Advice for travellers with diabetes mellitus
The journey
Be prepared and take adequate supplies of insulin, syringes, blood glucose strips. Carry necessary equipment in hand luggage where it can be easily accessed. Have a means of disposing of needles. If prone to travel sickness take an anti-emetic; vomiting can predispose to hypoglycaemia. Carry diabetic identification and inform travel companions of diabetic status.
Climate
Insulin absorption may be affected in a warm climate. Maintain a high fluid intake to compensate for loss. Ensure safe storage of glucose strips to maintain accurate readings. Keep insulin out of direct sunlight and in colder climates do not let it freeze.
Activities
Some people are more active on holiday, others less so. It is important that diet, oral glycaemics and insulin are adjusted to compensate.
Food and drink
The diabetic traveller has to be extra cautious to prevent infections which can cause gastro-intestinal upset. Vomiting and diarrhoea can lead to hypoglycaemia.
Insulin schedules
All international flights east or west involve crossing time-zones. Some practical advice on administering insulin is as follows:
- plan in advance
- talk with a specialist
- take adequate equipment and medication supplies
- take adequate carbohydrate or glucose supplies since delays can alter mealtimes
- MONITOR sugar levels especially on long journeys.
- be prepared for delays
- plan a schedule in advance but be prepared to alter it later if delays occur.
Insulin storage
Although some manufacturers state that insulin can remain stable for up to one month at normal room temperature, extremes of temperature can reduce its activity. When travelling keep vials in a cool, dark place. Polystyrene containers, vacuum flasks, face cloths in a sandwich container are all useful. Special travel-carry systems are available from specialist suppliers.
Footcare
During the journey make sure shoes are not too tight as feet can swell. Take a walk each hour as exercise limits the amount of swelling. If hospital shoes are normally worn then also wear them on holiday. Changing to ordinary shoes could cause ulcers. Avoid walking barefoot; wear protective footwear on the sand and in the water. Avoid sunburn to feet and legs by using protective sunscreens or covering up.
Skin care
Prevent dry skin by using moisturisers, especially on heels which crack easily. Moist skin can lead to infection. Take first aid kit for minor injuries. Examine feet regularly and seek medical attention if any problems arise.
Useful information Sources
Diabetes U.K. (formerly The British Diabetic Association)
10 Queen Ann Street
London
W1M OBD
Main switchboard for general/administrative queries (Tel: 020 7323 1531)
www.diabetes.org.uk
Careline:- Tel:- 0207 636 6112
Diabetes UK Travel Guide 0800 585088 For assistance with specific concerns related to diabetes.
Leaflets and information including 'Travel Guide' to the more popular countries visited abroad, with advice pertinent to the needs of diabetics.
Frio UK Ltd.
PO Box 10
Haverfordwest
SA62 5YG
Tel: 01437 741700 Fax: 01437 741781
www.friouk.com
Company that sells Insulin Travel wallets. Light and compact, reusable, activated by cold water only and refrigeration not
Medic-Alert Foundation
Freepost
1 Bridge Wharf
156 Caledonian Road
London
N1 9BR
Tel: 020 7833 3034 or 0800 58142
www.medicalert.org.uk
Another good specific site for diabetes is www.diabetes-travel.co.uk
Answering some commonly asked questions
(these were taken from the Diabetes UK website on www.diabetes.uk.org )
Q. I am worried about being stopped at customs with my insulin and syringes. What is the best way of proving that I have diabetes and need to carry this equipment?
A. You can ask your GP or a member of your diabetes team for a covering letter. Alternatively, you can apply to Diabetes UK for an insulin user's card. The cost of the card is £5.00. For further information use contact details as above.
Q. Can taking a blood glucose meter through the X ray machine at the airport be dangerous?
A. There is absolutely no problem with putting your blood glucose monitor though the X-ray machine at the airport. However, it has been known for customs officials to take the meter apart or want to remove the batteries. A covering letter from the doctor may help in this situation.