Traveling and diabetes Whether it’s for work or pleasure, travel can and should be fun. Having diabetes shouldn’t prevent you from experiencing the joy of travel. Here are the steps you should take to ensure your next interstate or overseas trip is safe, fun and hassle-free. Three months before departure 1. Plan your travel itinerary and make bookings If you wear an electronic device to monitor blood glucose levels (BGLs) or infuse insulin, check with the airline if they can be operated in-flight. Arrange your travel insurance for health and belongings. Check vaccination requirements. When booking your flights, you can choose to tell the airline you have diabetes so your needs are met. During booking, you can also order meals that are low in saturated fat and high in fibre and carbohydrate. You may prefer this to ‘diabetic’ meals served in-flight that can be quite bland. 2. Check airline security regulations Check that you comply with Australian airline security regulations for people with diabetes: The person with diabetes whose name is on the airline ticket must carry all their own diabetes supplies, including testing equipment, insulin and Glucagon delivery devices (syringes and pen needles and insulin pump consumables) in their hand luggage. It’s advisable to pack extra insulin in checked-in luggage. Your name must appear on all insulin and/or Glucagon script labels. You must carry scripts (that are readable) for all medications. Each script must include your name, the name and type of your medication, and your doctor’s contact details. Always carry your National Diabetes Services Scheme (NDSS) card. This serves as proof that you need to carry your diabetes equipment, including insulin, if applicable. Bring additional photographic proof of identity, such as a driver’s licence or passport. Bring several copies of a letter from your doctor (that are readable) to get you through Customs. It should outline your medical conditions, your medications, and the devices you use for your insulin and blood glucose testing. It should highlight the importance of carrying your medications with you. International travellers can carry no more than 100 ml of liquid per container, in their carry-on baggage. Your supplies of insulin are exempt from this rule. But you need to present the insulin at the security point with proof of your condition and need for your medication. If not travelling with an Australian airline, check in advance with the airline for specific security guidelines. 3. Arrange travel insurance You should arrange travel insurance for you and your belongings. Make sure your health cover applies to pre-existing conditions and the places you will visit. Note: The Australian Government has Reciprocal Health Care Agreements with a range of countries. Travellers can avail themselves of similar benefits to Medicare by showing their Medicare card. This is limited to acute or emergency care. For more information, visit Medicare Australia or call 02 6124 6333. Two months before departure Talk with your doctor Get the required vaccinations. Get advice on other tablets you may need to treat diarrhoea or nausea. Check your medication/insulin adjustments, Glucagon and testing for ketones during the trip. Arrange the papers you will need to comply with airline regulations. Tell your doctor if you’re travelling to places with different time zones. Your medications and/or your type of insulin may affect your activity. Your doctor may advise you to follow your normal routine until you stop travelling, have a long sleep and then start from scratch when you wake up. Or your doctor may recommend some medication or insulin changes. Before using a support hose that prevents swelling and reduces the risk of clotting in the veins of the legs, check with your diabetes team first. They may not be suitable for those with conditions like peripheral neuropathy (caused by damage to the nerves in the peripheral nervous system typically affecting the hands, feet and legs). One month before departure Arrange all paperwork, including a letter from your doctor, medication scripts, written details of next of kin, and NDSS and Medicare cards. Prepare diabetes medication and testing devices required for the entire trip. This includes medication, insulin, syringes/pen needles or pump and consumables, lancets, test strips, meter (bring spare if possible), Glucagon and delivery devices. Check and arrange other medical requirements, including medical identification. What to pack Bring a small, approved sharps container, available from the Diabetes Shop or your pharmacy. Many hotels and airports offer a sharps disposal service for your used lancets and syringes. Estimate the medication and diabetes supplies you will need for the entire trip and pack more in case of loss or damage. If possible, pack a spare meter. Take a small first aid kit with you in case of aches and pains, minor cuts and burns. Pack comfortable, well-fitting shoes. Carry some form of quick acting carbohydrate, such as glucose tablets or jelly beans in case of hypoglycaemia (low blood sugar). Pack an insulated bag for storing your test strips if you are travelling to a place that may be extremely hot or cold. Don’t forget your meter’s user manual. EXTRA PRECAUTION – Pack clearly written details of your next of kin or a family member. What to do in extreme temperatures Extreme heat or cold can affect your ability to manage diabetes. Here are some steps to take. Insulin and blood glucose test strips should be kept below 30 degrees Celsius. To protect them from extreme temperatures, take a small insulated bag available from the Diabetes Shop. Make sure to keep it in your carry-on luggage. Temperature also affects the accuracy of blood glucose results. Consult the user manual for your meter’s operational temperature range. Travelling by air Keep all your medication, and diabetes testing and insulin equipment in your carry-on luggage. You can split them evenly between two bags in case one goes missing. Pack a separate small bag with enough supply of insulin, injection devices, testing equipment and hypo treatment for the flight. For long flights, pack enough for the first leg and refill it before the next. EXTRA PRECAUTION – Wear medical identification that says you have diabetes. At the airport Arrive early to avoid rushing. It’s considered unlikely that insulin would be harmed by security X-rays. But you may ask airport security staff to physically check you and your luggage instead if you’re concerned. You’re not required to remove your insulin pump at a security point. If this is requested, security is obliged to provide access to a private consultation room. You can also request this room if security staff want to discuss your condition. During the flight There are things you can do to ensure you have an enjoyable journey. If you wish, you can tell the flight attendant at the start of the trip that you have diabetes so your needs are looked after. Keep your diabetes supplies within easy reach, like the seat pocket in front of you. Always wait until your meal is served before you administer insulin. For added safety, you can take your insulin halfway through or immediately after your meal in case of a major unforeseen interruption. Avoid alcohol. Drink enough water to avoid dehydration. Sleep as much as you can, but ask the cabin crew or your travel companion to wake you for meals. Wear comfortable shoes and exercise your feet to prevent swelling. Walk up and down the aisle to assist circulation and keep your blood glucose levels under control, as well as to avoid deep vein thrombosis. Decreased activity during the flight and the amount of food you eat can increase BGLs. They can go back to normal once you’ve resumed your routine at your destination. When something goes wrong With all your careful planning, it’s unlikely that something will go wrong. But don’t worry if you need medical assistance during travel. Get advice from your travel insurer. You can recover the costs through health benefits or through your medical insurance once you’re back home. Your diabetes should not stop you from enjoying a memorable and hassle-free trip. By taking doable steps at each stage of your journey, you can have a good time. Stay informed The NDSS has fantastic resources to help you prepare for your next trip: Travel factsheet Travel and type 1 diabetes