This is vacation season and diabetes shouldn’t be a barrier for exploring the world. Any journey to your destination, be it short or a long haul, even hours spent sitting and inactive during a drive or on a plane, can affect your blood sugar levels. Of course there will be delayed meals, unfamiliar food and if out of the country, then time zone challenges. But there is no need to worry. All you need is a little planning so that you can lessen your worries. Remember, diabetes is all about management.
1) Read the latest information about packing your supplies. Be absolutely sure of what is permitted and not permitted in carry-on and checked in baggage.
2) Carry a medical ID or prescription that states that you have diabetes, just in case of an emergency. Make sure you carry your hypoglycemia (low blood sugar) handout with you. This will help you to let air attendants know what to do in case of a sudden drop in blood sugar.
3) Don’t keep your insulin in your check-in luggage as it could get affected with changes in temperature and cabin pressure. Inform the security staff if you are wearing an insulin pump.
4) Keep healthy snacks with you in case the meal is delayed, or the meal provided does not have enough complex carbohydrates and protein.
5) Inject insulin only when you see the cabin crew come down the aisle with the serving tray. If you take your insulin too much in advance, the delay in the meal reaching you could lead to a drop in your blood sugar.
6) Remember, if you are heading to an international destination, travelling west makes you gain time and travelling east makes you lose time. This could affect your meals and how much medication you need. Always discuss with your doctor and diabetes educator prior to travel involving different time zones.
7) If you are flying to the west, the day will be longer. Because of this, you will need to take an extra dose of short-acting insulin with the extra meal 4-6 hours after your third main meal of the day.
8) If flying west to east, you will probably be having one less injection of short-acting insulin. You should continue to take your long-acting insulin at usual time.
9) The timing of oral medication is not as crucial as that of insulin. If you are on a twice daily regimen of sulphonylureas, it might be better to skip a dose when travelling time zones than to take two doses together and risk low sugar. Patients on medicines like SGLT2 inhibitors (gliflozins), DPP4 inhibitors (gliptins), or metformin can continue their usual routine.
10) Patients on insulin pump can continue the same regimen but they will have to change the time setting on their pump once they reach their destination.
11) Usually, most airlines exempt the 100 ml rule for people with diabetes for medicines, fast-acting carbs like juice and gel packs to keep insulin cool.
Most people overeat during vacations and festivals. For diabetics, it is even more difficult to manage their meals and find a balance. To indulge and enjoy while still managing blood glucose is not easy. So, you must know about foods that spike the blood glucose and distribute them judiciously throughout the day instead of having them at one meal. For example, distribute carbs evenly throughout the day.
1) Pack healthy snacks like nuts, roasted makhana, roasted chana murmura, seeds etc to munch on as mid-meals.
2) Instead of cold drinks and sweetened beverages, have coconut water/buttermilk/plain lemon water.
3) Maintain meal and medicine timings.
4) Have protein and vegetables in each meal.
5) Most restaurants have nutrition facts available, check the carb and fat content of dishes you want to eat.
6) Load your plate with vegetables, lean meats or meat substitutes like soya/ low fat paneer/ legumes and some portion of whole grain.
7) Most restaurants may also customise your meal as per your need and make it healthy for you.
8) Avoid flour, sugar, fried food, bakery products and sweetened beverages.
1) Always carry a prescription for carrying medication and insulin.
2) Take twice the quantity of medical supplies (medicine, insulin and glucometer strips) you would normally use for diabetes control.
3) In addition to carrying extra supplies, carry glucose tablets and glucagon injection if available. It’s always good to include pain killers, anti-diarrhoeal and anti-allergic medicines in your travel kit.
Please ensure that you have the facility to contact your doctor or his team while travelling. Many doctors nowadays provide telemedicine services. It is important to be able to connect if you face a major problem while away.