10 Tips for Traveling With Diabetes
Some extra planning and research is all that's needed for a person with diabetes to enjoy an incredible family vacation.
Know Before You GoThis includes visiting the doctor before the trip and researching doctors, pharmacies, and hospitals at your destination. The American Diabetes Association (ADA), the Mayo Clinic, the Centers for Disease Control and Prevention (CDC), and the Diabetes Research Institute Foundation all provide comprehensive travel information. 960 1280
Plan Snacks and Meals in AdvanceHolley Grainger, a registered dietitian and culinary nutrition expert, recommends bringing meals or snacks that are rich in fiber and protein, such as individual peanut butter packets with whole grain crackers, dried fruit and nuts, or string cheese. Conversely, depending on your destination, some of these items can also be found at airports and convenience stores. When eating out, Grainger says to be mindful of portion control, and choose meals that offer a balance of protein, fiber-rich carbs, healthy fat, and a vegetable. Beware of alcohol; the ADA has a tip sheet that covers specifics.
On international flights that include meals, request a diabetic meal in advance if possible, since Grainger says many airplane meals include too many carbohydrates. 960 1280
Pack Enough Medical Supplies“Be over-prepared in case of every scenario that you can think of,” says Dr. Amber Champion, director of The Diabetes Center at Mercy Medical Center. For example, she recommends pump users bring a spare pump and an extra supply of basal (or long-acting) insulin. Other necessary supplies, depending on the type of diabetes, might include insulin, medication, rubbing alcohol, hand sanitizer, syringes, a blood glucose meter, and test strips. Be sure to pack these in a carry-on bag. A cooler for insulin is also necessary if traveling to the beach, an extremely hot destination, or for an extended period of time. Otherwise, Dr. Champion says insulin can last for 28 days at normal room temperature. 960 1280
Know Airport and Flight ProceduresAllow extra time for going through security and customs at the airport; review the Transportation Security Administration (TSA) guidelines for special procedures beforehand concerning medications, liquids, supplies, and more. Dr. Champion says the TSA doesn’t typically question items like pumps or syringes, but they’re less common in some foreign countries, so it’s best to bring a doctor’s letter. It’s equally important to be aware of what’s allowed through customs at your destination; certain prescription medications are illegal in other countries, like Dubai. The ADA provides a comprehensive guide to air travel and diabetes, as does the CDC.
During the flight, the altitude change during the ascent and descent can affect some pumps. Dr. Champion advises disconnecting it during take-off and landing to prevent it from administering extra insulin. However, speak with a doctor about your personal situation beforehand. 960 1280
Be Alert for High and Low Blood Sugar SymptomsSigns of hypoglycemia, or low blood sugar, can include nervousness, dizziness, and feeling shaky or light-headed. Grainger notes that symptoms can strike quickly and affect a person’s ability to think clearly, in which case the travel companion should carry glucose tablets as a quick fix. They’re easy to find at drugstores and supermarkets in the U.S., but carry extra when traveling abroad. Grainger notes that orange juice is a good backup too, and Dr. Champion says that small bags of candy such as Skittles or jelly beans are easy to carry and also work. For extreme hypoglycemia, a travel companion should know how to inject glucagon, a hormone that raises blood sugar. Dr. Champion recommends an app called Glucagon that walks you through the steps.
Signs of hyperglycemia, or high blood sugar, can include increased thirst, dry mouth, blurry vision, vomiting, shortness of breath, headache, and even stomach pain. Consult a doctor before a trip to discuss treatment options, which, depending on the severity, range from administering an extra dose of insulin to visiting an emergency room. Dr. Champion says to leave insulin injections to the paramedics. 960 1280
Make Sure Travel Insurance Includes MedicalSome travel insurance plans only cover financial losses. Check the U.S. Department of State for a list of recommended medical providers. Be sure to choose one that includes medical evacuation, or medevac, in case of an emergency; that option could be cost-prohibitive if insurance doesn’t cover it. It’s also important to research doctors and hospitals at your destination. 960 1280
Adhere to a Regular ScheduleBoth Grainger and Dr. Champion advise sticking to a regular schedule as much as possible, both with meals and insulin, especially when changing time zones. Those with Type 1 diabetes need to time insulin injections with meals, and injections need to be at set times. Eating at least every three to four hours can also help prevent any blood sugar dips. 960 1280
Monitor Blood Sugar Levels FrequentlyAn increased activity level, time zone changes, and eating differently can all affect glucose levels. Stay on track by checking glucose levels more than normal. Travel companions shouldn’t be afraid to remind those with diabetes to check it, since it can be easy to forget while on vacation. 960 1280
Wear a Medical Alert BraceletIt’s reasonable to assume that someone with diabetes will have periods when they’re alone, if even for a few minutes. In the event of an emergency, such as a rapid onset of hypoglycemia, a medical alert bracelet can help paramedics quickly identify the problem. In addition, Dr. Champion advises that everyone with diabetes should carry a card with them at all times that includes a list of medications, their doctor’s name and number, and medical conditions. 960 1280
Avoid Going BarefootDr. Champion says this is especially true for patients with neuropathy, a condition that causes numbness in the feet, which poses an infection risk if they step on something and cut their foot without knowing it. However, Dr. Champion notes even those with Type 2 diabetes don’t always realize they have neuropathy. It’s best to err on the side of caution and always wear footwear, whether indoors or at the beach. 960 1280
Planning is EssentialChronic conditions, such as multiple sclerosis (MS) and diabetes, shouldn’t stop the entire family from traveling, even if wheelchairs or insulin are necessary. An extra level of planning is all that’s needed for a stress-free vacation. For starters, the U.S. Department of State is a good resource for medical needs, from finding hospitals, pharmacies, and doctors at your destination to traveling with prescription medications. The Centers for Disease Control and Prevention (CDC) is another good resource for traveling with a chronic illness. 960 1280
Check in With Your Doctor Before Your TripIt’s important for those with a chronic condition to visit their doctor beforehand for a number of reasons. Besides checking that they’re healthy enough to travel, they should also discuss what shots or medications they might need for their destination, and possible drug interactions. It’s also critical for them to devise a game plan with their doctor for managing their symptoms while traveling; it’s equally important for travel companions to be informed of this as well. Travel companions also need to monitor any signs of life-threatening symptoms, and should be aware of what to do in an emergency.
Timothy Holtz, the group travel director of Flying Wheels Travel, an agency specializing in trips for people with physical limitations and chronic illnesses, says it’s also important to consider the impact of a destination’s climate on symptoms. For example, heat and humidity will exacerbate fatigue and pain with certain medical conditions. Meals, activity level, and downtime also have to be factored into managing symptoms.
Carry Extra Medication and SuppliesAn ample amount of medications and supplies should be in their original, labeled containers and packed in a carry-on. Besides helping to get through security and customs faster, Holtz notes that it’s not uncommon for prescription medication to be stolen from checked bags.
Concerning supplies, Holtz advises that certain items that are easy to obtain in the U.S., such as rubbing alcohol, can be expensive or difficult to find abroad. Other common items might need a prescription in other countries, are sold only at specialized pharmacies, or go by a completely different name. (In the case of rubbing alcohol, it’s called surgical ointment in England.)
Allow extra time for going through security and customs at the airport; review the Transportation Security Administration (TSA) guidelines for special procedures beforehand concerning medications, liquids, supplies, and more. It’s equally important to be aware of what’s allowed through customs at your destination; certain prescription medications are illegal in other countries, like Dubai. 960 1280
Carry Medical InformationCarry medical records, contact information for a primary doctor, and prescriptions on a thumb drive. It’s also important to bring prescription copies for all medications. Finally, a medical alert bracelet can help paramedics diagnose the problem faster if the person happens to be alone. 960 1280
Make Sure Travel Insurance Includes MedicalSome travel insurance plans only cover financial losses, and Medicare doesn’t cover overseas travel. Check the U.S. Department of State for a list of recommended medical providers. Be sure to choose one that includes medical evacuation, or medevac, in case of an emergency; that option could be cost-prohibitive if insurance doesn’t cover it. If traveling abroad, it’s also important to know the generic name for any prescription medicines; don’t assume other countries will know the U.S. brand name.
Research Accommodation for Medical EquipmentFor example, if someone is traveling with an oxygen tank, check the special needs guidelines with each individual airline, cruise, or train, since what’s allowed varies. Review the Air Carrier Access Act from the U.S. Department of Transportation to understand your rights. Holtz says you need to double check, even if a device is FAA approved. For example, he had a client whose oxygen tank was approved by Delta, but not by a connecting flight on Avianca Airlines. Holtz notes that airlines also require a minimum amount of battery power for certain medical devices, which varies depending on the airline and the length of the flight, and could require bringing as many as 10 batteries. (Even though many planes are equipped with power outlets, that option isn’t always available.) 960 1280
Use a Specialized Travel Agent or Company“Anywhere is possible with proper planning,” says Holtz. He notes that while Europe is easier, he’s taken people to Machu Picchu, the Galapagos Islands, and more, and is currently organizing a yoga trip to India for people with MS. The Society for Accessible Travel & Hospitality is another resource for finding agents and companies. 960 1280
Enroll in the Smart Traveler Enrollment Program (STEP)The U.S. Department of State offers STEP as a free service that allows you to share your trip information with the local U.S. Embassy or Consulate at your destination—this way it’s easy to be notified in the event of an emergency. More importantly, there’s a section under Traveler Information that allows you to enter any relevant information pertaining to medical conditions. 960 1280
Consider an All-Inclusive TripAll-inclusive resorts provide a wide range of activities to suit everyone’s ability and activity level. Sandals features ADA-compliant rooms and grounds, and can also handle special requirements. Cruises are another good option since major lines have an infirmary with at least one doctor on board. In the event of an emergency, personnel can medevac the patient to a medical facility on land. Of course, always ask about emergency procedures before booking a trip. Royal Caribbean can arrange wheelchair and scooter rental and accommodate those who are oxygen-dependent. Carnival loans portable medi-coolers, while Norwegian Cruise Line allows travelers receiving dialysis. Disney World also accommodates a wide range of needs. 960 1280
Be Honest About Medical NeedsAlthough this seems obvious, Holtz says it’s common for people to downplay their medical needs with him because they’re afraid of being turned away. He emphasizes the importance of being honest about this when booking a trip, whether through an agency or independently, otherwise the proper arrangements can't be made. 960 1280
Don’t Forget the Needs of the CaregiverHoltz advises against seeing too much in one day in order to account for the stamina of both people. He also advises considering the amount of care someone needs, which affects how much energy the caregiver has to expend. For example, if the caregiver has to get up early to help someone in a wheelchair get ready, then both people might need an afternoon nap. Holtz says Flying Wheels Travel also offers travel companions on both independent and group tours, which gives the caretaker or spouse a vacation as well. 960 1280
Tangle-Free NecklacesArriving at your final destination to find your necklaces tangled or broken can ruin the best of vacations. Before embarking, unlatch, string half the necklace through a drinking straw and re-clasp on the outside. Small ones work for thin gold chains while smoothie straws are great for thicker strands. 960 1280
For the ShopaholicsIf you’re traveling with the intent of shopping, consider packing a suitcase within a suitcase. If you don’t, you’ll end of buying another (probably overpriced) suitcase for the return flight. And chances are you won’t use it again. We packed a week’s worth of clothes that fit into one carry-on bag within a 22-inch rolling suitcase. 960 1280
Know Before You Go: LodgingThe Americans with Disabilities Act (ADA) site is a good place to start for those with vision or hearing issues. While U.S. hotels, transportation, and cruise ships sailing in U.S. waters are required to be ADA-compliant, don’t assume that the foreign equivalent will be. For example, for those who are vision impaired, ADA-compliant lodging is required to allow service animals; provide large-print, Braille, or audio options for relevant hotel information; and comply with requests for adjoining rooms. Other services such as conducting a room orientation tour should also be provided.
For hard-of-hearing guests, ADA-compliant lodging is required to provide, upon request, a compliancy kit that includes visual alarms and visual notification devices. Teletypewriters (TTY or TDD) or amplified phones should also be available. If transportation, a cruise, hotel, or other lodging (such as Airbnb) isn’t ADA-compliant, call ahead to discuss what accommodations can be made. However, bring whatever aide is necessary in your carry-on, in case loaner equipment isn’t working or available. Multiple kits aren’t always available, so it’s a good idea to travel with devices such as SafeAwake, a travel-size alarm that shakes the bed and flashes a light if the smoke detector is triggered.
Joel Barish, founder of DeafNation.com, a comprehensive source for the deaf and hard of hearing, also advises performing a Google search to find similar communities at your destination. For example, Signs Restaurant & Bar in Toronto employs a deaf waitstaff that only communicates in sign language. Dans le Noir is a restaurant chain where you eat in complete darkness, with locations in London, Paris, Barcelona, and more. 960 1280
Know Your RightsIf you’re traveling within the U.S. or staying at a U.S. chain abroad, familiarize yourself with ADA laws, since you can’t assume that every staff member, regardless of whether it’s a hotel, cruise ship, theme park, etc. will know your rights and options. Review the Air Carrier Access Act for rights on U.S. airlines.
It’s also key to understand the laws for where you’re going. “They may differ significantly from the U.S. for protecting individuals who are disabled and for service animals that might need additional vaccinations,” says Dr. Margaret Wilson, chief medical officer for UnitedHealthcare Global. 960 1280
Use a Specialized Travel Agent or CompanyTravel agencies that specialize in trips for the blind or deaf can help facilitate a stress-free trip. Mind’s Eye Travel provides group trips that range from cruises to an African safari. Traveleyes is a UK-based company (although it attracts an international crowd) with a unique concept: trips are a blend of blind and sighted travelers. Upcoming trips encompass a broad range from Burma to Peru.
Deaf Globetrotters also offers group trips, (and provides a sign language interpreter) such as an upcoming one to Cuba, along with the opportunity to connect with the local deaf community. Group tours with translators can be especially helpful for those who are deaf, since sign language is not a universal language. Deaf Globetrotters can also arrange customized family trips. An organization like the Society for Accessible Travel & Hospitality is another resource for finding agents and companies. 960 1280
Visit a MuseumMany museums offer special programs for the deaf and blind. For example, MoMA in NYC offers touch and visually descriptive tours, as well as Braille maps. It also allows service animals. Sign language interpretation, captioning, and FM assistive-listening devices are available to the deaf and hard of hearing. The Louvre, the Smithsonian Museums, and the Vatican Museums also offer accessibility options. 960 1280
Get Reduced Fares on TransportationFor example, Amtrak offers discounts (from 15%-50%) to both the deaf and blind, plus a travel companion. You must show proof of your disability, such as a doctor’s note or ID card; visit the site for a full list of approved documents.
Reduced fares are also available on buses (such as Greyhound) and other trains both here and abroad, including Japan, London, and Singapore. 960 1280
Ask for AssistanceWhether at airports, hotels, train, or bus stations, alert the staff in advance so they can help with your needs. For example, airline staff can assist with getting through security faster. At the very least, familiarize yourself with TSA guidelines to learn about security procedures, such as traveling with a service animal. Amtrak also provides services upon request, including Red Cap agents who will carry luggage onto the train. Amtrak also allows service animals, but review its guidelines beforehand.
Even when assistance isn’t needed, it’s important to make staff aware of any issues, since a family member might not be present all the time. Nancy Nadler, deputy executive director at the Center for Hearing and Communication, recommends alerting staff of a disability in the event of an emergency or important announcement. 960 1280
Apply for a Free Access Pass from the National Park ServiceAny U.S. citizen with a permanent disability, including hearing and vision loss, is eligible to receive a free, lifetime access pass to any of the national parks, monuments, historic sites, and more. 960 1280
Consider a CruiseBy law, all cruise lines sailing in U.S. waters are supposed to be ADA-compliant, making them an ideal option. However, ADA guidelines for cruise ships aren’t standardized, so the level of service and resources vary—be sure to research each line. However, for those who are blind or have low vision, Royal Caribbean provides orientation tours, large-print menus and daily activity lists, and qualified readers. Braille signs are available in elevators and public areas, and service animals are also allowed. For those who are deaf or hard of hearing, Royal Caribbean will provide a TTY phone in the room, along with a visual alert system for the phone, door, smoke detector, and alarm clock. With advance notice (at least 60 days ahead) the ship will even provide sign language interpreters on cruises between the U.S. and Canada. 960 1280
Head to a Disney Theme ParkA Disney vacation is another great option for families, since the parks are sensitive to a wide range of needs. Those with vision issues can take advantage of handheld audio description devices, which provide visual details for various attractions and shows. Braille guidebooks and digital audio tours are available, and Braille maps are located throughout the parks. Service animals are allowed too.
Hard-of-hearing services include handheld, reflective, and video captioning, assistive-listening devices, and sign language interpretation at some of the live shows. However, sign language interpretation is available at other performances, such as Disney’s Spirit of Aloha, if it’s requested 14 days in advance. In-room options include TTY phones, strobe-light smoke detectors, and a bed shaker notification device. 960 1280