Adam Levbarg
TCOYD Newsletter, Vol. 26, 2008

As diabetics we really should consider ourselves lucky that our disease does not explicitly limit our ability to explore and engage with the world and its people. Let us also not forget that if we maintain good glycemic control, even in our elder days, we can find many years of active travel ahead.

However, we cannot ignore the reality that certain extra precautions and preparations must be taken in order to minimize disruption to our therapy and ensure that we'll be healthy enough to continue traveling for many more years. It will take a long time to see it all--the world is really quite big, you know.

Head to your closet. Dust off your travel gear. Break out those comfortable, worn walking shoes as we go through a few of the basics of traveling with diabetes.

Immunizations

Please don't overlook the importance of researching proper immunizations well in advance of your travels. Many vaccines need a month or two to become effective in your body, and often require a second dosage a month later in order to properly confer immunity. In addition, some people have adverse reactions to their immunizations, and it would be most unlucky to have a reaction while you're on the way to your dream vacation in Borneo. The gold standard rule with vaccines is to plan ahead--at least a month in advance, but preferably more. Visit a doctor who specializes in travel medicine. He or she will create a customized travelers immunization profile for you.

Travel Insurance

Absolutely Necessary! While domestic travelers can get away without it, international travelers would be foolish to skip this inexpensive investment in security and safety. There are many travel insurance policies available, such as those you can buy at STA Travel agencies throughout the country (and the world) www.statravel.com or www.worldnomads.com.

Please realize that ongoing diabetic prescriptions, such as test strips or insulin, will not be covered--this is a policy for travel emergencies, not your daily diabetic routine.

Learn From My Experience - After seeking treatment in Bangkok for a sinus infection, my travel insurance company emailed the claim forms to me a full two days after my appointment. You can imagine my shock when I read that the examining physician was required to personally fill out one of the pages! If I had moved to another region, it would have been a huge nuisance. Again--read your policy. Twice!

Medical Preparation

Be sure that you know beforehand if the quality of healthcare at your destination will be up to international standards. Consider enrolling for a free membership in the International Association for Medical Assistance to Travellers (www.iamat.org). Part of the membership package that this noble organization provides is a compact book of doctors trained to international medical standards, as well as medical facilities which also meet these standards, located all over the world.

Packing

The golden rule when packing for travel (as a diabetic or otherwise) is this--only pack those things in your checked luggage which you would not mind losing forever. Put all diabetes related supplies in your carry-on bag. Ideally, you should purchase a travel backpack which would be slim enough to be used as a carry on. I like the ones that Osprey manufactures--www.osprey.com.

It is always a good idea to carry a letter from your doctor stating that you are a diabetic. If you will be traveling in a country where English is not widely spoken, you might consider translating your doctor's letter into the local language.

You should purchase a small language phrasebook in order to have some capacity to speak with local people, and many quality phrasebooks have the word for "diabetes" listed under their medical heading.

Lastly, you should always pack more medication than what you will need, along with extra syringes and long acting insulin if you're on a pump.

Walking

I cannot stress enough how important good walking shoes and socks are. You should wear shoes that you have already worn and that you have already comfortably taken long walks at home. New shoes are unpredictable and can cause blisters during their break-in period.

As for socks, I really like the "Unholey Socks" they sell at Tilley Endurables (www.tilley.com). They're super strong, and when you're backpacking through Vietnam and washing your socks in the sink, the water wrings right out of them.

Emergencies

More useful than a Medic Alert bracelet is a travel partner who is at least minimally aware of your needs as a diabetic. My girlfriend was invaluable to me during our seven months of travels, and I rarely made a decision relating to my therapy without first consulting with her. When my blood sugar is low and I've eaten my last cookie, it's wonderful to have someone able to help me with the legwork.

If traveling alone, you may want to educate tour operators or the flight crew about your diabetes, but be aware that your diabetes is your responsibility. Do not burden your tour operator with special requests or expect special entitlement. Just as you do at home, you should make every effort to keep your medication stored properly, keep hypoglycemia treatments at hand, etc.

Cooling Solutions - One of the greatest challenges to overcome during my travels was keeping my insulin at acceptable temperature levels. While insulin can be left at room temperature for up to 30 days in temperate climates, I take no chances. Especially in tropical countries, I keep my insulin stored in a refrigerator whenever possible. During those times when a refrigerator is not available, I store my insulin in lightweight and convenient Frio cooling pouches (www.friouk.com/) which require no freezing or refrigeration and work quite well at keeping insulin at a safe temperature (as long as you follow the instructions closely.)

Summary

Travel can be a challenge, but it is an immensely rewarding one which leaves us with a better understanding of ourselves and the world we live in. Similarly, traveling with diabetes brings us on a rewarding journey of discovery and realization of how our body works and responds in unique circumstances. Whether your travels take you around the world or around the state, there are new things to learn about our diabetes and about the world.

Now get up and go somewhere different!

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Related Resources: Traveling With Diabetes, Episode 302