As any novice or expert traveler knows, planning the logistics of a trip, let alone the process of traveling, can get pretty tricky at times. This can be especially true for the adventurers with chronic medical conditions, namely those with diabetes. If you have diabetes and want to see the world but haven’t yet figured out how to balance the Colosseum with carb counting, or the Great Wall with glucose monitoring, then these tips are for you. Traveling with diabetes, whether Type 1 or 2, can certainly be a little stressful at times, but it is completely possible and should not hold you back from exploring the globe! Below is a list of 9 daily lifestyle tips for traveling with diabetes, made easy to implement in any adventure.
- Before you embark on your trip, if flying overseas, it’s good to know that you can order a special meal, usually up to 48 hours in advance. Visit the homepage of your airline and do a search for special menus. A review of Delta’s offerings shows that they serve 17 special menus. An overview of their diabetes menu states it’s low in sugar and avoids syrup and regular desserts. If you have high blood pressure or celiac disease, they also have a low sodium and gluten-free menu. But don’t fret. If you go with the regular menu, figure out your carb quota on the tray, so you don’t end up with a high blood glucose. Also, make sure to bring some healthy snacks, such as KIND bars, nuts, fresh fruit, and 100-calorie bags or popcorn. Keep some glucose tablets on hand in case of an emergency.
- Keep all medicines, syringes, inhaler and cartridges, blood sugar testing supplies, and all oral medications in your carry-on luggage. Don’t risk a checked bag getting lost or sitting in an unheated, uncooled cargo hold. If you usually carry a test kit and some exogenous source of insulin with you at all times, it may feel inconvenient to have to keep track of it during your travels. Luckily, medical equipment like test kits are available pocket-sized, and can be found at your local pharmacy. Store your insulin bottles and unopened packages of inhaled insulin between 33 F and 80 F. Don’t freeze insulin or keep it in direct sun. Once you open a package of inhaled insulin, you can keep it at room temperature safely for 10 days.
- Be aware of the potential language barrier in your destination country. In whatever area(s) you are traveling, certain words and phrases are critical to know and verbalize in the native language. It is too dangerous to assume that locals will be able to understand English in the event of a low blood sugar episode. Important phrases can include “I have diabetes,” “I have low blood sugar,” “I need medical assistance,” “I need a Coca-Cola” (most countries are familiar with, and carry, the iconic beverage). It is also crucial to carry an identification card or wear a medical ID bracelet that, in case of an emergency, explains your condition, which should have universal symbols that can be understood by any medical caregiver.
- In tandem with knowing the local language for speaking purposes, it is equally as important to be able to identify words that mean “bread,” and/or local dishes that are higher in carbohydrates. These can include pasta, potatoes, rice, pita, tortilla, or other local grains like quinoa or couscous. It’s also a good idea to practice reading nutrition labels in the local language; the word “carbohydrate” can be pretty easy to identify in some languages, but make sure you know what they are before leaving home. Also be wary that many European countries use Kilojoules instead of calories as a measurement of energy, and use commas instead of periods to designate decimals (for example, 12,5 grams as opposed to 12.5).
- If you are on insulin, you are probably pretty well versed on counting grams of carbohydrates. Despite your possible proficiency in carb counting, it may be helpful to refresh yourself on common exchanges of popular foods, like how 1/3 cup of rice or pasta is one exchange, and that one small slice of bread or dinner roll is one exchange. Also consider the sugar/carbohydrate content in syrups and dried fruit. It’s also a good idea to have a phone app such as HEALTHeDiabetes ($5.99 for iPhone) to check carbohydrate and sugar content of various foods. so you can quickly estimate the amount of carbohydrates in various dishes on the menu, before you order.
- You’ve probably heard that it is especially important to be mindful while sitting on a long plane, train, or bus ride. This is true or those with diabetes, as blood sugars tend to rise while remaining sedentary. Make sure to have your glucometer on hand at all times, and aim to test your blood glucose as needed to keep it in check. If you wear an insulin pump, you can temporarily set it to a higher basal rate during your travel, but make sure to go over those plans with your doctor or certified diabetes educator before heading out.
- The opposite is just as necessary to consider, as physical activity can deplete your blood sugar at an expedited rate. Make sure you have accessible forms of energy, like a granola bar or portable bottle of juice, to keep those blood sugar levels steady while you roam around Rio or traverse Tibet.
- In all cases, whether you’re driving a few states over or flying across the world,make sure you a card with your doctor’s name and phone number. Also keep a list of your current medications in your wallet and keep it with you at all times. And don’t forget a medical ID bracelet or card that states you have diabetes. Bring twice as many diabetic supplies as you think you need. Sometimes things just break, get stolen, or are lost in transport. Back-up supplies include an extra tube of glucose tablets for low blood sugar episodes, a back-uptest kit packed in another part of your baggage, extra insulin and/or oral diabetes medications, and extra medical condition cards in case your wallet is stolen.
- Last but certainly not least: eating! For many, traveling to new places is largely defined by new cuisines. Having diabetes has absolutely no hindrance on enjoying these new foods, as long as you stay mindful. If you want to sample a pizza in Florence for example, go for it (it’s practically necessary)! Keep the carb content in check by sharing the meal with a friend, or if you are alone, make sure you’re going to be exerting a lot of energy after your meal (like climbing up to the Piazzale Michelangelo). Limit the pizza to one or two slices and pair it with a salad. If you want to sample local desserts, opt for smaller sizes and try to balance it with a lower-carb meal, like a dish comprised of vegetables and a protein, like fish or a leaner meat source.
These may seem like a lot of things to keep in mind, when all you want to do is explore landmarks and experiment local cuisine like any other traveler. Visit here for more tips on traveling with diabetes. Following these tips can make your adventure run smoothly so you can get back to enjoying these amazing sights, sounds and tastes sooner. You are a traveler, and that means you are capable of dealing with anything that gets in your path on the road to new experiences. Happy travels!
Lisa Stollman, MA, RDN, CDE, CDN is based on Huntington, Long Island and New York City. She was recently honored as the 2015 Distinguished Dietitian of the Year Award by The New York State Academy of Nutrition and Dietetics. A special thanks to nutrition and writing intern Samantha Marks for her contributions to this blogpost. To find out more about Lisa, visit here.