Traveling with diabetes — plan ahead

Summer has arrived for many of us, and summer makes me think of travel and camping trips. Traveling with diabetes requires a little advance planning. Preparation depends on where you're going and what you're doing. The American Diabetes Association (ADA) provides some good travel trips that I'd like to share:

See your doctor before leaving

Ensure good blood sugar control. If your blood sugars aren't well controlled, allow enough time before your trip to improve control before you leave. I'd also recommend seeing a certified diabetes educator, if possible, for help.Get a letter and prescription from your doctor. Ask for a letter and a prescription with a list of your medications for diabetes pills or insulin shots. The prescription will cover you if you run out or lose your insulin or medications while away. However, in the United States, prescription laws may vary from state to state. When my son forgot his insulin, we went to a pharmacy from the same chain that he usually gets his prescriptions from and he was able to get a vial of insulin. Prescription laws may be different if you're traveling abroad. The ADA recommends that you write for a list of International Diabetes Federation groups — see www.idf.org.

Prepare for an emergency abroad

Know how to find a doctor. You can get a list of English-speaking foreign doctors from the International Association for Medical Assistance to Travelers — see www.iamat.org, or call 716-754-4883. If you have an emergency while traveling and you don't have a list with you, you can contact the American Consulate, American Express, or local medical schools for a list of doctors.Wear a medical I.D. bracelet or necklace. It's important to wear identification that states that you have diabetes. It could also be helpful to know how to say "I have diabetes" and "Sugar or orange juice please" in the language of the country you'll be visiting.

Pack extras

Pack extra medication and insulin. Aim for at least twice as much as you think you'll need. Keep your medication and insulin with you in a carry-on bag, because checked luggage can be lost.Keep snacks available. Bring well-wrapped, air-tight snacks such as crackers, cheese, peanut butter, fruit, and some form of sugar, such as hard candy or glucose tablets, to treat low blood glucose.Protect supplies from heat. Insulin stored in very hot or very cold temperatures may lose strength. So, don't leave your insulin in the car. Meters and supplies are also sensitive to extreme temperatures. If you're camping or backpacking, consider storing insulin or meter supplies in a cooling pack made specifically for diabetes supplies.

Understand potential insulin issues

Try to use the same insulin. Stick with the exact brand and formulation of insulin as prescribed by your provider. But if you run out while you're on the road and you're unable to fill your prescription for some reason, you can buy NPH or regular insulin over the counter in the United States. Contact a physician for equivalent doses. You can discuss this with your physician before leaving for your trip.Be aware of differences abroad. In the United States, insulin is usually sold as U-100 (100 units of insulin per mL). Outside the United States, insulin may come as U-40 (40 units of insulin per mL) or U-80 (80 units of insulin per mL). If you need to use these types of insulin, you must buy new syringes to match the new insulin. When my son had emergency surgery for an appendectomy in Ukraine, he was allowed to use his own insulin. Adjust for time zone changes. If you're crossing several time zones, talk to your doctor or a certified diabetes educator to help you plan the timing of your injections. Bring along your flight schedule and information about the time zone changes. Note that if you need to inject insulin during a flight, be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can cause the plunger to "fight you."

Take care once you're there

Monitor your blood glucose more often. Jet lag may make it hard to tell if you have high or low blood sugar.Carry hypoglycemia treatment. If you're more active than usual, your glucose may go too low. Carry along snacks if there's a possibility that meals will be delayed or missed.Be careful about what you eat. Avoid tap water overseas, and ask for a list of ingredients in unfamiliar foods.Protect your feet. Wear comfortable shoes, and check your feet daily for blisters, cuts, redness, swelling and scratches. I talked to a man who'd hiked in the Arizona desert for several hours; when he got home, he saw blood on his socks. A cactus needle had pierced through his shoe and wedged a quarter-inch into his foot! Because he had peripheral neuropathy, he hadn't felt it.

Lastly, it can be helpful to prepare for airport security if you're flying to your destination. Check the ADA's webpage on air travel and diabetes for more information about how security measures may affect you — www.diabetes.org.

Happy travels!

Peggy

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