Travelling can be a real pain in the ass for anybody, whether it’s domestic or abroad. Especially if you’re flying. But any level of travel becomes even more involved when you have Diabetes. Considering the amount of equipment that the average Type-1 Diabetic requires on a day-to-day basis, the preparation required for any trip can be quite involved. When you add in the supplies required for an insulin pump, it can also be quite an ordeal.
Since I’ve recently “indulged” in some cross-country travel, I thought I would take the opportunity to touch on some of the more important aspects of travel preparation for someone with Diabetes.
First, let’s discuss travel by its very nature. Travel is abnormal. At least it is for the modern person. Our ancestors were thought to be nomadic and usually never settled in one place for extended periods of time. But as humans evolved and we developed societies and technologies, we became more sedentary and started establishing permanent homes. This means that we usually find comfort in staying in one place and having daily routines. These routines become important for someone with Diabetes. In fact, routine tends to make the control of Diabetes far easier. When we stray from our usual routine, it tends to rain hell on the Diabetic system.
One of the first things I noticed from my flights home yesterday, was my unusually high blood sugar level. Despite my best efforts to correct and bolus accordingly, my blood sugars stayed in the teens until a while past 10 p.m. when I finally worked it down to 8.6 mmol/L, the highest being 19.4 mmol/L earlier in the day. There are a number of reasons behind these high levels; not least of which being stress, from travel and some bad news.
According to an article posted online by BeyondType1.org, “There have been studies that suggest that higher altitudes can cause insulin resistance due to carbohydrates not being metabolized as effectively. This can be another cause of high blood sugar and it can also lead to ketones/ketoacidosis in extreme cases.” The article goes on to say, “Blood glucose meters, continuous glucose monitors (CGMs) and pumps have been known to not work as effectively in high altitudes.” This could certainly be one of the outlying reasons for my extreme highs. The jury’s still out…(https://beyondtype1.org/altitude-type-1-diabetes/)
An important thing to remember is to calculate your approximate insulin needs prior to your departure and pack two extra sets of everything BEYOND what your requirements will be for the entirety of your travel. For example, my trip to New Brunswick last September saw me run short of supplies for my pump. I ended up having to buy a bottle of Lantus and some syringes in order to maintain myself until I landed back in Saskatchewan. Damned inconvenient!
The next step is to ensure that everything is properly labeled and clearly legible, identifying it as Diabetic prescription medication. Airlines are a bit sticky on the transportation of needles and sharps, so you need to ensure that you’ve dotted your “i’s” and crossed your “t’s”. Wearing your MedicAlert bracelet is also a smart move. I’m told it’s a smart move to wear it at ALL times, but I absolutely hate mine and never wear it unless I travel.
Another issue would be the airport security x-ray machines. Now, opinions about the validity of what I’ll say next has been discussed and debated for years now. But some sources, including some of the manufacturers, seem to indicate that exposing insulin to x-rays can cause damage and even affect its potency. For the most part, airline security SHOULD be reasonably accommodating in allowing for a manual inspection of your person upon request. This should include any bottles of insulin and your insulin pump. That being said, you may encounter some staff who are resistant and will claim it’s unnecessary. Don’t be afraid to ask for a security supervisor to plead your case.
That being said, there’s been no evidence that the same x-rays will affect your insulin pump. Granted, your pump is filled with insulin, so… yeah. At the end of the day, planning ahead and being familiar with your airline’s policies and requirements will go a long way. If you’re like me, you show up two hours prior to your flight’s time of boarding. this provides the extra time required to ensure a manual inspection of your insulin and medical devices and still allow you to make your gate in time to be boarded on your flight.
Test your blood frequently and adjust your insulin accordingly. Although it may seem unusual to bolus so much, the unusual circumstance may require it. Ensure you don’t skip meals. That much is often my mistake. Speaking with your doctor or medical practitioner prior to your travel may be an option as well. As much as having Diabetes may be a major pain, travel can be just as painful if you aren’t prepared. ☯