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Diabetic Traveler’s First Aid Kit

If you have diabetes, just think of diabetes as a star-struck lover who will never leave your side, no matter how far on a package tour or cruise or bus ride you go. There is no escaping it, even if you’re near the peak of Mount Fuji or inside the pyramids of Giza. It does not mean, however, that you can’t have fun when you travel with diabetes. What is important is proper preparation and planning way ahead. Anticipating the worst case scenarios almost always helps in avoiding them.

Common health problems diabetic travelers can anticipate
Common illnesses such as flu, pneumonia, and urinary tract infection can be acquired easily by any host with a compromised immune system. Viral or bacterial infections may be acquired through any route: air-borne, contact, or food- or water-borne. Traveling can be synonymous with indulgent and adventurous eating, therefore gastrointestinal disorders such as acute gastroenteritis manifested by diarrhea and vomiting are not so rare occurrences. Feet problems such as calluses or infections should be anticipated especially by ardent walkers or those with pre¬existing circulation or neurologic compromise. The cardiovascular complications of diabetes, namely heart attack and stroke, choose no time and place, and therefore one should be prepared anytime.

Hypoglycemia, or too low sugar, is a medical emergency that every person with diabetes should learn by heart. It is common during travel because of the change in time zones, diet, and exercise activity. Hyperglycemia, or too high sugar, is also common because of the gastronomic adventures and/or omission of medications. It is an emergency when accompanied by significant dehydration or ketoacidosis.

Planning ahead

What and how to prepare for travel:
1. Weeks before your planned trip, please have a check-up with your doctor to make sure your sugar levels, blood pressure, cholesterol, and other medical conditions are all under control. Make certain that the necessary immunizations are up to date. (It will be difficult to do this if you have the check up just one day before your departure). Please obtain a medical letter describing that you have diabetes, and that you need all the diabetes paraphernalia and medications for travel. You will also need a prescription for all the medications, with a lot of extra supply just in case you extend your vacation.

2. Arrange for travel insurance if applicable.

3. Have a medical alert bracelet or necklace made, to say “I have diabetes.” This is important, for example, in case you’re running around a place where no one else knows you, and suddenly you collapse because of hypoglycemia. A smart bystander, upon seeing your alert bracelet, will assume that you just overdosed on diabetes medications or skipped a meal. Then, if possible, he/she will check your capillary blood sugar, and thus give you life-saving glucose as necessary.

4. In the same light, learn the vernacular for “I need sugar” or “Give me juice.”

What to pack
1. Bring comfortable shoes that don’t give you calluses. Pack a lot of good socks.
2. Bring double the supply of your diabetes medications and blood-testing needs.
3. Bring a lot of healthy snacks. Always carry with you candy or any sugar source for episodes of hypoglycemia.
4. Don’t forget sunblock, a hat, and sunglasses.
5. FIRST AID KIT, with the following:

  • Glucose tablets or gel, or glucagon injection kit–for hypoglycemia
  • Anti-diarrhea tablets and re-hydration Treatment for diarrhea
  • Paracetamol for fever
  • Painkillers
  • Cough or asthma medication and antihistamine tablets–for allergy, anti-nausea or travel sickness medication
  • Standby antibiotic in case of upper respiratory tract infection, urine infection, skin infection, etc.
  • Topical antibacterial ointment for wounds
  • Treatment for vaginal yeast infections
  • Antifungal cream for skin infection
  • Blister treatments
  • Plasters
  • Antiseptic solution (Alcohol, Betadine)
  • Wound dressings
  • Gauze/cotton
  • Bandages
  • Scissors
  • Tape
  • Insect repellent
  • Water purification tablet

Tips if you are flying
1. Plan for time zone changes with the help of your doctor. Plan on when to take your diabetes medicine. Remember: eastward travel means a shorter day. If you inject insulin, less may be needed. Westward travel means a longer day.

2. Find out how long the flight will be and whether meals will be served. Carry enough food to cover the entire flight time in case of delays or unexpected schedule changes. If the airline offers a meal for your flight, call ahead for a diabetic, low fat, or low cholesterol meal. Wait until your food is about to be served before you take your insulin or diabetes tablet.

3. Plan to carry all or half of your diabetes supplies in your carry-on luggage. Don’t risk a lost suitcase. If going to the United States, visit the Transporation Security Administration website for updates on security and inspection rules regarding carrying liquids, needles, medication, and other gadgets in your carry-on bag. In general, all glucose testing paraphernalia, insulin in vials or pens, needles, and syringes are allowed. Remember to bring your medical letter and prescriptions.

4. Keep your diabetes medications and emergency snacks with you at your seat—don’t store them in the overhead bin.

5. If you plan on using the restroom for insulin injections, ask for an aisle seat for easier access.

6. If you inject insulin while in flight, frequent travelers suggest you be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can cause the plunger to “fight you.” This can make it hard to measure insulin accurately.

7. Tell your seat companions or the flight attendant that you have diabetes, especially if traveling alone.
8. Stay comfortable and move around to decrease the risk of blood clots in your legs.
9. Check your blood glucose often, especially immediately after landing. Jet lag can make it hard to tell if you have very low or very high blood glucose.

Other insulin tips

1. When you travel with insulin, give some thought to where you’ll be storing your supplies. Insulin does not need to be refrigerated. But insulin stored in very hot or very cold temperatures may lose strength. Don’t store your insulin in the glove compartment or trunk of your car. Backpacks and cycle bags can get quite hot in the direct sunlight. If you plan to travel by car or bike or to be out in the elements, take steps to protect your insulin. Many travel packs are available to keep your insulin cool.

2. Insulins used in the Philippines all come in the strength U-100. In other countries, insulins may come as U-40 or U-80 or U-1000. If you need to use these insulins, you must buy new syringes to match the new insulin to avoid a mistake in your insulin dose. If you use U-100 syringes for U-40 or U-80 insulin, you will take much less insulin than your correct dose. If you use U-100 insulin in a U-40 or U-80 syringe, you will take too much insulin.

General reminders
1. Check your feet everyday.
2. Don’t go barefoot.
3. Wear soft double socks when trekking.
4. Don’t go hiking alone.
5. Seek a health professional right away if there is redness, pain, or an open wound in your feet.

Relax!
Remember to rest. And don’t forget to enjoy your vacation (or whatever your purpose is for traveling)! It has been proven that proper preparation will save you a lot of money, keep you away from the emergency room, and leave you a lot of time to relax and have fun! Go where your heart leads you, but take your diabetes smarts with you!

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