Have Diabetes? Travelling Days are Not Over

Living with diabetes does not make people housebound for the rest of their lives. You can live a normal life and enjoy most of the activities along with the rest of your family.Travelling either on work or for pleasure is a common activity. For a stress free and enjoyable  time, be aware of the problems you may face, plan out and organize your activities, and make a few adjustments as required.

What are the problems one may face while travelling? Many factors such as missed medication, change in exercise routine, climatic factors such as temperature and altitude, illness,
change in diet, and changes in sleep timings upset blood glucose control. Infections , especially of the foot and the skin , and hypoglycaemia are also areas for concern.

Travelling in India can be challenging due to the different climatic and geographical conditions, lack of hygiene and overcrowding.

General care includes

• Care of the feet and regular checks for any changes
• Not walking barefoot in hotels rooms
• Comfortable sturdy shoes that don’t pinch the feet
• Using sunglasses, caps, long sleeved clothing and sun screen for protection from the heat and humidity.
• Precautions to prevent physical injury
• Avoiding the swimming pool.
• Clean, uncontaminated water and hygienically prepared food.
• A Diabetes Identification tag in case of emergency.
• Taking the minimum quantity of ‘prasadam’ if on a pilgrimage, as it is usually made of sugar and ghee,
• and not bathing in public spaces.
• Frequent monitoring of blood sugar levels.
• Quick snacks and medications at hand.
• Consuming plenty of water to prevent dehydration and hypoglycaemia in hot humid places.
• Good fitness levels when travelling in high altitude areas.
• Walking about to improve blood circulation during long journeys.

  If travelling by air…

1. Pack twice the quantity of all your medications and diabetes supplies to last the journey in case of unexpected delays or losses.
2. Keep medication in original packing and carry in the hand luggage. 
3. Be familiar with the generic name and brand name of the medications you use as many may be available under different trade names in other countries.
4. Get a letter from a diabetologist for security or customs clearance for medications and medical devices. It will also be helpful to replace lost or stolen or damaged medication or to get medical attention abroad.
5. Blood glucose is measured in different units in other countries . Know the conversion and have a conversion chart handy.
6. Monitor blood glucose every 4 – 6 hours while travelling long distances because changes in meal times and activity levels can upset blood glucose levels.
7. Pre- order diabetes friendly meals and carry snacks such as cereal bars, whole wheat or multi grain  sandwich, puffed rice and roasted Bengal gram and biscuits in case of delays.
8. Drink plenty of water.
9. If using insulin, learn to make dose adjustments according to the time if crossing more than 5 time zones.
10. Do not adjust your watch to local timing so that you get a better idea of the time.
11. Inform flight attendants or staff at destination about your condition.
12. Medication and monitoring equipment can be given to the flight attendants for storage.
13. Check opened insulin bottles for crystallization before you use them.
14. If using insulin pumps, continue with the normal basal and bolus doses till you reach your destination.
15. Carry extra batteries and supplies of insulin and syringes in case the pump does not work properly.

 If travelling by train or road – 

• Do not drive more than 12 hours at a stretch and do not wait for more than 6 hours between meals.
• Do not drink alcohol before you travel.
• Carry suitable snacks and inform travel companions in case you feel the signs of hypoglycaemia. Take immediate action in case you show signs of hypoglycaemia. In case of hypoglycaemic symptoms, stop and take some quick acting glucose.
• Do not drive if complications have started.
• People using oral medications can miss a dose and have a slightly raised blood glucose level for 6 – 8 hours rather than take 2 doses close together and get hypoglycaemia.
• If you are using medications such as caboose that prevent absorption of carbs, continue the usual regimen of taking it before meals.

The more you travel the easier it will get. People with diabetes who are travelling should meet with the diabetes educator before the journey to find out whether they are fit to travel, about vaccinations, travel
insurance, effect of weather on blood sugar level, diet plan to be followed, and storage of medications.
Talk to people who have travelled and share experiences. An informed person can make good
choices and travel confidently.