these than others, Your best bet is to calmly proceed through the screening points and if asked, show the staff where the pump is located for their inspection. However at no time should it be requested that the insulin pump be detached, taken apart or the batteries be removed. You have the right to keep this on you connected at all times.

Diabetic and proud! Wear some form of identification that says you have diabetes – it will make your life a lot easier and safer! We can direct you to a number of options for this.

Expect your control to be a little haywire! Be aware that the excitement and stress of travel and holidays can affect your blood glucose levels, so you may need to check your BGLs more often. These may be higher or lower than usual and may swing around more. Don’t stress about levels that are a little out of whack – this will not be a problem in the long run, it is a short term situation and as long as you feel ok and are safe, when in transit it is better to set a slightly higher target for your BGL’s. You can get advice from your doctor or diabetes educator about this prior to travel.

Changes to time zones - If your planned trip involves crossing different time zones, discuss this with your doctor well before the departure date - he/she can advise you on any changes to your individual routine. It may be easier to keep to your usual routines while travelling, then adjust on arrival. For example if on an insulin pump, don’t change your basal rates until you have settled in the country you are visiting.

Meals - When booking your flights, you can tell the airline that you have diabetes and order a “diabetic meal”. However, many of these "diabetic meals" are low in carbohydrate and so a standard meal may be more appropriate. You may also find these more interesting! Making sure you have your own snacks with you is helpful. Don’t rely on other people to provide you with the meals you need. We can assist with this once you have selected a destination, by making enquiries with the airlines for you.

Immunisations - If travelling to a country where there is risk of disease visit a travel doctor early and get advice re immunisations and management of acute illness in particular diarrhoea and/or vomiting. Useful websites include www.dfat.gov.au and www.health.gov.au.

Travel insurance is vital – you need to make sure it covers people with diabetes. The Australian government has arrangements with some countries providing benefits similar to Medicare if needed. Remember to take your Medicare card with you. For more information, call Medicare Australia on 132 011 or visit their website. Also if travelling overseas you should register with the Department of Foreign Affairs and Trade.

Arrival! Once you get to your destination, the changes in activity (more or less activity than usual), routines, food and stress/exciement, may affect your blood glucose levels. Food options may differ as well. If you're going to a different country, doing some research beforehand will help you find out what foods will be available to you. Always be careful with food and drink choices, particularly in developing countries where food hygiene may not be optimal. In countries where water is an issue always boil your water and do not use ice cubes or have fresh salads which may have been washed in water.

Replacing lost supplies. If the worst happens and your luggage and supplies are lost in transit, the best thing to do is attend a major hospital's emergency room which should be able to supply enough to get you through. Alternatively you can phone the diabetes organisation where you are and ask someone to explain how you obtain diabetes supplies in their state/country. We can assist you to locate the best options for handling these situations in your destination.

Here is an article about travel from one of our Board Members, Sharee, who has type 1 diabetes

Travelling overseas can be a truly wonderful experience.  Travel offers opportunities to discover and learn about different cultures, meet new people and create memories that will last for a lifetime. Travelling with type 1 diabetes requires a little extra planning, but it is well and truly worth it. (While type 1 diabetes is serious and means you have to be more careful about certain things, with a little extra planning it is still possible to see and experience the world.)

I have just returned from a trip to Thailand, Cambodia and Vietnam and have booked a trip to America and Canada in September this year: There is no way I am letting diabetes hold me back!

I had an absolute blast on the trip to Thailand, Cambodia and Vietnam. I met some amazing people that I still keep in contact with, seen some amazing places and have a photo album full of great memories and stories to tell.

When deciding on your destination and booking your trip it is important to visit your local doctor and specialist at least 6 weeks before leaving to consider some of the things that may affect your diabetes during your trip. Things such as; temperature changes (in particular how insulin will be store) and food in the country.

Seeing your doctor- a few things you need to talk about; seeing your doctor before you leave will ensure that your trip is well planned and therefore one to remember for all the right reasons! When you visit your doctor be sure to tell him / her where you are travelling and for how long. Make sure you have sufficient insulin for the trip (packing a little extra is always a good idea, as we all know it's not often an entire holiday goes exactly to plan!) So if you need extra prescriptions it is a good idea to get them now, so you have time to get them filled before you leave for your amazing journey! Also be sure to enquire about immunizations you may require in the particular country / countries you are visiting and check tetanus cover. Try googling Travel Doctor, there are doctors who are experts in this area of health. Discuss whether or not you require antibiotics or tablets for diarrhoea etc and obtain a list of contact names of doctors, hospitals and clinics in the areas you will be visiting. Discussing the effect of time changes on your diabetes routine with your doctor is also a good idea. They will be able to tell you if you will need to alter your routine for the trip or not and if so they will be able to tell you when and how.

The letter; one of the most important things to ask from your doctor is a letter declaring that you have type 1 diabetes and also any other health problems you may have. It is important in this letter that it states what insulin you are on, what dosages you are taking and any complications you may have. The letter should authorise your need to carry syringes / insulin pens and medication etc. It is also a good idea to mention where you intend to travel too (this is mainly for customs use.) When clearing customs you will most likely be required to present this letter to them, as they will want to know why you are carrying needles and syringes etc. (I have never had a huge problem with customs in my travelling ventures, they seem to be fine with me carrying my medication kit as long as I have an authorised letter from my doctor). Make sure you have a few copies of this letter in case you need to visit a doctor overseas- a letter outlining your medical history will help them treat you for any illness or injury.

Travelling with insulin; when I travelled to Asia the temperature was between 30 - 35 degrees with approximately 80 - 90 % humidity, a lot different from the 25 degree low humidity of Adelaide when I left! I already had a small cooler bag to store my insulin in (these are available from most chemists; I got mine from Diabetes SA). This meant my insulin was able to stay cool throughout the flight / stop over until we arrived at our hotel. I made sure to enquire that our room at each of the hotels that we were staying in had a fridge or at least one in the hotel that I could store my insulin in. On the days that we were out, for example in Cambodia when we spent 2 full days exploring the Angkor Wat temples (an amazing experience, I definitely recommend!) I stored my insulin in my small cooler bag, so I was able to take some extra with me. Making sure your accommodation has a fridge that you are able to store your insulin in is important, but it is also equally important to have your own cooler bag so you can keep your insulin cool when you are travelling between destinations or if you are on a trek / camping or a fridge is not available for a period of time. It is also important to have your own cooler bag in case your accommodations power cuts out or fridge breaks down. Considering and planning for these things can make the difference between a stressful or stress free trip.

Eating local cuisine; eating overseas can be a huge change depending on where you are travelling too. If you are from a westernised country and travelling to America or Europe you won't usually have to change your eating habits. Westernised countries all tend to offer the same type and variety of food. Travelling to Asia or Africa can be a completely different experience just on the basis of food! It is important to have an open mind about food and be prepared to eat things you would not eat usually. Having diabetes does not limit you to eating local cuisine, just make sure you know the approximate carbohydrate and sugar in your meal and you may have to monitor your blood glucose levels more regularly. Trying different things such as food is all part of the experience of travelling to a different country and experiencing the local’s culture. Whilst in Cambodia I was lucky enough (or not so lucky according to some of my friends) to have the opportunity to try deep fried spiders (Tarantulas to be precise) coated in chilli. Whilst the idea was not tempting at the time and the thought of it made my stomach turn, as I was on a tour at the time and with the coxing of some of the people I travelled with most of us all had a little taste! All I can say is be prepared and open minded about local cuisine. For the record it didn't actually taste that bad, just like the oil it was cooked in, I think it's worse because you know what you are eating.

Travelling is not for everyone and where and when you travel is an individual’s decision. Some people like travelling and staying in up market accommodation, others are happy to stay in basic accommodation and some like the idea of camping and trekking; Either way I think travelling is a wonderful experience and I think if you have the opportunity you should grab it. Some holidays will require a little more preparation and planning than others; for example camping and trekking trips will require you to enquire about facilities in which you can keep your insulin, whereas an up market hotel and most basic hotels will have a fridge where you can do this. If you are going to participate in more physical activity and be more active than usual it is important to prepare yourself for hypos and hypers and carry extra food and drink. If you are on a tour let your tour guide know about your type 1 diabetes and plan for extra breaks if you need them. Camping and trekking your way through out the world is not impossible and I love the idea and personally would love to do it.

Making sure you go on the holiday that suits you and being prepared to plan that little bit more is important; in the end the extra planning and preparation is definitely worth it!

Bon voyage and happy travels!