Traveling With Diabetes

One of the most anxiety provoking activities is planning a vacation and actually enjoying it.  Much advance thought is required to map out travel arrangements, destinations, and recreational activities.  Considering the additional planning required for a child or teen with diabetes - travel arrangements, different food choices, and activities - these can cause blood sugar fluctuations.

The key to an enjoyable vacation is to "expect the unexpected" and prepare as best as possible for different contingencies. Packing duplicate items (and triplicate) that are required for diabetes self-care and treatment is obligatory. You must remember to carry everything that you may need on board (plane, train, automobile, and boat) so you won't be without equipment or medication in an emergency.  A travel letter documenting supplies is good to have on your person (see sample), as well as the original labels on all medication. Carry your diabetes team phone numbers with you so that when in a Paris, France, pharmacie, the pharmacist (who hopefully speaks some English), can give you insulin after you left your insulin on the tour bus!  Be prepared to be flexible and expect markedly variable blood sugars. Keep in mind that foods will be prepared differently and that carbohydrate counting will be a major challenge. Still want to go? OK, good!

Traveling Tips

1. Actual travel: I have attached two travel letters that the Children's National diabetes team provides for all "travelers." In addition, I provided an algorithm to help manage insulin while traveling through different time zones. Keep in mind that your diabetes team may have specific unique instructions. I am providing ours in case you do not have any other references.

The following algorithms for adjustment of insulin dosage during travel are based on Management of Diabetes During Intercontinental Travel by Edward Bensen, MD, and Donna Hamilton, RN, CDE, with adaptations by the Diabetes Team at Children's National Medical Center and special assistance by Celia Henderson, RN, CDE, CPT.

Adjustment of Insulin Dosage

The management of diabetes is usually based on a 24-hour medication schedule. When traveling north or south, no adjustments in the 24-hour schedule are needed. However, east or west travel across time zones extends or abbreviates the day, depending on the direction of travel. When five or fewer time zones are crossed, no change is required in the usual insulin routine. When crossing six or more time zones, however, adjustment in the usual schedule is advisable.

Frequent blood glucose monitoring is essential for safety. In addition to the typical measurements before breakfast and dinner, travelers should check blood glucose levels whenever their daily routine is disrupted. When in doubt, measure. If the person feels even slightly ill, blood glucose should be measured.

Traveling East Across Six or More Time Zones

Two or Three Dose/Day Schedule