Plan Your Trip, Plan Your Diabetes Care and Then Go
The medieval walls of Prague, the winding streets in old Paris neighborhoods, the rolling corn and soybean fields of the American Midwest, the soaring mountains of northern India: what will lure you and your family away from home this year? If you've been hesitating to make plans because someone in your group has diabetes, Dr. Irl Hirsch, medical director of the Diabetes Care Center at University of Washington Medical Center, says you can go ahead and buy the tickets, once you've done some careful planning.
"When we talk about real problems and issues for people with diabetes who travel, what we're really talking about are people who take insulin," Hirsch says. "That's why these folks need to talk with their health care practitioner about how they are going to approach traveling. They have to consider what may happen when they miss a meal or are delayed while traveling and how they'll handle time differences."
Traveling to Kansas may not cause any problems for your insulin regimen, but the several hour time difference between your home in the United States and a destination in Europe or Asia could have a big effect on your schedule.
Hirsch says the beauty of all the new insulins is that they provide enough flexibility that you don't have to change your schedule over to a new time zone for just a few days.
"If, on the other hand, you're going to be someplace several time zones away, perhaps in Europe, for two weeks or more, we're probably going to help you make the transition to the new schedule," Hirsch says. "Typically, in the morning the body is more resistant to insulin than it is later in the day. Your body will start making the time adjustment over the course of two weeks, so you'll start needing higher morning insulin doses, just as you would at home."
When people are on vacation, they often change their activity levels. Particularly when they visit European cities, Americans tend to walk a lot more than they do at home. Of course, they're also eating different kinds of food, perhaps indulging in gourmet fare they don't typically cook at home.
"The exercise often trumps the added food, so they may need to cut down on the insulin," Hirsch says. "People with diabetes who are getting more or less exercise than usual on vacation need to do their testing more aggressively, both before meals and between meals."
Hirsch suggests that successful travel with diabetes calls for careful preparation for the worst that can happen, whether it's a car breakdown, a delayed flight or the illness of another family member:
- Never put insulin or other medications you may need in checked luggage. Keep it with you.
- Don't allow insulin to be subjected to temperature extremes and pay attention to expiration dates.
- Take along extra blood glucose testing supplies and, if you use an insulin pump, extra pump supplies.
- Keep snacks or small meals on hand. Many air flights no longer provide meal service, or meals may come at odd times that don't coincide with your medication schedule.
- Know how to use older types of insulin, which typically do not require prescriptions, just in case you are unable to get refills of familiar products in foreign countries.
- Make sure you have contact information with you, in case you need a prescription or advice from your health-care provider.
- Talk over your travel plans with your doctor. Hirsch says, "Be sure you understand how your regimen is supposed to work while you're traveling, so you can handle time differences and changes of diet more easily."
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