Travel trouble-shooting
By Carolien Koreneff, CDE-RN
Careful planning before traveling is an important step for individuals with diabetes. There are several considerations, including diabetes management, general health, packing essentials, securing travel insurance, assessing available food choices at the holiday destination, and identifying any special requirements both during the trip and at the destination. Your guidance as a health professional can significantly contribute to ensuring they have a safe and enjoyable travel experience.
Planning ahead
The NDSS fact sheet on travel is an excellent reference to help your clients prepare for travelling. It emphasises the importance of discussing travel plans with a doctor or diabetes nurse well in advance and obtaining a travel letter. Any doctor, nurse or allied health professional involved in the care of a person with diabetes can prepare a travel letter. The letter should include:
- A list of all their medical conditions
- Any medications they take, including the dosages, how often they take them and how to store them
- Supplies and products used to manage diabetes, including any treatment for hypoglycaemia
- Details of any insulin pumps and/or continuous glucose monitoring devices.
It is recommended they take several printed copies of the travel letter and an electronic version if they are carrying a device. Having easy access to their letter can assist at security check points or help if medical attention is required.
When preparing their medication pack for a trip, they should calculate the amount of medications and diabetes supplies needed for the entire trip and then add additional supplies in case of loss or damage. It is also beneficial for them to take any additional medication prescriptions they may have.
As part of their preparation, they should review their sick day management plan and ensure their sick day kit is well stocked with in-date supplies. Sick day kits should be kept handy and when flying, they are best packed in their carry-on luggage.
It is also good to suggest travellers are up-to-date with any vaccinations. This can include COVID, as well as any specific vaccinations related to the areas they may be visiting.
Recommend they take out travel insurance for both health and belongings. They will need insurance that covers any pre-existing conditions, so declaring their diabetes and checking for any limitations is strongly advised. They also need to ensure that the places they will visit and the activities they plan are covered. If they are using an insulin pump, it’s also worth considering insuring it.
When traveling to a different time zone, medication or insulin adjustments may be required. A credentialled diabetes educator or endocrinologist are the best people to advise on these adjustments. Variations in physical activity while traveling and any changes in diet will also need to be taken into consideration
When flying internationally, they may need to adjust their hypo management plan to comply with fluid restrictions. Soft drinks and juices, often used for treating a hypo, can only be taken onboard if they are in containers of 100ml or less. Clients might find it easier to use alternatives such as glucose gels, glucose powder, tablets, or jelly beans.
How to keep medication safe when travelling?
Insulin and injectable medications which generally require refrigeration can be kept cool during travel by being packed in an insulated bag. Also, when heading to locations where it is extremely hot or cold , it’s advisable to use insulated bag to store blood glucose monitoring strips, ketone testing strips, continuous glucose monitoring sensors and transmitters, as well as blood glucose monitor. The Diabetes Shop offers a range of suitable options.
To further safeguard medications and diabetes supplies from extreme temperatures, it’s recommended they are taken as carry-on luggage. Distributing them across two bags can also be a good idea, in case a bag goes missing.
What to do if there are travel delays…
The recommendation is to ensure that the pack they plan to carry contains sufficient supplies of medications, insulin, insulin injection devices, blood glucose monitoring equipment, and hypo treatment not only for the duration of the flight but also any delays. For extended flights, it is advisable to restock supplies before starting the next leg of the journey.
Carrying some snacks in case their meal or travel is delayed is also advised. Muesli bars can be handy, but options such as fruit cups, Vegemite scrolls, low-fat muffins, dried fruit, nuts, and cut vegetables like carrots, cucumber, celery, or capsicum are also recommended.
What to do if luggage is lost…
It is possible that checked luggage is accidentally sent to another destination or carry-on bags are left, lost or stolen. Some strategic planning should minimise the impact:
- Spreading supplies over multiple bags
- Having copies of scripts and other important documents in both checked and carry-on luggage
- Having access to documents electronically
- Getting travel insurance that replaces lost luggage
The good news is most luggage turns up in a few days.
Teens travelling (Schoolies)
Every year, from late November through December, school leavers gather to celebrate a significant milestone—the end of their school life—at holiday destinations across Australia and overseas. As part of this epic experience, teens are like to participate in large dance and music events and will possibly face challenges like drugs, alcohol, heat, dehydration, irregular meals, limited food choices and limited sleep.
Before embarking on any adventure, teenagers or adolescents with type 1 diabetes should familiarize themselves with the ‘Travel and Type 1 Diabetes (youth booklet)’ from the NDSS. This resource offers valuable recommendations and comprehensive checklists to ensure a well-prepared journey.
It is crucial for them to understand how alcohol and drugs can impact both their overall well-being and their diabetes management. Awareness of potential interactions with medications or insulin they may be taking is essential for their safety.
While enjoying social activities is part of the adventure, it’s important for teens to use caution. They should stick together with friends, watch out for each other and inform others about their diabetes or any other medical conditions. Additionally, keeping their family and friends informed about their whereabouts is a responsible measure.
Reminding them of the importance of consistent monitoring, adherence to medication and being mindful of the effects of alcohol and drugs on blood sugar levels is paramount. Also, facilitating connections with local support networks can further contribute to a successful and health-conscious travel experience.
For further information
Download the Travel and Diabetes Facts Sheet www.ndss.com.au/travel-information-sheet or the Travel and type 1 diabetes (youth) booklet https://www.ndss.com.au/wp-content/uploads/resources/booklet-young-people-travel-type1-diabetes.pdf.
Take a look at the Medicare Australia Website on Medical insurance: www.medicareaustralia.gov.au/public/migrants/travelling/index.jsp
Smart Traveller Website www.smartraveller.gov.au
Department of Foreign Affairs & Trade: www.dfat.gov.au/geo
Or call the NDSS Helpline to speak to a healthcare professional: 1800 637 700