Travel advice for diabetics
The rise in long haul travel poses some difficulty for diabetics. Travelling across time zones means that your insulin requirements may change and you might need to take more care with your diet and fluid intake. The following tips should be of use.
Before you go
Make sure you have had all the correct immunisations. Prevention of infection is important for everyone, but infection in diabetics may be more serious and the consequences more dangerous.
Check your travel insurance. If in doubt about the cover offered, contact Diabetes UK (link below) tel 020 7323 1531 Email email@example.com.
Think about how much insulin to take and whether the country(ies) you plan to visit use similar products to your own. Again Diabetes UK will be glad to advise. Remember to take more than your usual supply of all your usual medical supplies, including batteries for your testing equipment and cotton wool. Ask Diabetes UK for their address in the country you are heading for and the nearest hospital. Be prepared for the worst and it probably wonít happen!
Check the expiry dates on all your medicines and equipment.
If you donít already have something to identify you and your medical information, consider getting an identity bracelet or disc (available from the Medic Alert Foundation (link below) Tel 020 7833 3034)
Whilst on your way
Carry emergency supplies of snacks; remember to cater for the possibility of delays.
Pack your insulin and testing equipment in your hand luggage.
You may need to account for your needles and syringes, ask your doctor for a letter (there will be a charge), or contact Diabetes UK for a useful photocard detailing your medication.
Remember to dispose of your needles safely at all times.
Reduce the risk of thrombosis on long flights, by staying mobile and keep up your fluid intake. Donít drink alcohol during the journey.
How to manage your insulin on the journey
If a short trip < 8 hours, it is ok to stay on your usual schedule for meals and injections. If in doubt keep your blood sugars slightly high to reduce the risk of a hypo.
If the journey time is >8 hours you will need to rearrange your schedule. The following two methods are suitable and are generally thought to be the easiest.
Omit any medium or long acting insulin. Rely on short acting injections before your meals until you are in a position to resume a 24 hour clock on arrival. Take 20% of the total daily insulin dose as short-acting, with each of your three meals. Keep a close eye on your blood sugar with regular blood glucose levels. Keep the level slightly high until you can re-adjust back to your usual schedule when you reach your destination
If you are creating a longer day by travelling West increase the time between injections by 2-3 hours for the next two scheduled injections. For each shift of an hour in time your insulin may need to be increased by 2-4% of daily dose.
If you are shortening the day by travelling East:
Shorten the time between injections. This will lower the blood sugar, so you must decrease the amount of insulin by 2-4% of your daily dose, for each shift of an hour in time.
When you arrive
You may find that you are rushing around more than usual, doing the sights and therefore need to up your carbohydrate intake, or you may find that you are doing less than usual, lying around on a sun lounger.
Either way, more frequent checking of your blood sugars will help.
Insulin tends to be absorbed more quickly in hot climates, and this can lead to hypos. Carry some glucose tablets around with you.
You may find that you are more prone to various skin infections in hot, humid environments, remember that any wound takes longer to heal if you have diabetes. Women may be more prone to urinary tract infections and also to thrush.
Remember that some diabetics have reduced sensation in their feet. Avoid walking barefoot, particularly on hot sand or over rocks. Damage to your feet is more likely and could act as a portal of entry for infection. It may be sensible to invest in the type of sandals that you can wear in the sea.
You should follow the usual advice about water and ice. Make sure you only drink bottled or pre-sterilised water. Avoid ice in drinks, ice creams and salads.
If you develop vomiting and/or diarrhoea, continue your insulin or other diabetic treatments, but monitor your blood sugar levels frequently and adjust the dose accordingly. Rehydration solutions such as dioralyte or rehidrat are useful. If necessary, make your own solution from 1 litre of bottled/sterilised water mixed with 1 level teaspoon of salt and 8 teaspoons of sugar.
Seek medical help earlier rather than later.
How to store insulin
If possible, store in a fridge, away from any freezer compartment at 2-8 deg C. Stored like this, it will remain stable for up to 2 years.
Insulin will remain stable if stored at room temperature (20-25 deg C) for up to one month. It should then be discarded.
If you are unable to meet these requirements, or are in any doubt, invest in an insulated contanier such as a vacuum flask with a wide neck. Rinse this with ice or cold water and store your vials inside.
Check your insulin for colour. Any vials that have a brownish colour, a lumpy, cloudy appearance, or where the insulin sticks to the side of the vial, should not be used.
Enjoy your trip!
This article published on
25 November 2005
Next review date 11/1/2013