Breaking Your Routine - Travelling With Diabetes

There's no reason why your diabetes should interfere with or restrict your travel plans in any way. although if you're going abroad, you'd be wise to take out comprehensive travel insurance. Medical care and treatment abroad are rarely free, although the UK does have reciprocal arrangements with some other countries. If you're going to one of the countries of the European Union, before you go you should obtain a European Health Insurance Card (EHIC) either by filling in an EHIC from your post office or by applying online on the Department of Health website. Even when a country does offer a reciprocal scheeme, it's still worth having your own insurance on top, and essential in those countries where the health care is not equivalent to that provided by the NHS or is very expensive (the USA, for instance). There may be special considerations when you're heading somewhere extremely remote or inaccessible, so discuss your plans with your diabetes care team. Wherever you're going, and especially if it's off the beaten track, make sure that you will be able to obtain insulin or tablets there if necessary, just in case you somehow get parted from your own supplies. Never pack your insulin in your suitcase it is a good idea to tell your travel agent or airline that you have diabetes. You'll need to check out the immunisation requirements for your destination well in advance - sometimes it takes several weeks to complete the course. Preventative measures of this kind may be particularly important for travellers with diabetes, and it is reassuring to know that taking anti malarial tablets will not interfere with treatment for diabetes. You need to plan carefully if you're going on a long flight, and it's a good idea to do this with the help of your doctor or diabetes care team. Remember that travelling West extends your day, whereas travelling East shortens it. When You're on Insulin You will have fewer problems if you're on a multiple basal-bolus regime using an injection pen than if you normally inject just twice a day. For an extended day, the simplest solution is to have an extra injection of quick-acting insulin before the extra meal that's almost bound to be given on your flight. When you reach your destination, have your normal evening dose of insulin followed by your evening meal. Next morning, have your insulin before breakfast as usual, then try to match your eating pattern to that of the locals, although this isn't always easy if you have jet lag The night will probably be shorter when you're travelling east, so you should have a smaller dose of medium-acting insulin (perhaps 10 to 20 per cent less than usual), either before the evening meal if you're on twice daily injections or before bed if you're on multiple injections, followed by your usual pre-breakfast dose next day. Don't forget that you're not obliged to eat all the meals offered on the flight if you feel you don't want or need them. it is important to let the airline staff know that you have diabetes, and make sure that they or your travelling companions know what to do if you have a hypoglycaemic reaction and how to give insulin if you need it. The same applied if you are travelling by sea. You don't have to have a fridge to store your insulin as long as you can keep it somewhere relatively cool, but, if temperature is likely to be a problem, use a wide-necked vacuum flask. Do not store insulin in a freezer compartment. When You're on Tablets You shouldn't need to make any particular changes to your treatment schedule. it would be worth getting the advice of your diabetes care team before taking a very long flight, however, because if you are taking short-acting tablets before meals you may need either an extra one or perhaps one less depending on whether you are flying east or west. The principles are the same for those who are on insulin injections. Prepare for your Journey You will have to find room in your hand luggage for your medication, blood glucose testing equipment and any other medical kit; luggage does sometimes go missing when you're carrying syringes and needles, it's sometimes useful to have a letter from your doctor on headed paper explaining that you have diabetes and how it is treated. This is important if you are going to some Middle and Far Eastern countries. It is also advisable for anyone with diabetes to carry some form of ID card or bracelet indicating that you have the condition and what medication you take. Diabetes UK can supply ID cards giving details of your treatment in the local language of the country that you're going to, and it's worth getting one of these. you may never need to show them, but it won't hurt to have them, just in case. Breaking Your Routine - Travelling With Diabetes [l]