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Managing diabetes is often all about your routine: You test blood sugar at the same times every day, you take your medication at consistent intervals, you know when to eat certain foods or exercise to avoid blood sugar dips and spikes. Part of the reason we seek out vacation is to get away from the doldrums of everyday life, but those very disruptions in your daily routine can make managing your diabetes a little trickier when you’re jet-setting.
How much extra planning you need to do when have diabetes and head out on vacation has mainly to do with which medications you take and how controlled your diabetes is. But even if you don’t take insulin or need to check your blood sugar often, it’s important to take some extra precautions when you’re traveling with diabetes. Here’s what doctors and diabetes educators want you to know:
If you’re planning to travel longer than a weekend getaway, it’s prudent to see your doctor to ensure your diabetes is in control before traveling. Don’t wait until the week before you leave; you might need more time to make adjustments to your meds, diet, or other aspects of blood sugar management. You might need immunizations before traveling to another country. While you’re at the appointment, get a prescription and letter from your doctor stating the meds you take, devices needed, and when and how to use them. If you’re traveling with a partner, make a copy for them as well, in the event of an emergency. This letter may also come in handy for security screening at the airport.
Traveling with insulin can get a little tricky, especially if you’re traveling across time zones. This is why is crucial to talk to your doctor about their specific instructions for you may need to make adjustments depending on the type of insulin you use. “Basal insulin timing for glargine (Lantus and Basaglar), levemir, and NPH may need to be adjusted in preparation for travel across multiple time zones. Newer basal insulins such as Tresiba and Toujeo may not need adjustment,” says endocrinologist Stuart Weiss, MD.
Diabetestravel.org offers a helpful tool that takes the guesswork out of managing insulin when you fly. You put in your flight information, diabetes treatment, and medication timetable and it tells you how to manage your insulin properly, says Deborah Malkoff Cohen, a certified diabetes educator and CGM (continuous glucose monitor) and insulin pump trainer. Malkoff-Cohen also suggests insulin pump users change the date and time on the pump to the local time at the end of the destination.
First and foremost, pack twice as many supplies as you would normally use at home, says Malkoff-Cohen. Here are her best packing tips:
Did you know that long road trips, flights, and train rides can raise your blood sugars? “Patients tend to have higher than normal blood glucose values mostly because there is little physical activity to burn the glucose off,” says Dr. Weiss. Help counteract that by moving around as much as you can. Take a little walk around a rest stop. Walk up and down the aisles while you’re on the train or plane—a good reason to get an aisle seat if possible! Dr. Weiss also advises to drink plenty of water and steer clear from the junk food.
Toby Smithson, CDE, a diabetes educator and person with type 1 diabetes herself, travels frequently. As a traveler and educator, she recommends bringing a variety of snacks that will be suitable for such conditions as low blood sugar, to fill in gaps when food may be delayed or to eat prior to extensive exercise, like a day of walking or bicycle sightseeing.
In addition to packing fast-acting sources for low blood sugar, it’s also good to have snacks that combine protein and complex carbs for sustained energy. Think peanut butter on graham crackers, dehydrated cheese and whole grain crackers, or nuts and a nutrition bar. For between-meal snacks, aim least 7 grams of protein and 15 grams of carbs. Snacks that are replacing meals should have around 30 grams of carbohydrates.
Another savvy tip Smithson adopted is to bring her own packets of Splenda. “I like to make sure I have a low-calorie sweetener I’m comfortable with that won’t increase my blood sugar,” says Smithson. “The packets are easy to pack and it offers one less worry about finding an appropriate product to sweeten my morning oatmeal.”
“When traveling, your schedule, exercise and eating patterns, and food choices can be different than when you are at home,” says Smithson. If you’re feeling any symptoms of low blood sugar or aren’t sure how a certain meal or activity might have impacted you, it’s always better to test and know. Stash some alcohol-free wipes in your bag for testing, which can help if you’re in a place without access to running water.
No one wants to get sunburned or dehydrated on vacation, but when you have diabetes, it can be especially risky: Dehydration and sunburn can spike blood sugar. Keep well hydrated, wear a sun hat and protective clothing, and apply sunscreen to avoid sunburn, says Kelly Rodriguez, CDE, director of the Global Diabetes Program at Parkland Health and Hospital System in Dallas, Texas.
Don’t quench your thirst with caffeine, sugary sodas, or cocktails—as caffeine, alcohol, and sugar can make you pee more and actually make dehydration worse. (If you’re in another country, stick to bottled water. Diarrhea from tainted water can cause dehydration.)
Seek shade in hot weather. If you’re lounging by the beach or pool, take frequent dips in the water to stay cool. Studies show that people with diabetes may not sense how hot it really is and therefore may not sweat as effectively compared with people without diabetes. The hot sun affects the test results and accuracy of diabetes devices, testing strips, continuous glucose monitors, and insulin pumps, so keep them in the shade or protect them from the heat.
Rodriguez strongly recommends packing comfortable walking shoes (perhaps more than one pair for longer trips) and soft cotton socks to help absorb moisture, which can help prevent infections like athlete’s foot. As well, white socks can help you quickly identify a cut or wound to your foot. Don’t bring brand-new shoes on vacation; make sure you’ve worn them for a couple of weeks to break them in and avoid blisters. If you’re staying at a resort, it might be tempting to walk around barefoot near the beach or pool, but resist the temptation! Even a minor cut or scrape can take longer to heal or lead to complications when you have diabetes; to be safe, wear sandals or water shoes with good support and that keep your soles protected.