Planning ahead is the key to traveling with diabetes. People with diabetes can enjoy all kinds of recreational travel from a week at the beach, to camping in the Rockies, to sightseeing across Europe. The American Diabetes Association provides the helpful suggestions below for people with diabetes who are planning to travel.

Taking special care when traveling with diabetes

Be sure to have a complete medical exam well before you travel to make sure your diabetes is under control. This will allow enough time for immunizations, if you need them, and give you time to recover from any side effects. Also ask your healthcare provider to give you a letter with the following information:

• How your diabetes is treated (diabetes pills, insulin shots)

• All medicines and equipment needed to manage your diabetes (for example, insulin, syringes, and other medicines or devices)

• Allergies to foods or medicine

Also have your healthcare provider give you a prescription for insulin or diabetes pills. You should take more than enough of your medicine and syringes to last through the trip with you, but, in case of emergency, the prescription may help. Use only U-100 syringes while traveling, as other syringes will give you higher or lower doses than you need.

Prescription laws may be very different in other countries. If you are traveling abroad, contact International Diabetes Federation groups for more information. You may also want to get a list of English-speaking healthcare providers in the countries you are traveling to before you leave. Contact the International Association for Medical Assistance to Travelers (IAMAT) for more information.

It is important to wear a medical ID bracelet or necklace that shows you have diabetes. If traveling to other countries, you may also want to learn a few key phrases, such as "I have diabetes" or "sugar or orange juice, please" in the languages of the countries you will be visiting.

Packing for preparedness

Be sure to pack at least twice as much medicine and blood-testing supplies as you think you will need. At least half of these should be with you in your carry-on bag, which you should have with you at all times.

When packing, be sure to include the following items:

• All the insulin and syringes you need for the trip, plus some extras

• Blood- and urine-testing supplies; be sure to include extra batteries for your glucose meter

• All oral medicines

• Other medicines or medical supplies

• Your ID and diabetes identification card

• A well-wrapped, airtight snack pack of crackers or cheese, peanut butter, fruit, a juice box, and some form of sugar (hard candy or glucose tablets) to treat low blood glucose

• Keep the labels on all medicines and supplies. You may need these during the security check for air travel.

Before you fly, be sure to request a special meal low in sugar, fat, and cholesterol at least 48 hours in advance. Always carry some food with you in case your meal is delayed or there is a mistake in your order. Wait until you see your food coming down the aisle to take your insulin shot, otherwise, if your meal is delayed, you could experience low blood glucose. If you are accustomed to injecting some air into a bottle insulin before drawing out some insulin, do not do this while in the air.

Plan for crossing time zones

If you take insulin shots and will be crossing time zones, talk with your healthcare provider before your trip. Ask for help, based on your itinerary, in planning the timing of your injections while you travel. Eastbound travel means a shorter day, so if you inject insulin, you may need less. Traveling westbound means a longer day, so more insulin may be needed. To help you keep track of shots and meals through changing time zones, keep your watch on your home time zone until the morning after you arrive.

Checking blood sugar while traveling is just as important as when at home. It is important to check blood sugar soon after landing as jet lag may make it difficult to tell if your blood sugar is very low or very high.

Storage of insulin

Insulin does not need to be refrigerated, but should not be stored in very hot or very cold temperatures. It is important to store insulin properly. You should not store insulin in the glove compartment or trunk of a car, or in backpacks and other bags that could be exposed to the elements. Many travel packs are available to keep insulin cool.

Other tips for traveling with diabetes

Tips include the following:

• Take it easy for a few days following a long flight.

• Test your blood sugar according to your healthcare provider's recommendations.

• Plan your activities so you can work in your insulin and meals.

• Take along snacks when hiking and sightseeing. Do not assume you will find food wherever you are.

• Be extra careful about food and water precautions. Avoid uncooked foods and tap water. Foods that upset your stomach could cause your blood glucose levels to become uncontrolled.

• Wear comfortable shoes and never walk with bare feet. Check your feet every day, looking for signs of blisters, cuts, redness, swelling, and scratches.

• Get medical care at the first sign of any infection or inflammation.

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