The diabetic while travelling 'abroad'

Going on holiday should be a time of rest and relaxation, a time to get away from the daily routine, a time to enjoy new things. Being diabetic should not prevent anyone from having a good time provided that they have planned ahead. In general, such planning is very much based upon a mixture of common sense and experience. For instance: a diabetic who spend 50 weeks of the year sat behind a desk operating a computer and answering the phone would find 2 weeks climbing in the Himalayas a little different and so will need to think about changing their control regime!

The planning process

• Split the holiday into 3 sections i.e. the outward journey, the 'holiday' itself, and the return journey including a few days after getting back home.

• For each section think about what food will be available and when? Will the food be different to what you are used to? Will it be easy to obtain whilst you are travelling? How will you assess the carbohydrate content of 'new' foods?

• What activities will you be involved in during the 3 sections? Will you be more or less active than usual?

• Are all of your documents up-to-date and will they still be valid whilst you are away. For example: if you intend to drive whilst on holiday does your insurance cover you to drive abroad? Does your diabetes affect whether you can use a 'hire car' or not even if it part of the holiday package that you are buying? Does your holiday insurance provide you with the correct level of cover - are you certain that you have fully informed the insurance company of your medical condition and so you have the 'correct' cover?

• Are there going to be any issues relating to your medication? Not all types of insulin are available worldwide; even those that are common in most countries are not always available in the same strengths and so will require differing syringes. Insulin is sensitive to temperature variations and so how are you going to try to keep it from getting too hot or too cold? Not all aircraft have heated luggage sections and so it is vital that when travelling by air insulin MUST be carried in the in-flight hand luggage.

• Are your vaccinations up-to-date? Certain vaccinations can have mild side-effects which could make you feel a little 'of-colour' and so it would be better to have them done earlier than later! The most obvious place to go for advice and guidance is the diabetic advisor (GP, Diabetic Clinic or whoever the diabetic normally sees), who will be able to help work out how medication and/or diet will have to be adjusted in order to allow for all the possible changes due to the holiday. He or she will also be able to give advice on what to do in case of holiday 'bugs' such as diarrhoea and or sickness.

What to take with you

• Take at least twice as much medication, syringes, pens, needles etc as you would normally require - just in case!

• If you are travelling with a companion split your medication between the 2 of you – just in case. Ensure that your medication is in your hand luggage BUT check with the airline about the rules concerning syringes etc as the bulk of these may have to go 'in the hold'.

• If you are going abroad, ensure that, along with your 'normal' holiday paperwork you have a letter from your doctor or diabetic advisor confirming your medical condition and that you need to carry syringes etc.

• A basic first aid kit.

• Your blood monitoring equipment including a spare battery - just in case!

• A cool bag for storing your insulin.

• Your diabetic identity card or jewellery. Plenty of glucose tablets or whatever sweets etc you carry - just in case!

• A supply of carbohydrate in your hand luggage just in case there is an hold-up, delay etc and you cannot find anywhere to get a meal at the appropriate time.

• A list of your medication and the appropriate dosage - just in case you are unable to explain to someone yourself as to what you take and when.

Unusually 'things' to be aware of

• Insulin may be absorbed quicker in warmer climates which might affect your blood sugar balance. As such, more regular blood sugar monitoring at the start of the holiday is recommended to ensure that you can adjust your dosage accordingly. Do not forget to check the situation again when you get home.

• A change in altitude, as you go up and down mountains, can cause air bubbles to form within the cartridges used in 'insulin pens' and so care must be taken not to allow any air bubbles formed to adversely affect any injection.

• Altitude, heat and humidity might affect blood sugar monitoring equipment and so you need to be aware of the possibility of a false reading!

• In cold regions you may well shiver more than usual - shivering uses up energy and so can lower your blood sugar levels!

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