Prepare before your holiday
Before you book your holiday, do some research to find out where the nearest hospital is with appropriate medical facilities and get the name and number of a doctor who speaks English in the area. If you’re travelling with a child with type 1, you also need to make sure the hospital treats paediatric diabetes.
Make sure your travel insurance covers emergency treatment of issues related to diabetes. To avoid problems with security, ask your healthcare team for a letter confirming you have type 1 diabetes and specifying the supplies you need to carry on the plane.
Take time-zone changes into account
Discuss time-zone changes with your diabetes team so you can adjust insulin doses accordingly.
Buy cooling packs to store insulin in
Cooling packs are great for keeping insulin supplies cool in hot weather while you’re out and about. Transfer insulin to a fridge as soon as you can.
Medical equipment that is! Make sure you have three times as much medical equipment as you expect to use including insulin, test strips, glucagon, glucose tablets, lancets, needles and set change equipment. Pump users should take pens and insulin cartridges in case your pump fails, along with manufacturers’ helpline numbers for any countries being visited. Carry emergency supplies when going on days out or travelling far from the hotel.
Divide your medical supplies into two and pack them in separate bags…just in case you lose one.
Avoid packing medical supplies in hold baggage
If you’re flying, don’t put any of your supplies in your checked-in luggage as the temperature in the hold can drop to freezing. Instead, keep everything with you in your hand luggage.
Stock up on snacks for the journey
Always pack extra snacks and hypo treatments for the journey and excursions, especially if you dislike plane food. Never rely on finding a place to buy snacks.
Prepare for extra tests
You may need to do extra tests on holiday to cope with different foods, the varying temperature and levels of activity. Be prepared with everything you need.
Prepare for varying insulin doses
You may find you need to vary insulin doses for very active holidays or holidays in unfamiliar climates. If swimming for extended periods, test your blood glucose level regularly. In the evening and night, your blood glucose level could drop after periods of prolonged aerobic exercise, so beware of night-time lows.
Insulin absorption is more rapid in a hot climate so watch out for after-meal lows, followed by a spike. If you’re on a pump, use the dual or square wave function.
Diabetes technology and flights
Pump users: atmospheric pressure reduction causes predictable, unintended insulin delivery in pumps by 3 mechanisms: air pressure, dissolved and/or visible bubbles, and plunger movement.
“… that changes in ambient pressure during commercial flights did not affect insulin pump mechanical function. Plungers may potentially move, however, causing insulin overdose with massive, rapid depressurization that occurs 40–50 times worldwide per year.
(They) recommend for flights:
- The cartridge should only contain 1.5 mL of insulin.
- Disconnect the pump before takeoff.
- At cruising altitude, take the cartridge out of the pump and remove any air bubbles before reconnecting.
- After the airplane lands, disconnect the pump and prime the line with 2 units. Then reconnect the pump.
- During flight emergencies involving cabin decompression, disconnect the insulin pump.
Insulin pumps deliver excess insulin as ambient pressure decreases (ie during takeoff), which may cause hypoglycemia. We observed three mechanisms to explain this phenomenon.”
The UK Civil Aviation Authority also explains this.