People have a tendency to overpack- bringing those backup shoes just in case the safari includes a formal dinner- except when it comes to medication. Along with any meds, there are a few other items that will come in handy.
Refill any prescriptions and otherwise ensure you're well stocked with medications and devices. 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.
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 babelfish.yahoo.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.
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 diabetesailciousness.blogspot.com.
Now your bag is packed and you are ready to go! Time to hit the road.
Carry a letter from your doctor explaining you have diabetes. For those 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.
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.
All diabetes supplies are fair game for carry-ons, including insulin, which is an exception to the 3-ounce liquid limit.
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 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.
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.
Pack snacks or a small 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.
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 will 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.
Access to safe medications and best-practice medical care is not guaranteed in every country; these travel tips can help.
Should you need an emergency prescription refill, be comfortable asking for your medication in the country's language. Pointing to the written phrases on a note card will do the trick.
When it comes to pharmacies in 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.
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 evaluation.
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.
Carry your passport, credit cards, letter from your doctor, and money on you at all times (Dyment recommends using a wallet pouch 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 often travels for work.
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.
If you are a diabetic and do not currently see a podiatrist for diabetic foot care, call our office to make an appointment.
Richard E. Ehle, DPM
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