Travel is one the single greatest things you can do in your life. To experience another country, another culture, and the adventure of the unknown is an inherently human experience.
Does it come with risks?
Sometimes. But more often than not, we are responsible for placing ourselves at risk. It’s possible to be in the wrong place at the wrong time for sure, but this is rare and we have the capacity to mitigate potential hazards.
The same also applies for a diabetic. We have more to think about than the average navy seal but doesn’t that make it more exciting!?
Today we are blessed to have a plethora of technology at our disposal to ensure we’re not caught out, and unless you’re sat in the middle of Alaska with only a couple of tennis rackets strapped to your feet, then you’re more than likely quite close to a pharmacy and insulin.
Let‘s not sugar-coat it though. Being a diabetic and going anywhere takes preparation. So, what are we talking about?
1) Insulin - depending on where you’re going, you’ll need to keep it cool and remember it doesn’t last for more than a month. Double what you’ll need for the time you’re away.
2) Blood glucose monitor (BGM) - whatever your tech of choice, you need to have at least 2 different devices. A simple monitor like an Accu-chek mobile is my back-up to the Freestyle Libre.
3) Needles, needles and some more needles - excluding pump paraphernalia - if you’re MDI, make sure you have twice as many needles as you’re likely to use.
4) Surplus to requirements - strips, cartridges, batteries etc. If you’re going to Spain for a week then common sense needs to prevail and realise most things are easy to get. If you’re off to the Andes to climb a mountain then it’s a different story.
Common questions and misconceptions.
* Insurance - Having appropriate travel insurance is needed for most travel, but when you have diabetes, it’s important you find a good one. It will be classed as a pre-existing condition, which means you’ll be responsible to pay additional costs if you don’t meet certain criteria. These criteria can be anything from;
- you’ve had the condition for more than 12 months.
- you have no eye, kidney, nerve or vascular complications.
If you have good blood sugar control and no complications then you’ll likely pay the same as a non-diabetic.
Call around and always declare it.
Tip:I took out an AMEX credit card and this comes with comprehensive travel insurance.
* Airport Security - These days most airports are aware/trained to know the difference between a dangerous object and necessary medical equipment (I.e. needle).
I fly roughly every 6-8 weeks and my Freestyle Librè has never caused a beep walking through security and they have never questioned my needles, insulin etc. When I was first diagnosed I was told to have a letter from my doctor declaring my condition but I lost it and haven’t ever needed it. It’s a wise idea to have one though, particularly if you’re travelling to far-flung destinations.
* Timezones - Are your blood sugars more difficult to manage when you’re travelling long haul?.
If you’re flying from Australia to France then you’ll go through multiple timezones and your body clock won’t know what day it is. You need to be vigilant with your insulin regimen and make subtle changes to ensure you’re getting you’re required amounts and around the right times. When I travelled back to the UK from Australia (24 hour flight), I ensured my watch stayed on Australia time for a day after I landed so I could stick to the same injection times.
* Jet lag
Jet lag is a temporary sleep disorder. It occurs when the body's internal clock is out of sync with cues from a new time zone. Cues can include light exposure and eating times. mayoclinic.com
Trying to avoid jet lag is par for the course with long haul travel. Try and not eat too much, avoid alcohol and don’t sleep in the middle of the day. When you land, try and stick to the destinations day/night pattern asap to minimise effects.
* Other things to consider
- Stress: travel can be stressful, particularly if you’re not a good flyer. Stress will put up your blood sugars, so you can either take ‘stress relief’ (medication), or prepare, prepare, prepare. You’ll want your travel to be a military operation to keep you on the straight and narrow.
Tip: I increase my basal by 10% and my per-meal bolus by 10% when flying. I usually fly first thing in the morning, so the combination of impacted sleep and stress puts my blood sugars up.
* Food
Trying the local food is what makes travel amazing, but the same applies to being at home. It’s even a bit trickier whilst doing your rain man mathematics.
I stick to the ‘small inputs equals small impacts’ rule.
Giving yourself smaller amounts of bolus insulin and choosing less carb heavy dishes results in less risk of hyper and hypo (It’s also healthier).
The whole point of experiencing foreign cuisine is to eat it as is. Generally, you’ll know if it is carb heavy (think, Pad Thai in Thailand, or Chicken Madras in India), so give the bolus you usually would. Going a little high isn’t as bad as running the risk of severe hypos abroad.
Benefits VS Drawbacks
I may very well be biased - I’ve travelled most of the planet and emigrated from the UK to Australia. But that also means I’m well versed in the pros and cons of travelling with and without diabetes.
Before diabetes I ventured to most of Europe, washed windows in Montreal, and was a camp counselor for 3 years in an American summer camp in Maine. I’ve crawled through tunnels in Vietnam, walked through the killing fields of Cambodia and swam in the oceans of Thailand. I took risks, in the sense that I didn’t have much money so lived paycheque to paycheque. I came quite close to being homeless the first time I landed in Australia and had to rely on my parents throwing me a few hundred bucks on more than one occasion.
I was, it’s fair to say, reckless and didn’t take life too seriously.
But something changed when I landed in Australia (and I’m not taking about diabetes). Being so far from home and hitting hard times forced me to grow up. I began to get more responsible and my extensive travel benefited me in working out finance, logistics, researching a place to live, resourcefulness and approaching absolute strangers for information and support. I would consider myself considerably more resilient after my travel experiences.
Drawbacks?
There is an increased chance of things going wrong, but the severity of the word wrong is BROAD. Ranging from having a flight delayed to being taken hostage. Let’s be honest though, you’ve got more chance of being run over by a rhino in your local shopping centre than some balaclava wearing, gun touting pirate taking your fancy.
Have you read in the news about a poor little diabetic being stuck in the Congo without their insulin?
Nope. It doesn’t happen.. often anyway.
We’re a resilient bunch who deserve to see more of the planet than some over-privileged rich kid spending their parents money.
Don‘t let diabetes stand in your way of experiencing different places and people. The world is truly amazing and we are part of it.
Nathan
Believe the hypo