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28 Responses

  1. Karen
    Karen December 9, 2008 at 6:57 am |

    Here are my rules for travel:
    Always pack twice as many diabetes supplies as you think you’ll need (you never know what could happen).

    Always bring plenty of fast acting carbs for lows. Things that travel well are SweetTarts, gummys, Smarties and hard candy.

    Keep a close eye on your diabetes, but remember to have fun too. Differences in activities and foods are common when you travel, so things may be a little off. Test often and treat – but don’t be too hard on yourself if things are a little out of whack. Just do your best. :)

  2. Molly
    Molly December 9, 2008 at 7:16 am |

    The first thing that I do is remind myself of what supplies I use in a typical day. Things change… sometimes I change my site every other day, sometimes every 5 days. Some days I test 20 times, some days I test 5. This helps me know where I’m at and to plan for it accordingly.

    I bring extra supplies for my pump, and supplies for injections. I put supplies in individual bags (zip locks with all I need for one pump change, one reservoir change, etc) and separate those individual bags among my luggage. That way things are organized to just “grab and do” instead of digging through to find each individual piece.

    I always bring multiple glucagon kits, so that if one gets used, another is available–especially if the trip isn’t ending soon.

    I give my traveling partners a zip lock of supplies and a stash of quick carbs (gu, fruit snacks) for their bags. That helps me feel “covered” in case of an emergency. Much of my traveling happens in remote wilderness areas, and I am miles and miles away (usually by canoe) from civilization.

    When traveling, I try and stick to my schedule to avoid unexpected problems. (testing, site changes, etc)

    Traveling with diabetes takes a little extra planning, but the planning is worth the comfort that it brings knowing that I’m covered for anything and can have the trip of a lifetime! :-)

  3. PeggyS
    PeggyS December 9, 2008 at 7:26 am |

    Especially when flying, I set the target bg on my pump a little higher than normal. I carry more pump supplies than I’ll need, extra insulin, and syringes just in case. I also carry a prescription for insulin.

  4. Sara
    Sara December 9, 2008 at 8:21 am |

    Besides what has already been said (packing double what you need), I have a few additional suggestions.

    Since most of my h0oliday travel is air travel, that is where I have my best advice :) .

    I always pack my own snacks for the flight. Otherwise the candy and snakcs in the airport gift shops are just too tempting.

    The best time to test your blood sugar is right when the plane lands. At first I was self-conscious about this, but no one actually cares what you are doing. The walk to baggage claim is long, and you are likely carrying heavy bags so you want to make sure you aren’t low.

    My best advice for air travel though is – don’t tell them you are diabetic. Seriously! In the beginning, I used to tell them I was diabetic and wearing a pump, and while I did not set off the metal detectors I still had to sit through a private screening which slowed my whole group down. Now I adopt a ‘don’t ask – don’t tell’ policy, and have not been stopped once. I have syringes, insulin, test strips, and pump supplies in my bags and they have never been inspected. Sure, I carry a note from the doctor allowing me to carry it, but it has been folded up into the back of my wallet for years having never seen the light of day.

    As my mom always says – “have fun and be safe!”

  5. David
    David December 9, 2008 at 8:57 am |

    When packing for air travel, I do the following.

    Allow yourself plenty of time to get checked in and go through the security lines. I have learned to expect the unexpected, the delays, and the questions. Plan for it, and when it happens, you will be ready, When it does not happen, you can be pleasantly surprised.

    Pack all your essentials in your carry on bags. Do not put something that is essential in your bags you do not take on the plane with you. I pack so that if any luggage is lost, I have what is needed with me. I also pack my carry on baggage so, if there is no longer any room on the plane, and they need to take the carry-on away, that I can remove my essentials and continue to carry them on the plane in a smaller bag that I put under the seat.

    Find a good carry on bag that holds what you need in a strong protective case. It does no good to have it in the upper bin, and have someone else come in and crush your items with their baggage.

    Assume you will not be fed properly on your flight. Take items you can eat (for example cheese sticks) with you to last the flight. Make sure this is something that will go through security. Buy the correct drinks after you go through security and take them on the plane. Make sure you get a good meal before the flight departs and plan on where you plan to eat when you arrive.

    Carry a back up of your essentials in your other bags. If you do not have a backup BG meter, look at the house brands that are sold at Walmart and the bigger Drug Stores. These meters cost $9.00 and the strips are less than $.50 each. These can always work in a pinch.

    If possible, make sure your prescriptions are through a National Chain. If something happens, you can go to the local chain, and they can bring up you meds on-line and get you enough to carry you over for the short term emergency. You may also check with whom you made reservations with, or the credit card that paid for the flight. In many cases the gold or platinum cards provide travel insurance which also include emergency medical coverage.

    I also know that at some of the bigger airports there are pharmacies who can fill prescriptions if you have a copy of the prescription.

    Understand your rights as a traveler. If you have started a flight, and are waiting for a connection, there are some rules where if the flight is delayed, the company may provide you with a voucher for a meal at the airport. There are different rules for domestic flights as compared to international flights. If you do not know you can always ask at the counter.

    Understand that stress will affect your BG numbers. Get a book you can read that will relax you. Carry an MP3 player like an IPOD, with your favorite music and Check your numbers more often than normal to be sure you are on track.

    Do not forget to be physically active. If you are on a cross-country flight get up and walk around when they take the seat belt light off. I usually plan on sitting toward the back of the plane, and if it is not too busy, the flight attendants do not mind if you stand for a while in the galley. (however, I have learned to ask if it okay). When at the airport, I try to walk as much as possible. I avoid the moving walkways and the passenger trains (when it is possible) and walk. The exercise relieves the stress.

  6. Joe_h
    Joe_h December 9, 2008 at 9:15 am |

    always pack your meter, extra testing supplies, and your meds so you can reach them easily. travel with some sort of medical ID – it helps when you’re in trouble to have something to show seucrity/flight attendant/ect. if they give you a hassle about eating/your meds ect. I also pack emergency supplies of food that is readily accessible in case I get caught on the plane waiting for takeoff and can’t get any other food

  7. Cara
    Cara December 9, 2008 at 9:48 am |

    Always over-packing is very important to me. If I am driving to my destination, I cut down on packing by loading my daily vitamins/pills into a weekly case for the amount of days times 2. If I am traveling by air, all my bottles of meds and pump supplies (times 2 for meds and times 3 for pump supplies) are in my carry-on bag.
    Either way I travel, I always carry packs of crackers, granola bars, and glucose tabs. By air, I buy a bottle of juice & water (lows or highs) after clearing security. When landing, I find a convenience store or grocery store to buy myself some juice boxes to have. If driving, I take juice boxes (at least 1 per day, sometimes 2, depending on the plans) and bottles of water.
    I have found, that when visiting other people in their homes, they often do not eat on a schedule. Pumping makes this easier on me, but sometimes I have to eat regardless. This makes having crackers and other snacks with me, very handy.
    Another tip: always wear medical alert jewelry. I am single and travel alone a majority of the time. You never know when something might happen that you would need that jewelry to speak for you.
    Also: I carry a note from my doctor stating that I am a type 1 diabetic and must have my supplies with me at all times. I’ve never had an issue, but have heard too many horror stories of people being asked to remove their pumps during air travel.

  8. SLeal
    SLeal December 9, 2008 at 10:13 am |

    Travel far, travel hard. Always take a doctors letter about your diabetes. get duplicate prescriptions of your supplies and medication. Take the telephone numbers for your healthcare providers, pump company, insurance company. Have fun!!!

  9. Mike
    Mike December 9, 2008 at 11:30 am |

    Bring your own snacks and test as often as you can. I travel a ton for work and most of the time have to carry everything I need for a day in a backpack. I usually dedicate half my backpack space to the work tools I need, and the rest to food and diabetic supplies. My work requires lots of hiking and physical activity, which in and of itself helps to manage my diabetes.

    When I travel to visit family, I always bring my own snacks. Nothing stinks more than trying to switch from apples and granola bars (regular) to cream-filled oatmeal cookies (away).

  10. Bob S
    Bob S December 9, 2008 at 11:36 am |

    With my new job, flying and travel is a requirement and a part of life. Almost 100 days this year not including that crazy trip across the country in June. So, for a four day trip, pack two more pods or infusion sets, two more cgm stuff, and 100 test strips with two prickers. Bring the Frio and compression wear if it is a long flight. Stop at the newstand to get 3-4 magazines and Twizzlers. I set my pump to 130% once I’m on the plane for 6-8 hours. I’ve learned not to be afraid to change my basal rate as the correction boluses just make me go up and down and then I’m out of Twizzlers.

    Marriott Courtyards are now going to 24 convenience kiosks – really, really important for me.

    Everyday I’m gone and out of my routine of no riding, I’m on another basal rate called travel. If I get to ride and train (got to get out and enjoy where ever you are), then it’s back to normal until I get on the airplane again.

  11. AngelaC
    AngelaC December 9, 2008 at 12:51 pm |

    I flew overseas for the first time this year and learned a few thing about traveling with diabetes and insulin. One, the Frio is great for traveling. Not only did it keep my insulin cool, it also provided some protection for my Humalog vial. Having a note from my endo also helped me when I went through security checkpoints in Frankfurt, Germany and Dublin, Ireland, especially in Germany, where I did not speak the language. The note spoke for me when there was a language barrier and provided additional evidence for the need for all the supplies I was carrying (about 6 weeks’ worth of insulin, syringes, pen needles, etc). I also recommend being polite and cooperative with security personnel AND having all of your supplies in your zip loc bag, ready to be inspected before getting to the checkpoint; it makes it so much easier. I monitored my BGs more while flying and changing time zones so I could make the transition a bit easier. Finally, I try my best to maintain a “high state of coolness” through the experience (not always possible, but hey, I try!) If I can find something to laugh at or someone fun to talk to, so much the better — no stress induced high BGs!

  12. Windy
    Windy December 9, 2008 at 1:42 pm |

    I keep all my doctor’s numbers stored in my wallet and on my laptop incase a problem arises where I need to contact them.

    When flying, I stay away from alcohol and drink water water and more water! When I am hydrated my sugars tend to stay lower. I also wash my hands and use the antibacterial lotions a lot on planes, because we all know when we get sick, sugars go UP UP UP!

    And as stated in almost every comment above, I pack TONS of supplies to keep my mind at ease.

  13. tmana
    tmana December 9, 2008 at 1:57 pm |

    By car, remember to take both supplies and snacks (both low-glucose snacks and low-carb healthy snacks/meals). If you are traveling alone, keep a snacks cooler seat-belted to the passenger seat; if you are traveling with others, keep the cooler just behind, where your front seat passenger can reach the contents (or your back seat passengers can reach the contents to pass you a snack). Carry more supplies than you think you may possibly need, plus prescriptions for more (just in case). Keep your doctors’ notes near your automobile registration and insurance cards, just in case. Stop every couple of hours to stretch your legs, use the rest room, and test your blood glucose.

    By plane, remember to allow sufficient time for security inspection. That process may take considerably longer for those of use with diabetes. Consider investing in a Scott eVest jacket. It contains a number of pockets and conduits for holding your identification and personal electronic devices; many of those pockets can also be used to hold medical electronics and/or diabetes supplies. The jacket removes easily for placing under the x-ray scanner, and does not count as baggage. If possible, pack all your sharps in a single container, and declare the contents as you go through the scanner. Be prepared to present supporting documents from your doctor. Request hand-inspection of anything that could be harmed by x-rays (before I went digital, I used to do this consistently with my 35mm film cameras and film). Wear comfortable, relatively loose-fitting clothing, and compression hose (especially if you expect a long flight, or a lot of standing around in line). Walk around whenever possible. Remember to drink water when in the air. Ask if any of the restrooms en route to/from your gate include safe-sharps disposal units — no need to carry along used sharps if you can dispose of them safely en route. (If you have a layover, you may be able to range further abroad in search of safe sharps disposal — including the terminal first-aid station, which should have a moderately reasonable set of medical-waste disposal facilities.)

    In any case, try to find out in advance what the safe-sharps and medical-waste disposal laws are where you will be staying. (You may need to make an appointment to drop off your used supplies at a local hospital or medical center, or you may need to “pack out your trash”.) For short term, or for needles-and-lancets-only, consider MedPort‘s “On the Go Sharps Transport & Disposal” containers. A set of six costs $3 at Wal-Mart; I believe something similar may be sold singly at CVS.

  14. tmana
    tmana December 9, 2008 at 1:59 pm |

    Oops. Wrong URL for MedPort. Correct URL is http://www.medportllc.com

  15. Megan
    Megan December 9, 2008 at 2:01 pm |

    travel tips (garnered from a year spent in a transatlantic long-distance relationship, and the fact that I now live an ocean and a sea away from my parents):

    -take at least an extra week’s worth of diabetes supplies.

    -always have with me: glucose tabs/other fast acting sugar as well as more balanced snacks. (I’m particularly fond of Luna Bars.)

    -wait to change the time in my pump until I’ve arrived at where I’m going (layovers don’t count).

    -when flying: drink something (non-caffeinated or alcoholic) AT LEAST every time it’s offered by the flight attendants. On long-haul international flights, make good use of the water station.

    -also when flying: get up and wander around the cabin every hour and a half or so (exceptions made for time spent sleeping).

    -check blood sugar about twice as often as normal.

    -don’t feel obligated to eat the airplane food, even if they put it in front of you.

  16. June S.
    June S. December 9, 2008 at 7:19 pm |

    The number one rule of thumb for traveling is to have all your insulin, syringes and pump supplies, alcohol swabs, meters, blood glucose test strips and glucose tablets at the ready. Additionally, I like to carry Balance bars. Another useful thing is Coca-Cola syrup. If you should become nauseous, you can drink it and keep your BG’s up. Also ask your endo. for anti-nausea and anti-diarrhea meds.

    Study the time zones where you’re headed and, if you’re taking injections rather than using an insulin pump, do consult with your doctor about when to dose your long-acting insulin. Wear a Medic Alert bracelet, and also (if going to a country where English is not always understood) carry a little card that explains, in the local language, that you are diabetic and what they should do if they find you unconscious or incoherent, etc. Find someone who speaks that language (while you’re still at home) and type it up and have it laminated and placed in your wallet.

    Another tip I got from my endo., for travel to faraway places, is this: Get an American Express Gold card. They provide medical transport as one of your card benefits. Though I’ve never used THAT benefit, I did have my wallet stolen on a subway in Prague (Czech Republic) a few years ago, and the American Express folks got me a new credit card within one hour. This was rather important, as I only had a little bit of cash stowed away in my dormitory room! IN CASE YOU ARE WONDERING … NO, NO, NO! I DO NOT WORK FOR AMERICAN EXPRESS! I’m a lowly public schoolteacher in New Jersey!

    I will also point out that I survived 1 trip to Communist Romania and 2 trips to Communist Czechoslovakia, in the early 1980′s, with Clinitest strips for testing my urine(this was before I got my first-ever BG meter) and syringes, insulin and alcohol swabs.

  17. kdroberts
    kdroberts December 10, 2008 at 8:22 am |

    Some traveling is easy and doesn’t require much thought, some is not. A few general tips that apply wherever you go.

    1. Make sure if you are visiting people you let them know you’re diabetic or have other diet restrictions. Nothing worse than sitting down to a special meal they have prepared and having to pass on a lot of it. You’ll be hungry, may not be able to keep your blood sugars stable or hurt their feelings.
    2. If you know you will be going out, research the area you are going to. Find restaurants that have online menus and if possible, online nutrition. It’s a lot easier is you know some places that have food that will work for you and it makes ordering when you are there less of a pain. That’s a good tip for every day life really.
    3. As was already mentioned, take more supplies than you need since you never know what will happen.

    And some tips for international and domestic air travel

    1. Always, always, without fail, keep your medication/insulin/supplies with you and in their original packaging. Never put them in your checked luggage.
    2. Take a doctors note with you that briefly says you are diabetic and you need your diabetic stuff on you at all times. You most likely won’t need it but it’s good to have.
    3. If you are going to a different country, make sure you research your medications/insulins/supplies before you go. What you use or take may not be available where you are going so you might need to talk to your doctor about emergency alternatives if the need arises. If you take medication you may also have the issue that it’s called something different. Should you get sick or have some side effect and you are talking to a doctor or pharmacist they may not know the drug you are talking about. I had the situation in England before. They used the drug but it had a different name and it confused things when I was talking to the pharmacist when I got sick. Lastly on this subject, your meter, pump, whatever, is not guaranteed to never break. What you use may not be available so you should know what is and have the OK from your doctor to use it should you have to.
    4. When flying internationally my blood sugar goes haywire for a day or so. Try not to worry about it. If you can it’s better to get it down but sometimes you just have to wait it out. It will regulate itself.
    5. If you are flying through time zones, don’t try and take medication based on your home time. Take your medications at same time you normally would. This may require skipping a dose or taking two doses closer together so you should talk to your doctor about which one is better.

    Most important thing is don’t worry and have fun. the more you stress about it the harder it will be to control your blood sugar. The more fun you have the better it will be.

  18. meg
    meg December 10, 2008 at 9:19 am |

    Not too much to add to the ideas above, but I want to second the “don’t ask, don’t tell” suggestion (from Sara) for airports. My pump has never set off a metal detector and my supplies have never been questioned. However, once, when a new pumper, I did call attention to my pump and that resulted in a long delay. So, now I carry the prescriptions along with the supplies, say nothing, and breeze thru security with the rest of my party. Happy travels!

  19. Alan Lane
    Alan Lane December 10, 2008 at 1:05 pm |

    The best thing is to always drink plenty of water. With all the sitting and not excersising, i have to keep the water going. Also to take snacks that are good for me and filling.

  20. Megan
    Megan December 11, 2008 at 5:07 am |

    I remembered one more!

    -When planning a trip where you’ll be staying with many different people as a house guest (like my last trip to the States, where I was hosted by friends and family and employers over a three-week period) always make sure you have an ample supply of Clif Bars (or your favorite portable meal-replacer) just in case the breakfast options aren’t what you need them to be. This was more important for me when I was on MDI, but it’s proven to be immensely helpful even now that I’m on the pump.

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  22. Cara
    Cara December 12, 2008 at 7:22 am |

    I carry an “emergency” case in my purse. It’s a sandwhich baggie with my quick-serter, band-aids, an infusion set and reservoir, & glucose tabs. You’d be surprised how many times this has come in handy. I also carry at least 1 small juice box in my purse.
    This is an everyday thing, although it comes in handy for travel also.

  23. David
    David December 12, 2008 at 10:18 am |

    One thing I have learned is that no matter the type of traveling, wear comfortable shoes and great socks.

    Since I have to drive (about 3 hours) to get to my airport, I find that this is true for both driving, walking and going through Airport security.

    I learned right after 9/11 that I was the guy always picked out at security and learned to take off my shoes way before they started asking.

    I know everyone is different, but for me, I found wearing Crocs (sorry if this seems like a plug) are great. There are special ones designed for PWD. I find they are extremely comfortable for driving, walking in the terminals and going through security. They are easy to remove and throw into the bins that go through the x-ray machine. It is frustrating enough to have to worry about going through the security line and untieing shoes laces. The crocs come off easy. I also find that the security people never take a second look at them.

    Since many times I may end up in a location with bad weather I have another pair of shoes (or boots) in my checked baggage.

    One word of caution if you have never worn these type of shoes. These can become slippery if the ground is slick (ice or water).

  24. David
    David December 12, 2008 at 12:36 pm |

    With all the cutbacks that the airlines are doing, the number of flights are being cut back. As a result, the flights are now more crowded.

    Generally most airlines allow two carry on items. One carry on bag, (which goes above in the overhead bins) and one personal item (like a purse) which is expected to go under the chair by your feet.

    I always carry my supplies on the plane. (I have been stuck on a tarmac for 3 hours before we would be allowed to de-plane)

    I have learned from personal experience to pack these items with my carry on bags. I also pack these in a way that I take the most essential items if all the bags are taken away.

    In other words, my bag that goes in the overhead has my stuff, but with in that bag, is a backpack, and within the backpack are my essentials in ziplock bags.

    Why??

    If you get to the plane and try board, you may find it crowded and no bags allowed. For me, no problem, i take out the back pack and hand the carry-on to the crew. If they insist, not bags at all, I remove the zip lock bags and hand everything to them. I also have a small canvas tote bag. I throw everything in that bag if they allow it. If not they never question the ziplock bags with the essentials

    If I can take everything on with me, fine, but if the worst happens, I am ready.

  25. AngelaC
    AngelaC December 12, 2008 at 9:12 pm |

    Amy, I hadn’t even thought about posting about shoes, but after reading your question about what you would wear on your feet if you’re doing a lot of walking, I remembered my trip through the Aillwee Cave in Ireland and up to the top of the Zugspitze in Germany with my brother, both places where good shoes were fairly important. I wore my favorite New Balance sneakers (size 7 1/2 AA) with athletic socks in both places. I do not necessarily advocate buying “diabetic” shoes unless you have a medical necessity but if you are going on a trip where you will be doing a lot of hiking or walking, I recommend going to a shoe store with salespeople who will properly fit your feet before leaving. The salespeople should measure your feet and the store should carry brands that make shoes in a variety of widths. My personal favorites are New Balance and SAS shoes. Having properly fitted shoes has saved me from plenty of blisters, callouses, and ripped up heels, and since I discovered I have some neuropathy, avoiding foot problems has become a priority. And as my favorite author, Tad Williams, once wrote, “When a man’s feet are hurting, his soul is in peril!”

  26. Kristin
    Kristin December 14, 2008 at 4:18 pm |

    I feel like I have been “on the road” since I was diagnosed. Longhaul travel and changing time zones can present challenges for people using insulin. I currently use the pump, which admittedly makes things a bit simpler, but I have also done it on shots. Here is my strategy:

    (1) On the pump

    You need to change the time on your pump, but you should not change it all at once (because your basal rates are most likely different depending on the time of the day). As I wait to get on the plane, I move it one hour in the right direction and then throughout the flight, I adjust it 1 hour. I have to move forward or backwards 6 hours for my travel and I adjust the time on my pump every two hours during my trip until I reach the correct time. This smooths out the differences in the basal rates.

    (2) On injections

    How to do it depends on the length of your trip. For a short trip, I would not move the timing of your injections, unless it would interfere with sleeping. For a long trip, what I did was to move my long-acting insulin (Levemir, Lantus) to 1-2 hours earlier/later per day starting a few days before the trip.

    If you change time zone by 6 hours ahead (i.e. EST to continental Europe), that means that in three days you will have your Lantus/Levemir at the normal time.

    Say you usually take your Lantus at 10pm EST (4am European time), then a couple days before your trip start the following routine:

    DAY 1- take your long-acting insulin at 8pm (EST) and check for lows (since you will have slightly more basal insulin than usual)

    DAY 2- take your long-acting insulin at 6pm (EST)

    DAY 3- take your long-acting insulin at 4pm (EST), which is 10 pm European time (you’re all set to take your insulin at 10pm local time!)

    A few points:
    - if you want to be more careful, then just adjust by 1 hour… to avoid more highs and lows (which means it would have taken 6 days to adjust)
    - CHECK your blood sugar often during the adjustments
    - when you move your injection time to later (more than 24 hours since the previous injection), perhaps give a small bolus to insure that you have SOME insulin in you (no DKA!!!)
    - when you move your injection earlier, then eat a little something to make sure you don’t go low

    Hope this helps! Don’t let diabetes stop you from changing time zones!!!! Happy travels!!!

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