Whether for work or pleasure, travel can and should be fun and having diabetes doesn’t mean you can’t travel. With good planning, your trip can be safe, fun and hassle-free whether you’re going interstate or overseas.
Planning for Overseas Travel
If you’re planning a trip overseas, you will need to think about allowing for different foods, how to cope with changes in time zones, possibly vaccinations and extreme climates. You will also need to be well prepared for mishaps such as long delays and misplaced baggage.
There are many things to consider before you leave, such as airline regulations, a well-timed itinerary, in-flight needs and being prepared for that ‘what-if’ situation. Good planning is the key.
Plan Your Travel Itinerary and Make Bookings (Three Months Prior)
- Plan travel itinerary and make bookings.
- Check airline regulations.
- Arrange travel insurance for health and belongings.
- Check vaccination requirements.
- If you wear an electronic device to monitor blood glucose levels or infuse insulin, check with the airline to see if these devices can be operated in-flight.
When booking your flights, you may choose to tell the airline you have diabetes. This will be passed on to the cabin crew who are trained in meeting your needs during the flight.
In general, ‘diabetic’ meals served in-flight can be quite bland and no longer necessary. However you may choose to order meals that are low in saturated fat and high in fibre and carbohydrate at the time you make your bookings.
Check Airline Security Regulations (Three Months Prior)
Be sure to make arrangements in advance so that you comply with Australian airline security regulations specifically for people with diabetes. The regulations are:
- You must carry all diabetes supplies including testing equipment, insulin and Glucagon delivery devices (syringes and pen needles and insulin pump consumables) in the hand luggage of the person who has diabetes and whose name appears on the airline ticket. It is advisable to pack extra insulin in checked-in luggage.
- Your name must appear on all insulin and/or Glucagon script labels.
- You must carry scripts for all medications and check them before you go to make sure they are readable. Each script must include your name, the name and type of your medication and your doctor’s contact details.
- You must carry your the National Diabetes Services Scheme (NDSS) card, as it is accepted as primary proof that a person with insulin treated diabetes needs to carry with them their diabetes equipment. Supplementary photographic proof of identify, such as a driver’s licence or passport may also be required.
- You must carry several copies of a letter from your doctor which you will need to get through Customs. The letter should outline any medical conditions, any medications you take and the devices you use for your insulin and blood glucose testing, such as insulin pens, syringes and needles or pump unit. It should also stress the importance of carrying your medications with you. Check beforehand the letter is readable!
- International travellers can carry no more that 100 ml of liquid per container, including aerosols and gels, in their carry-on baggage. All liquids must fit into a transparent resealable plastic bag no bigger than one litre (approx. 20 cm by 20 cm). People with diabetes who need to carry supplies of insulin are exempt; however, they will be required to present the insulin at the security point and carry proof of their condition and need for insulin.
If you are not travelling with an Australian carrier, be sure to check in advance with your chosen airline for specific security guidelines.
Arrange Travel Insurance (Three Months Prior)
You should arrange travel insurance, both for you and your belongings. Make sure your accident and health cover applies to pre-existing conditions and the places you will visit.
The Australian Government has arrangements with a number of countries providing travellers with benefits similar to Medicare, but these are typically only for acute or emergency care.
Talk With Your Doctor (Two Months Before)
- Make an appointment to have vaccinations (if required).
- Make an appointment with your doctor or Credentialled Diabetes Educator to discuss travel plans, time zones, and other ‘travel’ tablets required.
- List and buy any special clothing items required; for example, comfortable, well fitting shoes.
At least two months before leaving, talk to your doctor about your travel plans. It is important to discuss your medication/insulin adjustments, Glucagon and testing for ketones during the trip. This is also a good time to arrange the papers you will need to comply with airline regulations.
If your planned trip has different time zones, discuss this too. What you do will depend on your medications and/or your type of insulin. Your doctor may advise you to follow your normal routine until you stop travelling, have a long sleep and then start from scratch when you wake up. On the other hand, you may be given specific information about any medication or insulin changes you may need.
During long hauls, support hose can help to prevent swelling and may reduce the risk of clotting in the veins of the legs. Check first with your diabetes team if this is okay for you. For some people with reduced circulation, due to conditions such as peripheral neuropathy (a condition caused by damage to the nerves in the peripheral nervous system which typically affects hands, feet and legs), they may not be suitable.
Important information about any vaccinations required can be obtained from your doctor or specialised travel medical centre. They will also advise you of other tablets you may need to take with you just in case, to treat diarrhoea or nausea.
One Month Prior to Departure
- Arrange all paperwork required including a letter from your doctor, scripts for all medications, written details of next of kin and NDSS and Medicare cards.
- Arrange all diabetes medication and testing devices required for entire trip including medication, insulin, syringes/pen needles or pump and consumables, lancets, test strips, meter (plus a spare if possible), Glucagon and delivery devices.
- Check and arrange all other medical requirements including medical identification.
What to Pack
When packing your bags for your trip away here are a few things you should consider:
- Include a small approved sharps container, available from your state or territory diabetes organisation or your pharmacy. Many hotels and airports offer a sharps disposal service for your used lancets and syringes.
- Estimate what medication, test strips, insulin and syringes you will need for the entire trip and pack more than you think you will need in case of loss or damage.
- If possible, pack a spare meter.
- Take a small first aid kit with you in case of aches and pains, minor cuts and burns.
- Pack comfortable, well-fitting shoes.
- If you are taking insulin or diabetes tablets, carry some form of fast-acting carbohydrate, such as glucose tablets or jelly beans in case of a ‘hypo’, plus some biscuits or dried fruit.
- Pack an insulated bag for storing your test strips and your meter’s user manual if you are travelling to a place that may be extremely hot or cold.
- EXTRA PRECAUTION - Pack clearly written details of your next of kin or family member.
Impact of Extreme Temperatures
Extreme heat or cold can affect your ability to manage diabetes.
Insulin and blood glucose test strips should be kept under 30 degrees. The strips will be damaged by temperature extremes. To protect them from freezing or from extreme heat take a small insulated bag which you can buy from your state or territory diabetes organisation. When flying, make sure you carry it in ‘carry on’ luggage.
Accuracy of blood glucose results is also affected by temperature. As temperature ranges vary for conducting a test, consult your meter user manual for your meter’s operational temperature range.
Travelling by Air
Carry all your medication, insulin, Glucagon, delivery devices and testing equipment in your carry-on luggage, preferably split between two of your bags in case one goes missing. Unless you are travelling alone, it is a good idea to give one bag to your travelling partner to carry.
Pack a separate small bag with the bare minimum of insulin, injection devices, testing equipment and hypo treatment needed for the flight. If taking a long flight, pack enough for the first leg and refill it before each new leg.
EXTRA PRECAUTION - Wear some form of medical identification that says you have diabetes.
At the Airport
Arrive early to avoid rushing.
It is considered unlikely that insulin would be harmed by exposure to x-rays in security equipment. If you are concerned, you may ask airport security staff to physically check you and your baggage rather than going through the x-ray equipment. Security staff members are obliged to respond to such requests under regulations administered by the Department of Infrastructure and Regional Development.
If you use an insulin pump you are not required to remove your pump at a security point. If this is requested, you have the right to request access to a private consultation room, which security is obliged to provide. You are also able to request this room if discussion about your condition is required by security staff.
During the Flight
During your flight there are a number of things you can do to ensure you have an enjoyable journey.
- You may decide to tell the flight attendant at the start of the trip that you have diabetes so your needs are well catered for. However, this is a personal choice.
- Keep your diabetes supplies where you can reach them immediately, perhaps in the seat pocket in front of you but not under the seat or in the overhead locker.
- Always wait until your meal is on the table in front of you before administering insulin. For added safety, you can take your insulin halfway through or immediately after your meal in case there is a major unforeseen interruption.
- Avoid alcohol.
- Drink enough water to avoid thirst and becoming dehydrated.
- Sleep whenever possible and ask the cabin crew to wake you for meals.
- Wear comfortable shoes and exercise your feet to help prevent swelling.
- Move around the cabin as often as you can. Walking up and down the aisle will assist circulation and help to keep your blood glucose levels under control as well as help prevent deep vein thrombosis. If you’re not able to walk around then regularly move your feet and legs in your seat.
The decreased activity while you are on the plane trip, together with the amount of food given often results in increased blood glucose levels. These return to normal once a more usual lifestyle has been resumed at your destination.
If Something Goes Wrong
With all that planning, something going wrong is unlikely. However, don’t panic if you need to seek medical assistance when required, if possible, with advice from your travel insurer. Most costs can be recovered through health benefits or through your own medical insurance when you get home.
With careful planning and taking a few precautions, diabetes does not stop you from having a trip that is memorable and hassle-free.