As our lives get hectic and rife with adult responsibilities, making time for some travel and exploration becomes increasingly important. The thought of such radical change in routine, however, can become a cause of concern for people dealing with diabetes.
Beer Patel, 43, had been postponing his trip abroad for quite a while for a similar reason. At a routine consultation with Dr. Silviya Irene, Consultant Endocrinologist at Sitaram Bhartia Hospital, Beer expressed his doubts regarding proper diabetes management while traveling.
“Traveling and diabetes do not need to be mutually exclusive concepts. With a bit of planning and careful monitoring, you can enjoy a holiday just like anyone else!” said Dr. Silviya. Eager to dispel his fears, she introduced him to some important things he needed to consider before he embarked on his trip.
Preparing For The Trip
“The importance of a preemptive checkup before the trip cannot be emphasized enough. You should visit your doctor at least 4 to 6 weeks before you start planning,” advised Dr. Silviya.
Your doctor will help determine your current health status and the potential adjustments that need to be made to your treatment plan.
Beer’s condition was deemed fit for a long-haul journey abroad, as long as he continued to correctly administer his insulin doses. He was also urged to thoroughly research his destination’s local cuisine, weather forecast, etc. in order to be prepared beforehand.
“Due to potential device failures, unexpected delays in travel, or even lost luggage, it is always advised that you carry at least twice the number of supplies with you. Don’t hesitate to carry some healthy snacking options for situations where you are not able to eat on time, or if their cuisine doesn’t suit your appetite.”
Regulating Your Medication
Understanding the basic way in which your medication works, with respect to how it works, how long it takes to function, at what time you can expect the peak action, etc. is essential too. This will help you make informed adjustments on your own to combat any changes in your meal plans. This is another reason it is important to gain a better understanding of your treatment plan in advance.
Maintaining A Travel Checklist
Beer was asked to maintain a list of important papers that he would require on his journey such as:
- A proper prescription issued by the doctor, with the details of all health issues mentioned, along with dosages of medication you are taking
- A travel letter, signed by your doctor, that permits you to carry required equipment for diabetes such as insulin, needles, cold packs, a glucometer, etc. without raising unnecessary red flags
- A small card or badge that allows medical personnel to be immediately alerted of your diabetes condition in case of any mishap
- Carry essential items with you for diabetes management such as insulin, glucometer, cotton swabs, ice packs, healthy snacks, glucose tablets or plain sugar to tackle hypoglycemia (low blood sugars), etc.
Traveling With Insulin
It is important to have answers to questions such as ‘what type of insulin are you using?’, ‘what is the onset and duration of insulin’s action?’, etc. as only then will you be able to make appropriate adjustments as required.
“You should also be aware of the availability of proper cooling facilities for the insulin you carry with you while traveling. Staying without appropriate refrigerators for a long period of time can cause problems in its storage, especially in warmer climates.”
Alternatively, insulin should never be allowed to freeze. Insulin should be stored at a temperature of 2-8° C. It should not be exposed to a temperature below 2° C or more than 20° C.
If traveling by air, do NOT leave the insulin in your checked in luggage as the cold temperature of the plane’s storage unit could cause it to freeze. Maintain proper temperature by keeping the insulin in your carry-on bag along with an ice-pack. Don’t forget to take the insulin out 30 minutes before you are planning to inject so that it is allowed to come to room temperature.
Traveling eastward results in shorter days while westward travelers experience prolonged days. In such circumstances, insulin timings should be adjusted accordingly.
If traveling by car, make sure you don’t leave your insulin in the dashboard. In order to prolong the cooling period, you can carry the insulin in a thermos with an ice-pack.
Figuring Out Proper Disposal Methods
Not only is it important to frequently check and monitor your blood sugars using a glucometer, but also correctly dispose of sharp instruments like needles and glucometer lancets. Beer decided to contact the Airport authorities in order to gather information regarding their waste disposal systems.
“You may also carry a separate sharps disposal container with you, which can be emptied once you land,” suggested Dr. Silviya. Beer kept this advice in mind when he couldn’t figure out the disposal systems on airplanes.
Managing Potential Risks While Traveling
Beer was determined to avoid needless accidents on his trip, so he decided to clarify his residual doubts about risks associated with traveling as well. Dr. Silviya asked him to be wary of the following factors:
- Dehydration – People with diabetes are often prone to dehydration, especially if they have uncontrolled blood sugars and find themselves urinating more often. This can become a problem if you do not have access to a water source, as the body steadily loses the amount of water it needs to function properly.
- Foot ulcers – Ill-fitting shoes or walking too long can cause foot ulcers or extra strain on your legs. If similar feet issues crop up, then make sure you keep your feet or wounds clean and do not subject the area to pressure.
- Hypoglycemia/hyperglycemia – Long gaps between meals can cause your blood sugars to dip (hypoglycemia), while eating high-carb meals too frequently can raise your blood sugars above the recommended limit (hyperglycemia).
In case you feel symptoms of hypoglycemia such as light-headedness, or experience excessive sweating, then consume foods such as glucose tablets or ½ a glass of fruit juice that can help raise your sugar levels.
Hyperglycemia, on the other hand, can be treated by covering up with extra insulin doses or oral medicines, as recommended by your physician beforehand. You may also engage in any form of light exercise such as a casual stroll.
- Blood clots in legs – As your legs remain dangling for too long during long-haul flights, it is possible that blood clots may form in your legs (venous thromboembolism). In order to avoid that, you are advised to get up and stretch or walk around every hour. You should also exercise your legs by stretching and bending your ankles periodically.
Dr. Silviya’s guidance gave Beer some newfound confidence and he left the consultation feeling reassured. Better equipped to handle any problems with these tips, he decided to go ahead and plan his holiday out!