As if type 1 diabetes is not challenging enough in our day-to-day lives, travel tends to make it pop its head up to gift us with some new issues we didn’t even think of. But that shouldn’t limit us or make us avoid anything - with the proper preparation and knowledge, nothing should be too big a trouble, and this article is here to help you with that.
We’ll cover some common sources of trouble -
And while proper preparation can usually keep you out of trouble, things do sometimes take a turn for the worst - and we have another article with information meant to help you out of nasty situations.
Dealing with time differences while traveling with diabetes
Crossing time zones might induce time differences that can mess up your treatment.
If you use a pump, adjust the hour on it so your basal rate fits your new timeline.
If you use long-acting insulin and you’re crossing several time zones, you have two options:
You can keep injecting your long-acting insulin according to your original time zone to avoid changes. However, this can be an awkward fit with your new time zone - nobody wants to wake up at 3 am every night inject their basal insulin... This option can work the best if the difference in time zones is not that big, or the trip is short enough that’s it’s not worth the trouble of changing your injection schedule.
You can also inject in your usual hour according to the new time zone. If you do that, try to gradually shift the time you inject your insulin by one or two hours a day rather than switching all at once. Changing your injection schedule too drastically might lead to too much or too little insulin on board around the day you shift.
Either way, setting up alarms to remind you when to inject your long-acting insulin can be helpful, as changes in injection times, routine, and environment might make you miss your shot even if you usually wouldn’t.
Foreign climates can affect both you and your insulin.
The weather can affect your basal rate, meaning you’ll need less or more long-acting or basal insulin. I find, for example, that being cold can have a similar effect on my glucose levels as mild physical activity – So I try to inject a little less long-acting insulin when I expect to be cold often. (This doesn’t apply the same if it’s cold outside, but I’m well dressed and feeling warm). When unsure, go with the safe bet of choosing low over high amounts of basal insulin and then see how it’s going.
Your insulin can last at temperatures of up to 30°C/86°F for up to one month. So if you’re traveling for less than a month and temperatures are below that, you probably have no reason to worry – just keep it out of the sun and enjoy your trip. If a fridge is available in your destination, keeping most of your insulin inside is your best option.
If it is hot outside or for any other reason you’re worried about keeping your insulin cold during your trip, using an insulin cooling case will ensure that your insulin stays cool & safe during your trip and prolong its life. I recommend our very own BreezyPacks (huge surprise, I know). They use specialized, actively cooling materials to keep your insulin cold when it’s hot outside and regenerate by themselves at room temperature, so all you have to do is place your insulin inside and let our packs do the work. I honestly think it’s the simplest and most comfortable solution. Still, it’s not the only one – another product that I’ve used in the past is Frio insulin cooling cases, which need to be soaked in water and then cool by slowly evaporating water. There are also plenty of simple insulated cases sold for insulin. However, be aware that insulation alone will not last as long compared to an actively cooled case, will usually keep less cold, and requires access to a fridge or something similar to cool your insulin after each time it loses its warmth.
Long journeys and activities
Long journeys on buses, boats, or cars require a similar organization to air travel: keep your insulin accessible and make sure to have enough food for cases of low sugar. Don’t go on a long bus or car ride and discover halfway through that all your food is in the trunk…
The activities you do during your trip can affect your glucose levels. If you go on a strenuous hike, for example, consider lowering your basal insulin levels the night before or injecting less long-acting insulin. I try to avoid having a lot of insulin on board before doing an intense physical activity of any kind, especially before ones during which dealing with low sugar levels might be difficult, like when engaging in extreme sports. Long-distance, multiday hikes, scuba diving, and other activities are their own world and require proper preparation; We plan to add specific articles for these, so stay tuned.
How to estimate the amount of carbs in foreign food?
Foreign food might be jarring when you’re not used to it, but I definitely wouldn’t avoid it – food is such a great way to experience cultures (and so many places have downright delicious traditional cuisine).
A relatively easy technique to estimate carbs is to “convert” the local cuisine to your own. Check what are the staples in your destination and compare them to ones you know: If you’re traveling to Central America, for example, you’ll want to know that Yucca (Cassava) has double the amount of carbs as potatoes, so for the same portion size you’ll want to inject double; Plantains have more than the similar-looking bananas, and are comparable to cooked white rice. To make things easier for you, we’re going to publish a nice little conversion chart soon, by destination :)
Do you have any other questions? Something you agree or disagree with in this guide? Let us know in the comments!