Taking special care when traveling with diabetes

Have a complete health exam well before you travel. This helps to make sure your diabetes is under control. It will also give you enough time to get any needed vaccines and time to recover from any side effects. Ask your health care provider to give you a letter that lists:

• How your diabetes is treated (diabetes pills, insulin shots).

• All medicines and equipment needed to manage your diabetes (for instance, insulin, syringes, and other medicines or devices to check your blood sugar). Whenever you can, bring prescription labels for medicines and medical devices.

• Any allergies to foods or medicine.

Also, have your provider give you a prescription for insulin or diabetes pills. Make sure to bring more than enough of your medicine and syringes to last through the trip. But in case of emergency, the prescription may help. Use only U-100 syringes while traveling. Other syringes will give you higher or lower doses than you need. (If you're using U-500 syringes already, be sure to bring these with you.)

Prescription laws may be very different in other countries. If you're traveling abroad, contact International Diabetes Federation groups at www.idf.org for more information. You may also want to get a list of English-speaking health care providers in the countries you're traveling to before you leave. Contact the International Association for Medical Assistance to Travelers at www.iamat.org to learn more. 

It's important to wear a medical ID bracelet or necklace that shows that you have diabetes. If you're traveling to other countries, you may also want to learn a few key phrases. It may be helpful to know how to say, "I have diabetes," or "Sugar or orange juice, please," in the languages of the countries you will be visiting. Buy travel insurance in case you miss your flight or need medical care.

Packing for preparedness

Pack at least twice as much medicine and blood-testing supplies as you think you will need. At least half of these should be with you in your carry-on cabin bag at your seat for insulin, glucose tablets, and snacks. Have this bag with you at all times. Keep the labels on all medicines and supplies. You may need these during the security check for air travel.

When packing, include:

• All the insulin and syringes you need for the trip, plus some extras.

• Blood- and urine-testing supplies, plus extra batteries for your glucose meter.

• All your oral medicines.

• Other medicines or medical supplies.

• Your ID and diabetes identification card.

• A well-wrapped, airtight snack pack of crackers or cheese, peanut butter, fruit, a juice box, and some form of sugar (hard candy or glucose tablets) to treat low blood glucose.

• Your health care provider’s letter and prescriptions.

• Extra pharmacy labels you can attach to plastic bags. Ask your pharmacist to print these for you.

• A TSA notification card. This is optional, but it can help the screening process go more quickly and smoothly.

At least 48 hours before you fly, request a special meal that's low in sugar, fat, and cholesterol. Always carry some food with you. This is helpful in case your meal is delayed or there is a mistake in your order. Don't take your insulin shot until you see your food coming down the aisle. If your meal is delayed, you could have low blood sugar. If you are used to injecting some air into a bottle of insulin before drawing out some insulin, don't do this while in the air.

Plan for crossing time zones 

If you take insulin shots and will be crossing time zones, talk with your health care provider before your trip. Ask for help in planning the timing of your injections while you travel. This will be based on your travel route. Eastbound travel means a shorter day. So if you inject insulin, you may need less. Traveling westbound means a longer day. So more insulin may be needed. To help you keep track of shots and meals through changing time zones, keep your watch on your home time zone until the morning after you arrive. Set an alarm on your phone for taking medicine if you’re traveling across time zones.

Checking blood sugar while traveling is just as important as when at home. Check your blood sugar soon after landing. Jet lag may make it hard to tell if your blood sugar is very low or very high.

People with diabetes are at higher risk of blood clots. So make sure to stop and get out of the car or walk up and down the aisle of the plane every hour or two to prevent blood clots.

Storing insulin

Manufacturers advise storing insulin in the refrigerator. But cold insulin injections may be painful. So you may store the bottle of insulin you're using at room temperature for 1 month.

Don't store insulin in very hot or very cold temperatures. Don't leave insulin by a pool, in direct sunlight, or on the beach. Don't store it in a car trunk or glove compartment, or in backpacks and other bags that could be exposed to differences in temperature and weather. Don’t put insulin directly on ice or a gel pack. Many travel packs are available to keep insulin cool.

Check all expiration dates before you travel. Don't use any insulin past its expiration date.

Other tips for traveling with diabetes

Here are some more tips:

• If you're wearing an insulin pump or a continuous glucose monitor, tell the airport security workers. You should be eligible for a more private security screen. You shouldn't need to disconnect your system.

• Take it easy for a few days after a long flight.

• Test your blood sugar according to your health care provider's advice. Treat the highs or lows as instructed by your provider or diabetes educator.

• If you use insulin, check the bottle of insulin before each shot. See if it has changed in appearance since you last used it. If it has, don't use it.

• Plan your activities so you can work in your insulin and meals. You may be much more physically active during your vacation. It's best to check your blood sugar before and after your activities. This will help in adjusting your food, activity, and insulin as needed. You may need to change the doses of your medicines so you don't have hypoglycemia.

• Take along snacks when you hike and sightsee. Don't assume you will find food wherever you are.

• Be extra careful about food and water safety. Don't eat uncooked foods or drink tap water. Foods that upset your stomach could cause your blood glucose levels to become uncontrolled.

• Wear comfortable shoes. Never walk with bare feet, not even on a beach or by the pool. Check your feet every day, looking for signs of blisters, cuts, redness, swelling, and scratches.

• If your vacation is in the great outdoors, bring disposable wipes or alcohol-based hand sanitizers so you can clean your hands before you check your blood sugar.

• Get medical care at the first sign of any infection or inflammation.

• Take steps to manage diabetes in the heat. People with diabetes get dehydrated more quickly. Here are some things you can do when the weather is hot:

  • Don’t be active outdoors during the hottest part of the day. Stay indoors, preferably in air-conditioned rooms, hotels, or malls.

  • Avoid alcohol and drinks with caffeine, like coffee and energy or sports drinks. They can lead to water loss and spike your blood sugar levels.

  • Wear sunscreen and a hat when you’re outside. Sunburn can raise your blood sugar levels.

  • Wear loose-fitting, lightweight, light-colored clothing.

  • If you’re driving, pack a cooler with healthy foods and plenty of water to drink.

  • Heat can damage your blood sugar monitor, insulin pump, test strips, and other diabetes equipment. Keep them in a cool, dry place. Don't leave them in a hot car, by a pool, in direct sunlight, or on the beach.