Even though you’d prefer to take a vacation from your diabetes, the fact is, you take your diabetes on vacation with you. But that doesn’t mean you have to limit possible destinations  or activities.

If you have diabetes and are going on vacation or traveling for business you just have to do some extra planning. How much extra depends, in part, on your destination, the kinds of activities you’ll be participating in and the length of time you’ll be gone.

But for any trip, long, short or even around town, there are a few things that you should always do:

Carry Medical Alert ID. Sometimes seconds can make the difference in a life and death situation and you want emergency professionals to know your status.

Carry Contact Information. In addition to emergency contact information also carry the name and number of your primary care physician. Also be sure to carry your medical insurance card and emergency number for your medical insurance company.

• Always pack DOUBLE the amount of diabetes medicine and supplies needed for your trip in case you should be delayed for any reason.

• Glucagon kit if you use insulin – glucagon kits contain a liquid injectible hormone that can be given to diabetics if they lose consciousness due to severe hypoglycemia.

 

• While modern insulin does not need to be refrigerated, they still need to be kept within a temperature range of 33 - 80 degrees F for maximum effectiveness so an insulated bag and blue ice are advised if you are going to be in extreme temperatures.

• Bring a list of current medicines and keep it with you at all times.

• Snacks: snack pack of crackers or cheese, peanut butter, fruit, a juice box, and some form of sugar (hard candy or glucose tablets) to treat low blood glucose

• First aid kit including: bandages, gauze and topical antibiotic, pain reliever,
medicines to treat diarrhea and motion sickness, sunscreen and insect spray.

Planning is essential and that begins with where you want to go and what you are going to do while you are away. One week of back packing in the Rocky Mountains, two weeks in Southeast Asia, or a week on a cruise are all going to create different demands on your diabetes. The longer the trip and more exotic the location the more research and planning you need to do.

Check your A, B, C’s (A1c, Blood Pressure and Cholesterol). With 4 – 6 weeks before departure you have an opportunity, if necessary, to make some small adjustments to your self-management routine before your trip.

Discuss your travel plans with your doctor and get any necessary immunizations 3 – 4 weeks prior to your departure, as some of the shots do have mild adverse reactions and can alter your glucose levels for a short time.

Get written documentation from your doctor outlining any particular diagnosis you have including your diabetes. The letter should also list the medications you take for each condition. It should list insulin, syringes, and any other medications or devices you use. Be sure your doctor includes any allergies you have, or any foods or medications to which you are sensitive.
Also get an extra prescription for any medications. Of course, you are going to pack DOUBLE what you need for the entire trip, but a prescription can come in handy in case of an emergency. In the United States, prescription rules may vary from state to state.

Just in case, get the names of the generic versions of the drugs that you take from your pharmacist so, if you have to get them on vacation, you have more than one option.
In general, you should stick with the exact brand and formulation of insulin your doctor has prescribed. However, if you run out while you are on the road, and your regular brand is unavailable, you may substitute another brand's equivalent formulation (for example, NovoLog for Humalog, Humulin R for Novolin R). But never substitute a formulation (for example, from rapid-acting Humalog to short-acting Humulin R) without medical supervision.

Insulin, in the United States, is all U-100 strength. In foreign countries, however, insulin may come as U-40 or U-80. If you need to use these insulins, you MUST BUY new syringes to match the new insulin to avoid a mistake in your insulin dose. For example, if you use U-100 syringes for U-40 or U-80 insulin, you will take less insulin than your correct dose. If you use U-100 insulin in a U-40 or U-80 syringe, you will take too much insulin.

 

No matter what type of traveling you are doing: a Caribbean cruise, backpacking through Europe or a trip to your favorite cabin in the woods, changes in meal patterns, activity levels and time zones can affect your blood sugar levels. So, be sure to test your blood glucose levels more often than normal.

Traveling with others is always more fun and, depending on your travel plans, people with diabetes may want to consider having someone along. This is particularly important if you are traveling to an exotic or foreign locale or if you are going to be undertaking a lot of strenuous activities, such as hiking or camping.

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• Get your ticket and seat early to prevent being bumped.

• Ask for an aisle seat if you will use the restroom for insulin injections.

• Double check what type of food and beverage service is offered on the flight. Most domestic carriers don’t serve in-flight meals anymore so, be prepared to bring your own or purchase something in the terminal that fits your needs. International flights, due to their length of time, still offer in-flight meals so, be sure to request a special meal, if necessary.

• Before you travel, always check with the Transportation Security Administration for the latest travel updates.

• Keep medicines, syringes and blood sugar testing supplies in your carry-on luggage. Do not check these supplies with your luggage, in case it is lost. Some sources suggest that you carry your testing equipment and insulin on your person, in case, for some reason, you can’t easily access your carry-on luggage in the overhead bin.

• Make sure you tell security that you are diabetic and that you are carrying medical supplies.

• Your supplies can be taken through security check points, but they must have a prescription label on them. All of your supplies should have a proper manufacturer's label. (what can I take?) Syringes will be allowed through security if you have insulin, as well.

• If you are wearing an insulin pump, you must notify security. They will visually inspect the meter. You must request that the meter not be removed.

• If you have a problem while being screened, you should ask for a supervisor. Calmly explain what the issue is and present any documentation that you have with you to support your diagnosis and right to carry your medical supplies with you.

 

If you feel you have been discriminated against because of your medical status, you may file a complaint. Complaints about discriminatory treatment by TSA personnel should be directed to TSA’s Office of Civil Rights, by calling

1-877-EEO-4TSA or by mail:

Transportation Security Administration
Director, Office of Civil Rights
601 South 12th Street - West Tower, TSA-6
Arlington, Virginia 20598
Attn: External Programs Division

If you think your air carrier or their personnel has discriminated against you (pilots, flight attendants, gate agents or check-in counter personnel), you should contact your air carrier and you may also file a complaint with the Department of Transportation’s Aviation Consumer Protection Division (ACPD) by calling 1-202-366-2220. Additional information on where travelers may file complaints for travel service problems is available here.

 

• Special food service or food service itself is virtually non-existent these days, except for overseas flights. So, bring appropriate food to get you through the flight.

• If traveling alone, be sure to inform the flight attendant in your section that you have diabetes.

• Check your blood glucose more frequently.

• If you need an insulin injection during your flight, follow your normal procedure. However, due to pressurized cabins, frequent travelers suggest you be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can cause the plunger to "fight you." This can make it hard to measure insulin accurately.

• Move around every one to two hours to increase comfort and reduce risk for blood clots.

 

 
If you are traveling alone or going to a foreign country:

• Be prepared. Know what facilities are available within the region that you will be traveling.

• Spend a few extra bucks and get travelers insurance. If there are any problems that cause you to delay your trip, or if you should require medical attention while on vacation, the travel insurance will cover those expenses.

• Get diabetes identification in the languages of the countries you will visit.

• Let your tour guide, or another person in your group, know you have diabetes.

• Learn certain phrases in the local language, such as: "I need help" or "I have diabetes, where is the hospital?" or "I need sugar."

• If an emergency occurs and you do not know where to go, try to reach the American consulate, the Red Cross, or a local medical school.

You may want to get a list of English-speaking foreign doctors from:
International Association for Medical Assistance to Travelers (IAMAT)
1623 Military Road - #279
Niagara Falls, NY 14304
716-754 4883 (phone) 716-754 4883 (fax)
(www.iamat.org).

Follow proper food and water safety in the countries in which you are traveling. If necessary, use bottled water to brush your teeth, forego the ice and eat only cooked vegetables or fruit that can be peeled. You want to experience the local cuisine, but avoid food or water borne illnesses that could ruin your trip!

 

If you take insulin shots and will be crossing more than one time zone, talk to your doctor or diabetes educator before your trip to help plan the timing of your injections while you travel.
Traveling east means a shorter day. If you inject insulin, less may be needed. Traveling west means a longer day, so more insulin may be needed.

Check your blood glucose level as soon as possible after landing. Jet travel can make it hard to tell if you have very low or very high blood glucose.

After a long flight, take it easy for a day or two. Plan your activities so you can work in your insulin and meals. Check your blood glucose often.

If you are more active than usual, your blood glucose could go too low. Take along snacks when hiking or sightseeing. Don't assume you will be able to find food wherever you are.

 

People with diabetes require special foot care. Follow these tips:

• Pack at least two pairs of comfortable shoes, so you can change shoes often. Changing shoes will help prevent blisters.

• Do not go barefoot. Instead, wear shoes specially made for ocean or beach walking. Protect your feet at all times when you are walking by the pool, in the park, on the beach, or swimming in the ocean.

• Wearing open-toe shoes, including sandals or flip-flops, increases your chances for injury.

 
• Follow your daily foot-care regimen. Check your feet every day. You should look for blisters, cuts, redness, swelling and scratches.

• Get medical care at the first sign of infection or inflammation.