As soon as you decide on a destination, find out if any vaccinations are needed. A travel clinic, your local public health unit or your family doctor can advise you. Some vaccinations are required well ahead of your departure date. If you need travel medication, such as antimalarials or remedies for travellers' diarrhea, see your doctor for a prescription. Fill it at your local pharmacy as soon as possible. Some medications must be started well ahead of departure.
Ask your airline about the kind of meals provided. Make any special requests days ahead of the flight. Do some research to find out what new foods might be available at your travel destination.
You will need a copy of your prescriptions and a letter from your doctor detailing your medical condition, medications and supplies. Make copies of these documents. Keep one in a secure place, and carry another copy with you at all times while travelling. You should also have identification on you indicating that you have diabetes. This should be in both English and the native language of your travel destination.
Travel insurance is a must. You may have a health emergency that requires medical attention when you are on your trip. Travel insurance can be purchased through the Canadian Diabetes Association. For more information, visit www.diabetes.ca and key ‘insurance’ into the search box, or call 1-866-266-0166.
In other countries, different measurements may be used to test blood glucose. This can lead to confusion and improper treatment. Discuss potential problems with your diabetes education team before you leave.
Prepare for time zone changes that may affect your usual routine, especially if you use insulin. If you are travelling straight north or south, then you will not have to adjust as the time zone stays the same.
Travelling east or west will affect your usual routine as you cross time zones. Travelling east requires less insulin since you usually lose time. As your day will be shorter, less food should be eaten. Travelling west is the opposite. You gain time and your day becomes longer, so extra insulin and an extra medium-sized meal may be necessary. In general, if you are crossing fewer than five times zones, you may not need to make changes.
Keep your watch set to your time at home until the morning after your arrival. This will help you keep better track of your meals and insulin. Work with your diabetes team, such as your doctor, diabetes educator, nutritionist, or pharmacist, to calculate what adjustments may be needed.
Make a list of what you need to pack and how much of each item you will need. Take twice your usual amount of medication and supplies, in case of delays or emergencies. Divide your supplies between two bags. This way you will still have enough if one bag gets lost.
If you are flying, these supplies and medications should be packed in your carry-on luggage. Checked luggage can get lost and can be exposed to extreme temperatures. Find out if there are any limits for your supplies or medications in your carry-on luggage. If you must pack any insulin, supplies, or medications in your checked luggage, be sure to insulate them.
It is a good idea to take along two glucometers, and two insulin pens so that you have a replacement if one breaks. Also take extra batteries, syringes or pen needles, test strips, urine ketone strips, lancets, and glucose gel and tablets. Control solution for your glucometer is a good addition, so you can be sure you are getting accurate results.
If you use insulin, consider taking along a glucagon emergency kit in case of severe hypoglycemia. An insulated bag with refrigerated gel packs for insulin storage is handy. Remember to bring a sharps container to safely dispose of syringes and pen needles.
If you have type 1 diabetes, it is especially important to take supplies for ketone testing. Ketones give additional warning that diabetes is getting out of control and medical help may be needed.
Keep medications and diabetes supplies in their original packaging with the prescription label attached.
Consider including a first-aid kit, anti-diarrhea medication, painkillers like acetaminophen, and medication for motion sickness. Other possibilities are insect repellent, antihistamine medication for allergic reactions, and any other medications that you would like to have on hand.
Sunscreen is a must if you are going to a warm getaway. Sunburn can ruin your vacation and affect your blood glucose control. Speak to your pharmacist to make sure you do not forget any essentials for travel.
Packing snacks such as granola bars, cookies, crackers, peanuts, fruit bars, and juices is wise in case of delays that might prevent you from eating at your regular times. Depending on where you are going, you might want to pack bottled water. Having water accessible at all times is important as dehydration can increase blood glucose levels.
Whether you are travelling by land, air, or sea, storing insulin properly is essential. You must be careful that insulin does not overheat or freeze, as this reduces the effectiveness. Keep in mind that it can usually be stored at room temperature for up to four weeks.
Always inspect your insulin for any crystals or particles before use. If there are any, use another supply. If you are not sure whether your insulin has been stored properly, check your blood glucose more often. Good blood glucose readings indicate that insulin has not been affected.
If you are travelling by car, do not use the glove compartment or trunk to store insulin as the temperatures in both places can get very hot. Also, do not place insulin in direct sunlight. Instead, pack it in an insulated bag with refrigerated gel packs. Take frequent breaks to stop and stretch your legs. Eat and drink at regular times to maintain good blood glucose control.
Allow extra time at the airport if you are flying. You may need more time during the inspection process at the terminal. Be sure to let your screener know that you have diabetes and be prepared to present paperwork from your doctor. Putting insulin, supplies, and medications through the x-ray machines should not cause problems. However, if you are concerned, request that a manual inspection be done instead.
During the flight, get up to stretch at least every hour to encourage blood flow. If you draw insulin with a syringe from a vial during the flight, expect a bit more resistance. This happens because the airplane cabin is pressurized. More care is needed to accurately measure insulin in the airplane. Remember, do not take your fast-acting insulin until you receive your food.
After arriving, test your blood glucose frequently. Jet lag can make it harder for you to notice that your blood glucose is too high or too low.
If for some reason you need to use insulin from a different country, remember that it may come in different concentrations, such as U40 or U80 instead of the U100 used in Canada. To take the right amount, you must use syringes that measure in the same concentration. Ask a doctor or pharmacist for help.
Be sure to apply sunscreen to exposed skin at least thirty minutes before going out. Reapply it every two hours or more often if you have been swimming or sweating a lot.
Do not go barefoot anywhere and wear comforable shoes. Be sure to inspect your feet every day for cuts, blisters, and redness. Seek medical attention if you suspect any infection.
Always have a bottle of water with you to keep hydrated, and snacks in case no shops or restaurants are close by. Avoid local tap water and ice cubes, and be careful of what you eat or drink to avoid stomach upset.
When eating in restaurants, ask about ingredients in the dishes. Have a dictionary handy in the language of the country you are visiting if you are unfamiliar with the language. Again, do not take your fast-acting insulin until your food is served.
If storing insulin in a small refrigerator in your hotel room, monitor the temperature closely. Small refrigerators might not have closely regulated temperatures. As mentioned before, always check your insulin before using it, and check your blood glucose frequently.
If the temperature is extreme at your vacation destination, it may be a good idea to test your glucometer with control solution. This checks if your equipment or test strips have been affected by the climate.
We all need holidays. Still, make sure you do not take a vacation from proper blood glucose control. Prepare ahead of time and everything will fall into place. Enjoy yourself!a community pharmacist with Canada Safeway Pharmacy, practising in the lower mainland of British Columbia.