As a person with Diabetes Type 1, insulin dependent for over 45 years I feel qualified to share some tried and true travel tips with our readers. I am also an RN of over 30 year’s experience but today I write based on my personal accounts of what may work, what to watch out for, and just a general offering that may spark your own individualized ideas around how to prepare for your travel any time of the year.
In our blog from earlier this month, Sarah Hammaker outlined many important points regarding traveling with Diabetes… I will not repeat but provide personal examples based on her writing, with some additional added tips. As a disclaimer, I am not a doctor or Advanced Care Provider (NP or PA), so please, do not take my experiences and what I write in this article as a substitute for discussions with your providers or Diabetes Education Team.
Location Matters:
Even when you are planning vacation or travel plans, it is extremely important to have an idea of the location you desire to travel to. Are you traveling outside of the United States requiring a Passport? If yes, is it a center city, remote island location, or rural location near to stores and hospitals? Or are you traveling inside of the United States? Again, thinking of whether it is a city, remote location, or a rural location. Why is this important? I have traveled both in State and to other countries – a mission trip to Ecuador (that is a blog in itself!), to St. John, and Grand Cayman Islands. State-side I have traveled mostly on the east coast including many beach locations, my daughter’s college town (also another story!), and Florida.
Why would it matter where I am traveling?
It matters! The first recommendation when you are planning travel out of the country or in the states is to understand where you are actually staying. Will you be moving around frequently visiting many locations along the way? How much travel time will it take? Is this by airplane, driving, train, or even by bus?
Next what type of activities do you plan to do? Sitting on the beach and wading in a pool for a restful day is completely different than perhaps touring the countryside in Ireland, or visiting as many Disney parks as possible. All require a different activity level. It is very beneficial to evaluate how you will be spending your vacation time.
Why are these points important? They are important because it helps you understand how many supplies and back up supplies you need to pack and plan for. Are you swimming? Do you need an insulin pump over patches or just one more extra set up? Do you need an adequate day supply bag for a countryside tour in Ireland or in my case traveling from Quito, Ecuador to Machala, Ecuador.
Plan!
When going on vacation my husband used to say when we were in the states, “Why are you packing so much? We are not traveling to Mars!”. Well, he was correct about that. But – I have figured out over the years that if I need an urgent prescription refill or run out of supplies it results in disruption! I learned on several occasions this is a total disruption in my vacation plans and now I’m on the phone calling offices, people, pharmacies, and CGM companies (yes this happened too). Now, family and people are waiting for me! They say, “it’s ok – we will be late but your health is more important” or perhaps we have a scheduled bus tour that leaves at a certain time and now we will miss this opportunity for the tour. I learned something about myself long ago ~ the reason I pack supplies like a pack mule ~ is because I don’t want to be disrupted, inconvenienced, miss out on anything, or disappoint myself or others who I am traveling with. Not to mention all the effort I took into planning the vacation, I want to experience what I planned. Not having enough or the right supplies is an enormous bummer and has brought me distress and to tears on past experiences. Depending on where you travel, if you cannot easily get supplies, sheer panic will set in and now it is full on focus with everyone on the phone and using all hands on deck and resources to find what you need.
Traveling out of the country.
One of the most important things I do for myself is obtain a note from my doctor stating all the supplies I carry with me from all pump supplies, insulin, back up insulin, needles, syringes, glucagon, meter and CGM (continuous glucose monitoring supplies), quick acting glucose and snacks stating that all supplies are necessary for my travels. If it is several years when I travel out of the country, the first thing I do is update this letter from my doctor with updated information. This helps in a few ways, first you have your doctor’s name and contact info on the letter head. If you change doctors, request an updated document called a “travel letter”. Second, it verifies that you are able to travel with said supplies (syringes, needles, etc) and it is necessary to sustain your health. Third, in the event your supplies are lost or ruined for any reason it might be helpful to an out of country provider again to verify your needs. Lastly, it does provide some peace of mind. I have presented this willingly to the airline security attendants, in my hand announcing, “I am type 1 Diabetic and I have a pump and CGM”. Once they hear the information and see I have a letter, in my personal experience, I did not encounter any concerns.
Plan, Plan!
I double and triple check how many supplies I need for our time away. I count accurately and then I think “how many back ups might I need?” Oh, we will be on an island in the middle of the Caribbean (St. John) with little to no access easily to supplies. I think to myself what type of instances could crop up in my vacation. For St. John I considered the following: It’s a remote island, we will be swimming and snorkeling, my parents are older and ability to help could be limited, where is the rest of my family staying, who in my family knows everything about me, do they have a hospital, what might happen if there is a sudden emergency (St. John has Sunami/flood warning signs to seek higher ground)? So a 10 day vacation turned into a 3 week supply list of every supply I could think of, even supplies that might be rare and not necessarily needed. But as stated before, my diligent preparation allowed me to enjoy the time, snorkel, enjoy food and the company. Periodic thoughts dropped into my mind while vacationing – such as what would happen if? I was fairly prepared and had a back up to the back up to the back up plan. St. John requires plane travel from the states to St. Thomas and then a Ferry ride from St. Thomas to St. John and then a car ride to our vacation house. So many obstacles!! This trip, Grand Cayman, and Ecuador required the most preparation and I started very early!
Starting early includes looking at your current prescriptions. About 1 month ahead or more for travel to such locations, I review all my prescriptions and begin to think about what I can refill before travel or what do I have enough of. For any trip outside of the country, I recommend traveling with all original prescription bottles and medications with labels on your supplies. Again, there is no question what you are carrying and provides a ton of information. Local or short trip travel may look a little different.
Plan, Plan, Plan!
Whether you are traveling out of the country or in the States, I can’t express enough about the strategy of packing for moving through your travels and being able to manage yourself on the fly.
Pack your supplies so they are easily accessible and keep them on you such as, in a carry on bag (yes there is a story here). Pack how you would use them and invest in a good travel supply bag that suits your needs. I have tried many and I finally landed on 2 hand carriers I purchased that accommodates several supplies. The most important tip I can share ~ if you are traveling with a said number of supplies for daily use or overnight use ~ never, ever, ever let this bag out of your sight! Keep it with you and watch it like a hawk. To lose your bag of supplies means again – no supplies, medicine and a ton of disruptions and there is no guarantee you can replace supplies on the fly.
Over 45 years, it took some time to fine tune my preparation and packing process. I think through all of the above and if I am traveling by car or require an overnight stay (driving to Florida), I pack my supply bag in my backpack on top. Why on top? To have it most accessible in a pinch or if I have a planned insulin set change. Same if you are air traveling, bus, or train. You may need to change a set-up, CGM, or give an insulin injection during your travels. Adding to this accessibility of my primary daily supply bag, I carry an extra set up and back up syringe in my purse. A very small case that has one set change and insulin…. just in case!
If traveling by car, I do pay attention to where that bag is and the rest of my supplies as you would not want any of your supplies directly against a heat vent or in the sunlight. I learned the grab and go, pack it on the top strategy a couple years ago where I missed that I needed to change a pump site while traveling on a weekend getaway with girlfriends. I found myself digging through luggage and bags and emptying the trunk just to get to my day supplies (also prompted the purse back up) and that was within the first hour of our travels.
Plan, plan, plan ~ food!
It might seem like something you should not have to worry about when traveling by air or in the car, however, I can count so many times we were in traffic, traveling off hours, no restaurants in sight and you have 4 hours to travel only arriving and hitting the sack to sleep at 11 pm. Meals are immediately thrown off, blood sugars could be going haywire, not to mention those who are hangry traveling with you.
SNACKS! If you don’t have time to plan for a car picnic or you are uncertain where you will be at mealtime, it is very important to carry quick acting glucose for lows below your designated threshold as well as small snacks such as bags of pretzels, granola bars, approved protein or energy bars by your provider or dietitian. Due to traffic or wonky travel arrangements, not ideal, but I have survived on a day or half day of snack food as needed but the important part – try real hard to stop for breakfast, lunch, or dinner and your snacks can be your back up plan.
When traveling long distances outside of the country ~ these snacks are your best friend. Keep 1 in your backpack, 1 in a purse or a relative’s purse, lunch bag etc. Again ensure your partner, friend, family member is within reach with your snack.
I hope this was helpful to provide many ideas to think about when you travel! I have had a good bit of trial and error and if I don’t take up too much space with this Blog, I’ll be happy to share more examples and how I was able to work through them.
That sounds like a lot of planning, but as I stated, location of your vacation matters! When you arrive at your destination, assess where the hospitals are, where the good restaurants are, determine if you will drink alcohol or not (choose not!), think about your day trips and all of the tips above (back pack w/ on the go bag and a back up purse of you carry a purse). If this is interesting to you, check out our social media pages about this blog, and leave comments with some of your own travel tips. I would be happy to do a follow up article!
Travel safely and don’t forget to prepare!! It sounds like a lot, but I promise you – it is worth the peace of mind!
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About the author
Julie, RN-MSN, Informatics Certified
WellSpan Health, Clinical Operations Manager with Medical Service Line
