Diabetes Forecast

Tips for Traveling With Diabetes

By Tracey Neithercott ,

Vacations can seem idyllic until you pack. That's when reality hits: You've filled your carry-on with an entire wardrobe, a pair of shoes, and backup toiletries—but what about diabetes stuff? Start here to head off hassles.

Before You Leave

People have a tendency to overpack—bringing those backup shoes just in case the safari includes a formal dinner—except when it comes to medications. Along with any meds, there are a few other items that will come in handy.

What to Pack

Click here for a checklist; depending on your regimen, you may not require all items.

Stock Up. Refill any prescriptions and otherwise ensure you're well stocked with medications and devices (see "What to Pack"). Alene Kelsey Metcalf, 38, of San Antonio always brings double the amount of supplies she needs. "I learned the hard way over 9/11. I was traveling and got stuck in Seattle for four days. I ran out of syringes." If you use a pump, bring syringes and vials of long- and short-acting insulin as backup.

Note Your Contacts. Make a list of your health care providers, including their names and phone numbers, note your medications, and carry a copy of your health insurance card. If you run out of medication, experience a health problem, or have a medical emergency, you or a travel companion will know whom to call.

Plan to Communicate. If you don't speak the language of your destination, write down translations of diabetes terms. Include phrases such as I have diabetes, I need juice, and Where is the hospital? A good site for quick translations is https://translate.google.com/. Metcalf asked a coworker who spoke Mandarin to write "type 1 diabetic on insulin pump." The note helped Metcalf get through airport security in Shanghai.

Anticipate Screenings. To smooth your way through airport security, learn your rights. For answers to specific questions, call the Transportation Security Administration's toll-free help line for people with medical conditions at 1-855-787-2227. "I've gone as far as printing out the rules from [the TSA] website and giving it to them," says Kelly Kunik, who has type 1 and blogs at diabetesaliciousness.blogspot.com.

In Transit

Your bag is packed and you did indeed shut off the iron. Now it's time to hit the road!

Ease Through Airports. Carry a letter from your doctor explaining that you have diabetes. For using insulin and other injectables, the note should include information on how you take the meds—via syringes, pens, or an insulin pump—and if you use a continuous glucose monitor (CGM). A doctor's note isn't required by the TSA for a person with diabetes to pass through security, but having one makes the process go smoother if an officer questions your meds and supplies.

Device Safety

To ensure device function and maintain warranties, some manufacturers warn against walking through full-body scanners with pumps or CGMs or sending the devices through X-ray scanners. It's OK to take them through metal detectors, however.

Keep Supplies Close. Everything you need to care for your diabetes and any other medical condition should be packed in a carry-on. "I would never put anything critical in a checked bag," says Doug Dyment, a packing expert and founder of OneBag.com. The risks of temperature extremes, unpressurized cargo space, and losing your luggage are too great. Keep your diabetes supplies together and separate from nonmedical supplies. This makes it easier to explain your rights to a TSA officer if necessary.

Know Your Liquids. All diabetes supplies are fair game for carry-ons, including insulin, which is an exception to the 3-ounce liquid limit.

Manage Temperatures. Don't worry about keeping your opened insulin vials or pens cold—insulin in use will be stable at room temperature for about 30 days, says Janie Lipps, ANP, BC, CDE, diabetes nurse practitioner at Vanderbilt University Diabetes Center. If you'll bring backup insulin for a long trip, keep it cool during travel by using strategically placed cold packs. But be cautious: Too-cold temperatures are equally as damaging to injectable meds as heat and sunlight.

Load Up for Lows. Whether you're traveling by plane, train, or automobile, bring glucose tablets, candy, or gel to treat lows. And always pack more than you think you'll need for the entire trip.

Bring Some Eats. Pack snacks or a meal that you can eat in transit—in case there's no place or time to purchase a bite to eat. Even if your flight will serve a meal (which occurs only on long flights), packing snacks is smart.

Set Your Watch. When taking multiple daily injections and crossing time zones, use background (long-acting) insulin at the same time you take it at home, says Lipps. That is, if you take it at 9 a.m. at home but traveling east has put you three hours ahead, you'd take insulin at noon. (Wearing a watch set to your home time zone can help.) Short-acting insulin can still be taken at mealtime, regardless of the time change. Different rules apply to pumps. "With a pump, it's good to change [to the destination time] as soon as you start flying," says Lipps.

Wear an ID. Identify your name and conditions on a bracelet or necklace, just in case.

Safety Abroad

Access to safe medications and best-practice medical care is not guaranteed in every country; these travel tips can help.

Politely Point. Should you need an emergency prescription refill, be comfortable asking for your medication in the country's language. Pointing to phrases written on a note card will do the trick.

Head to the Hospital. When it comes to pharmacies in some foreign countries, "the thing you have to be careful about is, where did the medication come from?" says Dyment, who notes that this isn't an issue in most Western European countries. If you're in another region, you may want to go to the hospital, not a pharmacy. If you're really in trouble, contact the American embassy. Also, be aware that some countries use insulin that's a different concentration than U.S. U-100 strength.

Check Insurance Coverage. How you'll pay for an emergency hospital visit abroad depends on the country. In some, you'll need to pay out of pocket and then submit the charge to your insurance company when you get home. (Not all plans reimburse expenses from overseas travel; check with your plan to find out.) You can buy travel medical insurance, but policies often exclude preexisting conditions. According to Kelly Regan, editorial director of Frommer's travel guides, companies such as InsureMyTrip.com and SquareMouth.com provide coverage for medical treatments and emergency evacuation.

Count on Exercise. Chances are, you'll be doing plenty of sightseeing—and walking. More activity than usual may put you at risk for hypoglycemia. Carry a source of glucose at all times. If you use insulin, a lower dose may be necessary.

Protect Your Papers. Carry your passport, credit cards, the letter from your doctor, and money on you at all times. (Dyment recommends using a wallet pouch that you can keep under your clothing.) If you're traveling with a lot of cash, consider leaving some in your suitcase. "I split [my money] up to make sure that, if for some reason I was mugged, I have backup," says Brian Phelps, 48, who travels often for work.

Thwart Pickpockets. Load your supplies into a bag that you wear across the front of your body—not in a backpack. Backup meds and supplies left in your room are generally safe at reputable hotels, but not when left at hostels or campsites.

Invest now in travel preparation and gain more time to kick back and enjoy your journey. It might be the difference between relaxing with a glass of wine in Paris and waiting in line at the hospital for more insulin, s'il vous plaît.

Expert Travel Tips

"I know insulin pump companies sometimes give out loaners so you have a backup."—Kelly Kunik, blogger with type 1 diabetes

"Always take a little extra medication. Never assume that just because you're scheduled to fly back on the 14th, you're going to get home on the 14th."—Doug Dyment, packing expert

"In the States, you can go into Walmart or Walgreens and buy your brand of meter and the strips. . . . You don't need a prescription for that."—Janie Lipps, ANP, BC, CDE

"Especially if you're going to be doing a lot of sightseeing, make sure you have plenty of glucose with you. Test often. The amount of walking you'll do is deceptive." —Alene Kelsey Metcalf, traveler with type 1 diabetes

"Keep your cool with the TSA. Nobody feels like they're going to lose it more than I do at times, but stay calm and state your rights. It's hard to argue with a person who's calm and stating the facts."—Kunik

"Before you go, ask your pharmacist to print out your prescription in the language of the country you're going to visit."—Anne McAlpin, PackItUp.com

"Batteries are a big thing that people forget. In other countries, batteries tend to be really high-priced items."—Kelly Regan, Frommer's travel guides

"A lot of [U.S.] pharmacies are computerized so you can go to CVS and have them call Walgreens for your prescription." —Lipps

"If you haven't traveled and you want to go but you're worried, a cruise is a good option. Large cruise ships have a medical facility on board."—McAlpin

"If you're going out of the country, you want to call your credit card company and let them know that's you spending the money."—Dyment

"Having diabetes doesn't mean you can't travel. It just means you need to travel with smarts."—Kunik



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