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Are you going on vacation? ... taking a business trip? ... visiting
relatives? ... joining a sightseeing tour? Whatever your reasons,
taking a trip will mean some changes in your life for a while.
Changes do require some planning. People with diabetes who use
insulin have to be especially careful that the timing and amounts
of INSULIN they take are balanced well with the FOOD they eat and
the ACTIVITY planned for the day.
- Eat something - a meal or a snack -about every 4-5 hours
- Try to choose foods prepared without fat - steamed, baked or
broiled.
- Test your blood glucose after you've eaten any foods that you're
not used to eating.
- If the big meal of the day will be served late at night, you
may want to eat a snack at your usual supper time, and omit your
bedtime snack.
- In some parts of the world, breakfast is very light so you may
want to have something extra to add to it.
- Watch those calories - they can add up fast when you're eating
away from home.
- In some countries, bacteria makes drinking water and food unsafe.
Bottled drinks, bottled water (nonlocal) and boiled water are
okay, but ice cubes are not. Ask a travel agent about foods to
avoid in the country you are visiting.
If you
... Walk more than you're used to ... play an active game or sport
... stay up late at night ... are under unusual emotional strain.
... Your blood glucose test result will help you decide if you
need more food to bring your blood glucose level up into the normal
range. Ten to 15 grams of a combination of carbohydrate and protein
(like fruit and cheese or a peanut butter cracker) should be enough.
... It takes a little time before the insulin you inject reaches
the point when it has the most strength. Ask your healthcare professional
to explain insulin timing (or call Novo Nordic at 1-800-727-6500),
and try to avoid strenuous exercise when your insulin is working
at its full strength.
Monitoring your blood glucose level is just as important when you're
traveling, as it is when you're at home - maybe more.
Some compact meters are easy to carry with you.
Use your diary to write down the food(s) you ate and your activities
in connection with your blood glucose test results, so you can review
it the next time you take a trip.
Take enough insulin and syringes for your trip, plus a little extra.
Insulin delivery systems, such as a pen-like device or a syringe
profiled with insulin, used with a disposable needle, may be more
convenient than a syringe and vial, especially for travel. Ask your
doctor or call Novo Nordic at 1-800-727-6500 for more information
about these systems
Novocain® human insulin (rDNA origin) is available in Regular,
NPH, and Lente®. And 70/30 (70% NPH and 30% Regular, premixed).
If you use a pump, be sure to take back-up supplies of insulin
and syringes, as well as extra pump supplies. Talk to your doctor
about resetting the pump if you are changing time zones. You might
want to take your user manual with you.
Unopened vials should be kept in their cartons in a refrigerator;
using an insulated container during travel will protect the insulin
from extremes in temperature.
If it has been frozen or exposed to very hot temperatures.
If refrigeration is not possible, insulin should be kept in a cool
place away from heat and sunlight.
If you keep insulin in a plastic bag in a wide-mouthed thermos
jug lined with a wet washcloth, the insulin bottles stay cool and
protected from breakage.
Prefilled syringes or cartridges containing intermediate-acting
insulin can be kept at room temperature for 7 days; regular insulin
in a profiled syringe or cartridge can be kept at room temperature
for 30 days. Insulin should not be left in a car or in any place
where extremes of temperature are likely to occur.
Visit your doctor or diabetes educator and ask for…
A signed letter on the doctor's letterhead hat explains: that you
have diabetes (and any related medical information) that you must
carry insulin and syringses your current treatment (including any
medicines you are taking besides insulin) any allergies or sensitivity
to food or medicine.
instructions to others about how to help you in a diabetes-related
emergency any inoculations you need - get them well in advance,
if you can, so
Any reactions will be over before your trip.
Recommendations for medications you might need for motion sickness
or diarrhea.
Guidelines for treating other illnesses and for making adjustments
in your treatment plan. For example, if you plan to fly and will
be changing time zones, talk about possible insulin schedule adjustments.
If you are going west, your first day of travel will be more than
24 hours, so you may need extra insulin. If you're going east, the
day will be less than 24 hours, so you may need less.
Ask about taking Regular insulin even if you don't normally use
it. Regular is good for short-term extra injections, and during
illness.
See your dentist, so your chances for unexpected dental problems
are reduced.
Keep your supplies with you, not in your luggage. Besides insulin,
syringes, pump supplies, prefilled syringes, you'll need your blood
glucose testing equipment and some food for treating low blood glucose
-peanut butter or cheese and crackers, hard candies, glucose gel
tablets. Also put any other medicines you are taking in your travel
kit.
Comfortable shoes that fit well - not new ones
New socks or stockings - holes or darned
Spots can hurt your feet if you get blisters, don't break them
unbroken skin is less likely to get infected
Sunblock, if you'll be in the sun, and lightweight clothing that
covers arms and legs.
An extra pair of glasses
WEAR YOUR IDENTIFICATION BRACELET AND CARRY THE ID CARD THAT SAYS
YOU HAVE DIABETES.
If possible, travel with a companion who knows how to test your
blood glucose and understands what you might need in an emergency.
If you are traveling alone, you might feel more comfortable if
some responsible person in the situation knows that you have diabetes
(in case of an unexpected insulin reaction) - A flight attendant,
the train conductor, someone in the hotel's management, your host
or hostess or tour guides.
Travel light or get help carrying heavy luggage.
Allow plenty of time so you don't have to race to catch trains
or planes or taxis.
Plan overnight stops to ensure a full night's rest.
The in-flight meal might fit into your meal plan or you can order
a special meal by requesting it when you make your reservations,
but be sure to confirm it with the airline 24 hours before the flight.
Get up and walk around every 20-30 minutes.
Try not to sit for long periods with your legs crossed.
Have snacks ready in case of delays.
Lessen 'jet lag' problems: don't drink alcohol before or during
the flight!
Drink plenty of liquids before and during your flight - eight glasses
of water or diet soda - unless your doctor says otherwise.
On the train you can stretch and walk and eat as needed. Take advantage
of bus stopovers to walk around. Be sure to have extra snacks along
in case of delays you can make arrangements for special meals on
a cruise.
Stop and walk around at least every 2 hours. Your blood glucose
test will tell you how much snacking you should do during the trip.
Children seem to need slightly more calories than usual when traveling.
Plan ahead each day and adjust your schedule for Food, Activity
and Insulin.
Take snacks with you if you're hiking or sightseeing where no food
is available.
Don't wear anything tight around your ankles and legs that can
hurt circulation.
Protect your feet from heat and injury - going barefoot (even at
the beach) is too risky.
Don't forget to have fun!
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