First, make sure your diabetes is under control. Make an appointment to see your doctor several weeks before your travel date. If you do need better control, you will have some time to work on it before you leave. Keeping your diabetes well controlled prior to travel will definitely improve your ability to cope with changes in your regular routine.

Ask your doctor for a letter stating that you have diabetes. It should include a list of the medications and supplies that you must carry while travelling. For instance, needles, syringes, insulin pens, lancets, and pump supplies should all be listed. This precaution can help you avoid problems, both with airport security and when travelling in foreign countries with these supplies.

Carry a record of your diabetes treatment plan from your doctor or diabetes educator. Pack a copy of sick day management guidelines (see below) to help in case of illness.

Gather a list of your medications by talking with your pharmacist. Include generic names and doses of your medications. Check that the type of insulin, whether it is short or long-acting, and the dose are also indicated. Always keep the original prescription labels on your medication bottles and insulin when travelling. This proves that they are prescribed for your personal use.

Be sure to wear a medical alert bracelet or necklace that shows you have diabetes, in case of an emergency. Travel health insurance is a must. Your coverage should include pre-existing conditions like diabetes, as well as evacuation and trip cancellation.

Visit the Canadian Diabetes Association website for information about travelling with diabetes, including tips on where to access travel health insurance

Pre-travel consultation

It is wise to arrange a personalized pre-travel consultation with a travel medicine specialist. This is best scheduled for six weeks or more before departure, but plan to meet even if you will leave sooner. Together, you can assess your specific itinerary (including destinations and activities) for health hazards. Then, discuss how to manage, prevent, or self-treat them.

Depending on your travel plans, your specialist will provide:

prescriptions you may need
necessary immunizations
precautions against insects
strategies to prevent or treat jet lag, motion sickness, malaria, altitude illness and traveller’s diarrhea
details on how to access medical aid where you are travelling.

Packing and storage

Always take twice the supplies and medications that you expect to need for your trip. This protects you in case of loss, theft or breakage. Pack your supplies in different bags in case one is lost. Carry enough supplies in your carry-on luggage to last the entire trip, as checked luggage can go missing.

Never put insulin in your checked baggage as it may be exposed to extreme temperatures. Most insulins can be stored at room temperature for up to 30 days. For tropical destinations, research what storage options are available where you will be staying. You may need a cooler with ice packs to keep the insulin at an appropriate temperature.

Security scanners at airports do not normally damage insulin or blood glucose meters. Even so, always examine your insulin before injecting it to ensure that it is safe to use.

In contrast, metal detectors and scanners can affect insulin pumps. Ask the security officer to do a physical search instead. Pump users should also pack insulin syringes, in case the pump stops working properly. Contact your pump supplier to see if you can get a second loaner pump for travel. As well, check to see if you need to handle the pump a certain way during air travel.

Pack your blood glucose meter, strips, lancets and extra batteries, as well as the instruction manual for your meter. Have urine testing supplies for ketones on hand, so you can test if you become ill.

Bring dextrose tablets or other fast acting glucose to treat low blood glucose levels. Dextrose tablets are available in small containers and are simple to pack. You might also include a glucagon kit to treat severe hypoglycemia.

Allow yourself extra time to check in at the airport, as medical items could be thoroughly searched.

Finally, pack snacks with you in case flights or in-flight meals are delayed, or if the menu lacks appropriate carbohydrates. Crackers, cheese and granola bars are easy to take. Depending on the airport, you might buy fruit after clearing security or crossing the Canada/USA border.

Travelling through time zones

Crossing time zones can affect the timing of your insulin, oral medications and meals. If the time change is more than two hours either way, consult your diabetes educator to work out your needs in advance. When you travel east, your day gets shorter. You may require less intermediate or long acting insulin. Going west, your day is longer and you may need extra short-acting insulin and more food. Travelling within North America usually does not require medication adjustments.

Staying comfortable

In the air and throughout your trip, keep yourself well hydrated. Wear loose clothing, and move and stretch regularly. Remember to check your feet daily for pressure sores, and treat them appropriately should they occur.

Meal planning

Food plays a large role in managing diabetes. Try to do some research on local foods ahead of time. Check the carbohydrate content of popular foods. Your travel agent may know more about the local cuisine. Ask for help planning an itinerary that meets your health needs.

Local restaurants may have ingredient lists for foods you are interested in trying. Use technology to your advantage. Some cell phone applications can supply the content of certain foods.

By testing before and two hours after meals, you can better understand how local foods affect your blood glucose levels.

Check with your airline ahead of your flight to see if they provide special in-flight meals for people with diabetes. Always be sure to carry extra snacks with you in case meal times are delayed on tours or excursions.

Test your blood glucose regularly

Travel can affect your blood glucose. Changes in your routine, physical activity levels, and different food choices can all have an impact. Long periods of inactivity while travelling may increase your blood glucose level. Physical activity during your vacation can lower it. Testing regularly and frequently helps with control.

In Canada, we measure blood glucose in mmol/L. Some other countries, including the United States, measure blood glucose in mg/dl. This can be confusing. Meet with your diabetes educator before you leave to troubleshoot issues like this one.

Sick day guidelines

Before you leave, work with your diabetes educator to develop guidelines on what to do in case of illness. With the guidelines in hand, you know what to eat and drink if you are sick. They should list how often you should be testing your blood glucose. As well, discuss which, if any, medications to stop taking when you are ill.

Testing ketones is important when you are sick, so pack the supplies needed to test ketone levels.

Be sure to let the people you are travelling with know that you have diabetes. Keep a list of emergency contacts on hand in case you need it.

A little extra planning can go a long way to helping you have an amazing experience abroad. You can then relax and enjoy yourself, knowing your health needs are being met.

Travelling with Diabetes Planning ahead to protect your health

With a little extra planning, you can relax and enjoy your vacation, knowing your health needs are met.

Getting ready