You might not be able to take a vacation from managing diabetes, but don’t let that ground your plans. A little planning now means less stress and more time enjoying your journey.
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:
1. Check with your doc
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.
2. Make sure you understand how to adjust your insulin
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.
3. Pack for the unexpected
First and foremost, pack twice as many supplies as you would normally use at home, says Malkoff-Cohen. Here are her best packing tips:
- No matter what mode of transportation you use, always keep medications and supplies in your carry-on bag. If there's a delay or your luggage gets lost, you'll have what you need.
- Always keep medication and supplies with you when you sightsee or take day trips away from your lodging.
- Carry a fast-acting glucose source like tablets or gel so you're always ready to treat low blood sugar.
- Pack extra batteries for devices.
- If you take insulin, bring a cold pack to keep it cool. A good rule of thumb: If it's warm enough outside to wear a swimsuit, it's probably too hot for your insulin, which should be kept at room temperature.
- Pack insulin vial protectors to keep insulin safe from breakage.
4. Stay active while you're en route
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.
5. Pack snacks that travel
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.”
6. Prepare to check blood sugar more than usual
“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.
7. Be sun smart
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.
8. Take care of your feet
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.
9. Traveling abroad? Get these key phrases down
Jus d'orange s'il vous plaît (“orange juice, please!”) could be more important to memorize than “Where is the bathroom?” when you’re in France. If a medical situation like low blood sugar arises, it’s essential to convey what you need. “If you're traveling to a foreign country, learn some key phrases like: ‘I have diabetes’ and/or ‘Sugar or orange juice, please’ in the language or languages of the countries you'll visit,” says Malkoff-Cohen.
10. Pack "ICE"
Malkoff-Cohen also suggests wearing a medical ID bracelet or necklace. “If you don’t wear a medical ID bracelet, keep a list of all your medications in your wallet, where it is easily accessible, and with your travel partner in case of an emergency,” says Malkoff-Cohen. In addition, add an ICE (In Case of Emergency) contact on your phone. Here’s more info on how to do it.
11. Be smart about blood clots
If you zonk out on a long flight and don’t move your legs or drive/ride hundreds of miles without occasional stops, you could be setting yourself up for potential blood clots. People with high blood pressure, heart disease, or diabetes that isn’t well managed (a high A1C) are at higher risk for travel-related blood clots. One thing that can help: compression socks. “The socks continuously squeeze your legs, thereby helping your veins and leg muscles move the blood more efficiently. It pumps the blood so it does not stagnate and helps to avoid clot formation,” says Malkoff-Cohen.
12. Get travel insurance
The chances are slim if you’ve taken all the above precautions, but what if you have a diabetes emergency and need to see a doctor? Or even if you were to slip and break your wrist while sightseeing, say, or get a stomach bug while traveling out of the country? Emergency medical care isn’t cheap. Purchase travel insurance just in case. “Your healthcare coverage may not be effective when traveling abroad or in other states,” says Rodriguez. Make sure you are clear about what is covered and what isn’t before you buy it. When you arrive, it’s also prudent to make note of where the nearest emergency services are at your destination.