Vacation—all you ever wanted. As exciting as it is to finally head out on a much-anticipated getaway, having a health condition like diabetes can add to the packing and prep challenge. How to pack light with all that medication and insulin? What snacks can travel safely on an airplane (and through TSA’s tight bag checks)? What if you have a health issue hundreds (or thousands) of miles away from your trusted doctors?
When it comes to traveling with diabetes, extra planning can go a long way toward making you feel comfortable. In this video, nutritionist Amy Hendel, RD, shares some tips to manage diabetes while traveling, whether it’s a flight to Greece or a camping trip a couple hours away.
Don’t focus on packing ultra light. Yes, it’s sometimes ideal to arrive at the airport with only a carry-on bag, but this may not be the safest option for you if it means compromising your needs. Pack twice as much medication and blood testing supplies as you think you’ll need.
Wear a medical ID bracelet or necklace to alert others that you have diabetes, just in case of an emergency. (It probably won’t happen, but it’s best to be prepared.)
Learn how to say “I have diabetes and I need sugar or orange juice, please,” in the language of the place you are visiting. This is not the time to depend on others to know English, especially during a low-blood sugar moment.
Alert TSA agents. Keep your medication in your carry-on, just in case your checked bag gets lost (ugh), and let an agent know that you have medical supplies for diabetes in your bag. This may help you get through a horrendous security line a little faster.
Request a diabetes-friendly meal. If you’re flying a longer distance that serves an in-flight meal, alert the airline in advance that you have diabetes and will need a diabetic, low-fat, or low-sugar meal.
Pack snacks. In case your flight doesn’t serve a meal—or it’s simply taking too long to get to you—you’ll want to have snacks on hand to avoid blood sugar emergencies. Try one of these diabetes-friendly (and TSA-friendly) snack options: quarter cup of trail mix, apples, oranges, baby carrots, or some blueberries. (Here are some of the best snacks for diabetes.) Again, don’t pack light. Take more snacks than you think you’ll need in case of flight delays.
Alert a flight attendant that you have diabetes. If something happens to you during the flight, the attendant will be more prepared to assist you—fast.
Beware of cabin pressurization. If you need to give yourself injectible medication during a flight, the syringe may give more resistance than usual, which may make it tricky to get the right dose.
Take note of time zones. Eastward travel results in a shorter day, so you may need less insulin, but westward travel may require a little extra. Check your glucose levels more often to monitor how you’re handling all that extra vacation craziness.
Beware of insulin in other countries. Insulin comes in varying strengths outside America, so know the right dose with the proper syringe before any injections are needed.
Traveling with diabetes might feel like a lot to keep track of, but the majority of the work happens in the packing and planning process. With a little extra planning, you can step into the airport with no worries—well, except whether or not TSA is going to confiscate your favorite shampoo.
Diabetes Mellitus Review
Reviewed August- October 2014, Mera Goodman
General comments: can do better job delineating type I vs II vs other dm
Video 1: The Gold Standard Test for Diabetes
- A1C twice a year (0:49)
- US Preventative Health Services Task force – says you can use either fasting plasma glucose, oral glucose tolerance test or A1C, Screening Intervals. Evidence on the optimal rescreening interval for adults with an initial normal glucose test is limited.1 Cohort and modeling studies suggest that rescreening every 3 years may be a reasonable approach for adults at low risk with normal blood glucose levels.3-6 For adults at high risk or those who have near abnormal test values, repeat annual screening may be warranted (fresh 2014 guidelines).
- Mayo clinic: how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended:
- Twice a year if you have type 2 diabetes, you don't use insulin, and your blood sugar level is consistently within your target range
- Three to four times a year if you have type 1 diabetes
- Four times a year if you have type 2 diabetes, you use insulin to manage your diabetes, or you have trouble keeping your blood sugar level within your target range
- Uptodate:
- If you had an A1C test to check for diabetes and your A1C was less than 5.7 (meaning you do NOT have diabetes), you should have A1C tests done every 3 years.
- If you had an A1C test to check for diabetes and your A1C was between 5.7 and 6.4 (meaning you do not have diabetes but are at risk for it), you should have A1C tests done every year.
- If you do have diabetes and your blood sugar is well controlled, you should have A1C tests every 6 months.
- If you have diabetes and you recently changed treatment plans or you are having trouble controlling your blood sugar, you should have A1C tests every 3 months.
- A1C gold standard
- Mayo clinic: An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation recommends that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes.
- Us preventative task force / Cochrane – fasting / challenge okay alternatives
Video 2: Managing Diabetes
- 70-130 before meals, no higher than 131 180 after eating (2 hours after eating) (American diabetes association cited as source) – (1:21)
- Ideally, this means levels between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, - See more at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/tight-diabetes-control.html#sthash.4nDRW0OU.dpuf -ADA, does not mention 131 as low which is only on text not said verbally in video
- best way to treat – maintain a healthy weight – utd, stills says will likely need medication
Video 3: Diabetes and Foot Care: The Basics – all from nih
- talc between toes
- do not use medicated lotions or razors for callous
Video 4: Diabetes and Foot Care: Top Concerns
- n/a
Video 5: Diabetes and Alcohol (great video)
- nearly 26 million americans with diabetes (0:10)
- ADA - In 2012, 1 million Americans, or 9.3% of the population, had diabetes. In 2010 the figures were 25.8 million and 8.3%- See more at: http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav#sthash.QdnJ4IDB.dpuf
- Cdc national surveillance report 2014 -1 million people or 9.3% of us population
- Recurrent pancreatitis can cause diabetes – diapedia and mayo
- Moderate drinking 1 drink/day woman and 2 drinks/day for men >65 if over 65 – 1 drink/day – have source
- 1 drink = 5 oz wine – 100 calories , 12 oz beer = 150 calories, 1.5 oz of 80 proof distilled spirits – 100 calories (2:21) ,ada limits
- Women should have no more than 1 drink per day. Men should have no more than 2 drinks per day. *One drink is equal to a 12 oz beer, 5 oz glass of wine or 1 ½ oz distilled spirits (vodka, whiskey, gin, et- See more at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/alcohol.html#sthash.dUOf9HkW.dpuf
- Calories: diabetes association of Canada says wine has ~120 calories; the other calories are correct; ucsf dm center agrees w video http://dtc.ucsf.edu/pdfs/alookatyourliquor.pdf
- Nih: wine slightly more than 100,
- 2 hours for ounce of alcohol to be metabolized - mayo clinic
Video 6: Diabetes and Celebrations
- n/a
Video 6: Diabetes and Travel
- n/a
References:
- Pancreatitis: Basics. Mayo Clinic, MN. http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/causes/con-20028421. Downloaded 11/4/2014.
- Alcohol and Diabetes: Mayo Clinic, MN. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-blog/alcohol-and-diabetes/bgp-20056464?p=1 11/2/2014.
- AIC: Basics. Mayo Clinic. MN. http://www.mayoclinic.org/tests-procedures/a1c-test/basics/why-its-done/prc-20012585. Downloaded 11/1/2014.
- Alcohol and Diabetes. Canadian Diabetes Association. Toronto, ON. http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/alcohol-diabetes Downloaded 11/3/2014.
- American Diabetes Association, Alexandria VA:
- http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/alcohol.html downloaded 11/1/2014.
- Statistics about Diabetes. http://www.diabetes.org/diabetes-basics/statistics/ downloaded 11/4/2014.
- Tight Diabetes Control. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/tight-diabetes-control.html. Downloaded 11/4/2014.
- National Diabetes Statistics Report, 2014. Atlanta, GA.
- Chronic Pancreatitis. Amsterdam. http://www.diapedia.org/other-types-of-diabetes-mellitus/chronic-pancreatitis. Downloaded 11/2/2014.
- Draft Recommendation Statement: Abnormal Glucose and Type 2 Diabetes Mellitus in Adults: Screening. US Preventive Services Task Force. Rockville, MD. http://www.uspreventiveservicestaskforce.org/Page/Document/Recommend…entDraft/screening-for-abnormal-glucose-and-type-2-diabetes-mellitus Downloaded 11/1/2014.
- Prevent diabetes problems: Keep your feet healthy - National Diabetes Information Clearinghouse. National Diabetes Information Clearinghouse (NDIC) A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). Bethesda, MD. http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/#can 11/2/2014
- Alcohol and Diabetes: A Look at Your Liquor/USDA National Nutrition Database. San Francisco. 2005.
- Uptodate:
- McCulloch DK. Initial Management of Blood Glucose in Adults with Type 2 Diabetes Mellitus. September 2014.
- Patient Information: Hemoglobin A1C (The Basics). Downloaded 11/2/2014.
- McCullock DK and Hayward RA. Screening for Type 2 Diabetes Mellitus. September 2014.
Note: These are all the sources used for every video in this series, not every source listed was used in this specific video.