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Living with Diabetes

Going on Holiday

Plan your Holiday

  • CartoonBefore going away take time to plan your Holiday. Work out how much travelling is involved, the type of accommodation (urban or remote). If you are going abroad consider the impact of the difference in climate and food on your diabetes. Access to medical supplies and services may not always be available. Do not take it for granted that you can get a fresh supply of insulin if you run out!
  • It is a good idea to sort out your travel and health insurance to cover your stay. Make sure your travel agent or provider of travel insurance is aware you have diabetes. Diabetes UK offers travel insurance though it is a good idea to shop around for the best quote.
  • Calculate the difference in time zones and make a plan for adapting your insulin regime during your flight and change in schedule once you reach your destination. If you are not sure how to adjust your insulin or tablets, please contact your diabetes specialist nurse.
  • Make sure you take the right footwear - especially if you have a lot of walking planned.
  • If travelling to Europe, request  the E111 form from your doctors surgery or post office. This certificate allows you access to free medical care within the European Union.
  • Draw up a list of all the things you need to take with you. A sample list is given below.
  • Some travel agents are able to provide extra help such as arranging a fridge in your room
  • Taking needles and syringes on board an aircraft may prove difficult unless you warn them in advance!

Insulin

  • Take more insulin than you would normally need. If you are travelling with someone else its a good idea to put half your supply in the other persons baggage just in case yours goes astray!
  • If you use an insulin mixture, consider taking a small supply of soluble or 'clear' insulin which you can use if you are ill.
  • If you are travelling to a tropical climate take a cool bag or vacuum flask to keep you insulin cool. While on the plane always keep your insulin in your hand luggage to avoid the solution freezing in the hold.
  • Make sure you have an extra supply of pens and syringes in case you lose a pen or the device malfunctions.
  • Carry a letter or document which states that you have diabetes. You may find it difficult to explain why you are carrying a suitcase full of syringes and needles!
  • Airlines are not likely to agree to place insulin in a refrigerator. They will however provide you with enough ice to keep your insulin cool during a long flight

Dealing with time zone changes

Dealing with time zone changes is complex and best discussed with your doctor or diabetes nurse specialist. There is no definitive method for dealing with time zone changes and you are likely to discover your own preferred method of adapting. The following general tips are useful if there is a time zone difference of four hours or more in between home and your destination.

  • A long haul flight to the WEST ‘lengthens’ your day (or night) so you need to make up the insulin deficit. The easiest approach is to give your usual dose followed by an extra dose of soluble (short acting) insulin according to your blood tests
  • If you are on a long flight heading EAST, your day (or night) is shortened. Take half your usual dose of insulin before the flight and use your soluble insulin to cover any deficit.

While on Holiday

  • Many people are more active when on holiday and meal times are often erratic as you may be travelling. You are therefore likely to be at risk of hypos! Stay aware of hypo symptoms and make sure your travel companions can recognise the symptoms of hypoglycaemia.
  • Take care of your feet. Many ulcers start of as blisters on holiday. Wear footwear at all times and never walk barefoot on the beach. If you are swimming in the sea watch out for sharp shells, sea urchins and other sharp objects which are scattered on the ocean floor!

Vomiting and Diarrhoea

Traveller's diarrhoea is unfortunately a very common cause of a ruined holiday. Mass catering in resort hotels does have its problems. Watch what you eat - take sensible precautions and always drink boiled, cooled water or bottled water. If you do develop vomiting or diarrhoea do not omit insulin (see 'sick day rules'), keep up you intake of fluids and seek medical attention early before dehydration sets in.

Holidaying in the Tropics

  • do your homework! Find out about your destination and the climate.
  • Keep up a good intake of fluids. Avoiding dehydration is a key part of staying healthy in the tropics, especially if you have diabetes. Plenty of non-alcoholic drinks are recomended
  • sample local delicacies by all means but remember many 'sweetmeats' you may be offered on your travels in Asia and Africa may have a high content of sugar
  • Take precautions against mosquito and insect bites which easily become infected. Legs tend to be bitten if bare! Use insect repellents and plenty of moisturising cream especially if you are bathing frequently
  • take malaria prophylaxis if necessary
  • wear footwear on the beach - you can burn your feet on hot sand!
  • you may need a 'cool bag' to store and transport your insulin. Lightweight cool packs are readily available - have a chat with your diabetes nurse for more advice.
  • Its easy to forget the time when lying on the beach. Don't forget to take your insulin or meals.

Elephants in Sri Lanka

The elephants may be friendly in Sri Lanka, but the mosquitoes bite!

Holiday List!

Plan your holiday. If travelling abroad it may not always be possible to get fresh supplies.

Print this list off, and even if you forget your toothbrush don't forget your insulin !

  • Medications – insulin, syringes/pens, needles, 
  • Testing equipment – meter, test strips, lancets,
  • For Hypos – glucose tablets, Lucozade,  hypostop, glucagon
  • anti-sickness medication and anti-diarrhoea tablets
  • Emulsifying cream and sunscreens
  • Food – sugar free drinks, snack bars, biscuits
  • Sweeteners if you need them
  • Identification documents / bracelet (Medic-Alert) giving details of name, address and instructions for hypoglycaemia.
  • Travel insurance

And Finally....

Enjoy your Holiday!

 

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service
October 2002