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
Peanuts at 30,000 FeetPeanut allergies are among the most severe, yet peanuts are synonymous with in-flight snacks. Many airlines no longer serve peanuts–check the airline website for policies–though other passengers may bring peanut snacks aboard. Airlines such as Southwest will not serve peanuts if contacted a few days before the flight. Speak to a gate agent before your family's flight and ask to pre-board in order to wipe down the seat and area where your family will be seating to remove any peanut dust and particles. Flight attendents can also make announcements before takeoff asking passengers to please not open peanut-containing snacks during the flight. 960 1280
Give Yourself Extra Time for SecurityIf you travel with more than 3 ounces of liquids, such as almond milk, peanut butter or apple sauce, it's helpful to have a doctor's note to present to TSA agents, if necessary. Give yourself extra time in security for additional screening of items, but you shouldn't have any trouble getting an exception. 960 1280
Epinephrine InjectionsThe TSA considers epinephrine injectors a medical necessity, and allows them to be carried aboard flights. Epinephrine injectors should be bagged with other carry-on liquids for inspection. At least two injectors should be available (consider one injection lasts for about 20 minutes), and if you're traveling alone, notify your flight attendent where your injectors are should you go into anaphylaxis. Make sure they are clearly labled and accessible. Airplanes carry at least one epinephrine injector in the onboard medical kit as well, and flight attendents are trained in their use.