A holiday trip is a stressful challenge for many people with diabetes. Different thoughts may go through the patient’s heads: have I taken the right amount of medication? Will the trip cause any complications? Maybe I’d better stay home? As a part of “With diabetes on vacation” campaign, we answered these questions, proving that travelling can be an enjoyable experience.
We are providing patients with information in a nutshell that will help them to prepare properly for a trip without unnecessary stress.
PREPARATION FOR A TRIP
What you should start with?
– gather the necessary medical supplies from the previously prepared list,
– take twice the quantity of medical supplies you would normally use – as if your trip would be longer,
– diabetes patients treated with insulin should consider to take following medical devices for a longer trip: 2 pens (if you do not use disposable pens), pen needles, 2 glucometers of the same type, test strips, batteries or a charger for the glucometer (depending on the type of glucometer), 2 lancets of the same type, a supply of lancers for the lancing device, glucagon and glucose tablets or liquid – if you take liquid glucose, remember that you must be carried in containers with a maximum capacity of 100 ml,
– if you are travelling abroad, take a diabetes travel letter (in English) with you confirming that you have diabetes, you can get it from your doctor. Keep your all medications and blood glucometer in your carry-on luggage (medicines transported in the luggage hatch are exposed to too low temperature, which may impact on their properties),
– when travelling by plane, inform the crew that you have diabetes, before the flight review the airline’s website to see what’s allowed on board and whether or not they can accept special requests,
– in case of changing the time zone, take two watches: one set for the new time zone so that you can control the time of taking your medication.
DURING A TRIP
Wear a diabetes medical ID during the trip, for example, a wristband with the sentence “I have diabetes”. Always have healthy snacks or glucose tablets with you in case of hypoglycaemia – if you take insulin, make sure you also have glucagon injection.
Wait until food is about to be served before injecting insulin to prevent hypoglycaemia. If you change the time zone, see your healthcare team before a trip and learn how to manage your insulin and make a new insulin dosing schedule.
Wear comfortable footwear for a trip, drink plenty of water and move around as often as possible to minimize the risk of thrombosis.
BLOOD GLUCOSE MONITORING
Remember that blood glucose level during the journey will probably be higher than normal because of your lack of physical activity.
Blood glucose should be monitored as often as possible. Based on its results, you can decide whether to increase insulin dose or limit the amount of meals you eat – mainly those containing carbohydrates.
If you are travelling by car, take breaks every 2-3 hours to monitor your blood glucose.
CONTRADICTIONS FOR TRAVELLING
Each longer journey should be consulted with a doctor. Travelling may be associated with more serious complications for some people with diabetes.
Travelling by plane can be dangerous for following group of patients with:
– gastrointestinal autonomic neuropathy,
– symptoms of cardiovascular autonomic neuropathy,
– proliferative retinopathy,
– the presence of an active ulcer (active phases of the Charcot foot) what is generally a contradiction to a longer journey.
All people with diabetes should remember one rule to enjoy safe journey: consult a doctor before any journey, either shorter or longer and follow all the recommendation.
Benbenek-Klupa T. Chory z cukrzycą w podróży. W: Franek E.,Walicka W.: Leczenie cukrzycy w praktyce klinicznej. Tom 1. PZWL, Warszawa, 2018.