On The Go? Plan Ahead

Planning a trip? Whether you're camping or cruising, you can go anywhere and do almost anything. It just takes a little planning ahead to handle your diabetes. How you prepare depends on where you're going and for how long. Two weeks backpacking through Europe takes different planning than a week at the beach. Will you be crossing time zones? What kind of food will you eat and when? Will you be more active or less active than usual? Getting Ready Before a long trip, have a medical exam to make sure your diabetes is in good control. Schedule the exam with enough time to work on your control before you depart. Get immunization shots -- if you need them -- at least one month before you leave. If the shots make you sick, you'll have time to recover before your trip. Before any trip, get two papers from your doctor: a letter and a prescription. The letter should explain what you need to do for your diabetes, such as take diabetes pills or insulin shots. It should list insulin, syringes, and any other medications or devices you use. The letter should also list any allergies you have or any foods or medications to which you are sensitive. The prescription should be for insulin or diabetes pills. You should have more than enough insulin and syringes or pills to last through the trip. But the prescription may help in case of emergency. The prescription laws may be very different in other countries. No matter where you go, wear a medical ID bracelet or necklace that shows you have diabetes. If you're leaving the country, also learn how to say "I have diabetes" and "Sugar or orange juice, please" in the language or languages of the countries you'll visit. Packing Tips The second rule of travel for a person with diabetes: pack at least twice as much medication and blood-testing supplies as you think you need. Pack at least half in your carry-on bag so that your medication is always with you. Whether you travel by car, plane, boat, bike, or foot, you'll want to keep this "carry-on" bag with you at all times. Pack this bag with: * All the insulin and syringes you will need for the trip. * Blood and urine testing supplies (include extra batteries for your glucose meter). * All oral medications (an extra supply is a good idea). * Other medications or medical supplies, such as glucagon, anti-diarrhoea medication, antibiotic ointment, anti-nausea drugs. * Your ID and diabetes identity card. * A well-wrapped, air-tight 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 Eating in the Air When you fly, you can request a special meal low in sugar, fat, or cholesterol. Make your request at least two days before the flight. If you take insulin, wait until you see your food coming down the aisle before you take your shot. Otherwise, a delay in the meal could lead to low blood glucose. To be safe, always carry some food with you. If your meal is delayed or an order is mixed up, you won't be stuck with an empty stomach. Have Insulin, Will Travel When you travel with insulin, give some thought to where you'll be storing your supplies. Insulin does not need to be refrigerated. But insulin stored in very hot or very cold temperatures may lose strength. Don't store your insulin in the glove compartment or trunk of your car. Backpacks and cycle bags can get quite hot in the direct sunlight. If you plan to travel by car or bike or to be out in the elements, take steps to protect your insulin. Many travel packs are available to keep your insulin cool. Insulins used in Malaysia are all of the strength U-100. In foreign countries, insulins 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. If you use U-100 syringes for U-40 or U-80 insulin, you will take much 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. Crossing Time Zones If you take insulin shots and will be crossing time zones, talk to your doctor or diabetes educator before your trip. Bring your flight schedule and information on time zone changes. Your doctor or educator can help you plan the timing of your injections while you travel. Remember: eastward travel means a shorter day. If you inject insulin, less may be needed. Westward travel means a longer day, so more insulin may be needed. To keep track of shots and meals through changing time zones, keep your watch on your home time zone until the morning after you arrive. If you inject insulin while in flight, frequent travellers 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. Testing your blood glucose while travelling is as important as when you're at home. Also test your blood glucose level as soon as possible after landing. Jet lag can make it hard to tell if you have very low or very high blood glucose. Welcome After a long flight, take it easy for a few days. Test your blood glucose often. If you take insulin, plan your activities so you can work in your insulin and meals. Take along snacks when hiking or sightseeing. Don't assume you will be able to find food wherever you are. No matter what kind of diabetes you have, it's smart to watch what you eat and drink when traveling. Avoid tap water overseas. This includes ice cubes made from tap water. Ask for a list of ingredients for unfamiliar foods. Some foods may upset your stomach and hurt your diabetes control. But you will also find foods that give you a healthy taste of culture. Go wherever your heart leads you. Just remember that you take your diabetes with you. Take your self-care along, too.