TRAVELLING WITH DIABETES (0617)A bit of a trial for anyone, there’s an extra level of anxiety when travelling with diabetes. Going overseas now inevitably involved passing through security, which is fair enough, but we have to do it while keeping our insulin safe (ie. taking liquids onboard), carrying sharps (needles, lancets) or we may even be wearing a medical device (insulin pumps, and particularly CGM, which incorporates a transmitter). These mean a ‘pat down’ by a member of border control is almost a dead-cert. It’s so inevitable, there’s no point in resisting, objecting or being bothered. Just be prepared and go for it.
Keep your kit with you. You could pack spares into luggage that goes in the hold, but all insulin and other medications are best kept right where you are, you would not want to be separated from them should your luggage end up at another destination than your own, and insulin can not go in the hold as it could freeze even on short flights, which will render it inactive. It should be fine carried in your hand luggage and kept with you; there is no need to refrigerate nor necessarily to keep it cool, though items like a Frio bag help keep it safe. Keeping it cool only really matters if you destination is very hot, or if you are waiting in a hot airport.
None of the insulin pump suppliers have done the necessary tests with X-ray to prove that their devices are not affected by going through X-ray. To be on the safe side, take it off, keep it in your hand, and show it to the security personal explaining is it an insulin pump. They are likely to swab it, but they should know what an insulin pump is, even if they may not have seen one before. Likewise, it is possible that repeated exposure to X-rays may affect insulin effectiveness, and air cabin pressure may affect accuracy of dosing on a pump. In the main however, occasional flights should not lead to trouble so don’t worry, just take care and keep blood testing.
CGM is a little more complicated, as you are wearing a transmitter, plus should your glucose be too high or low you would have to deal with the alarms should they go off. Having said that, if you need that kind of information to keep you safe while you take a flight, then that’s exactly what it’s there for. You could plan to just carry your next sensor (with all the gubbins that inserting one requires) and put it on when you get there. Or if you have the wherewithall, use a Libre glucose monitor instead for the duration of your holiday. They are more discreet, but still tell the security personnel if you are wearing one so it’s not a surprise to them if you do get a pat-down.
Blood test meters and some insulin pumps and CGM equipment may use batteries, for which you may want to carry spares too while travelling, these all need to be shown at security as they are among items not allowed onboard flights.
Going the distance
Long-distance flights need extra planning around food intake, insulin dosing, adjusting around international time variations and generally trying to get comfortable for the duration.
When travelling long-distance, it stands to reason that you’d want to keep blood testing so you know what’s going on, so make sure you keep your kit handy. You will probably need to amend your insulin doses, both in terms of amount (you may need slightly less as you will be sat in a seat an inactive) as well as timings, amending them based on the time zones you are heading towards. You can plan a schedule of injections by plotting them so that you do smaller injections more frequently, which is particualry helpful for background insulin doses which are normally taken once (or sometimes) twice a day. This is much easier on an insulin pump, where you can keep updating the time on the pump every few hours or so, keeping your basal delivery rate in keeping with how your daytime hours are shifting.
For more general aspects of comfort while on a long-distance light, you might want to consider taking a pair of compression socks with you, and wearing them during the flight. Not everyone is at risk of deep-vein thrombosis (DVT), but long-distance can increase risk. According to NHS/Livewell, wearing compression stockings during flights of four hours or more can significantly reduce your risk of DVT, as well as leg swelling (oedema). The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Fitlegs is a new brand from suppliers G&N Medical, which has a record for post-surgery compression socks and has recently branched out with ranges based outside the hospital arena with a range of diabetes socks and everyday compression socks ‘for work and travel’. The soft material they are made of has no seams, has heel support, comes in four sizes and has a compression level of 14-17mmHg (a measure of pressure using mercury as used in pressure gauges).
Jet lag should no longer be a cause for concern when booking long haul holidays if you follow guidance from The Sleep Council, which advocates that you drink plenty of water on your journey, and while on holiday, to keep your body feeling hydrated and refreshed. Once on the plane, set your watch to local time of your destination. Pack an eye mask and earplugs and use them if it is night-time where you’re going; equally keep the light on and mask off if it’s daytime. During your break away, maintain a healthy diet to help control your wakefulness: high protein meals increase your alertness; lots of carbohydrates make you feel sleepier. Lisa Artis, speaking for The Sleep Council says, “Whether on your journey there, or on your way home, eat according to normal mealtimes of your destination, avoid alcohol and take regular walks up and down the aisle. For less exotic destinations, sleep issues are more likely to extend to comfort than jet lag. Having an eye mask and ear plugs will aid sleep if noise or light outside may be an issue. Keep your bed as a ‘sleep zone’ and check the temperature in your room. It’s hard in hot places, but if you can, try to keep the bedroom cool; the ideal sleeping environment is 16 to 18 degrees. Try to keep to regular hours as much as possible and remember it’s still important to factor in some wind-down time – spend at least 15 minutes doing something relaxing before bed.”
For copies of The Sleep Council’s Good-Night Guide or Bed Buyers Guide call 0800 018 7923 or visit www.sleepcouncil.org.uk
Show and tell
Tips and tricks for travelling with your kit and getting through security.
1. Don’t laugh (even if they do tickle you).
2. Don’t make jokes (security is no laughing matter)
3. Be polite (be grateful someone is doing that job).
4. Show and tell (have your kit handy and be ready to explain it).
5. Carry a doctor’s note (a letter from your doctor stating your condition and why you need your kit).
Check this out
Click on the link TRAVELLING WITH DIABETES (0617) to download our handy travelling checklist. You can print it out and amend it with your own notes to fit around your own specific kit for when you travel.
Holiday help from IDDT
Going on holiday for people with diabetes is not quite so straight forward and requires more planning, especially for those treated with insulin. The security at airports and on flights means that carrying injection devices and insulin on planes requires prior arrangements to be made.
The InDependent Diabetes Trust [IDDT] provides a Holiday Information Pack with tips on looking after diabetes in hot weather, foot care while on holiday, carrying tablets and insulin to other countries.
IDDT can send the FREE Holiday Pack to you. Call 01604 622837 to request a copy or email firstname.lastname@example.org or write to IDDT, PO Box 294, Northampton NN1 4XS.
News items and features like this appear in the Desang Diabetes Magazine, our free-to-receive digital journal. We cover diabetes news, diabetes management equipment (diabetes kit) and news about food suitable for a diabetic diet. Go to the top of this page to sign up – we just need your email address.