Diabetes mellitus and the traveller

The following gives general advice that may be helpful to the diabetic traveller.
Comprehensive country-specific advice is available from: The British Diabetic Society, 10 Queen Ann Street, London W1M OBD

The journey

Climate

Insulin absorption may be affected in a warm climate. Maintain a high fluid intake to compensate for loss.
Ensure safe storage of glucose strips to maintain accurate readings. Keep insulin out of direct sunlight and in colder climates do not let it freeze.

Activities

Some people are more active on holiday, others less so. It is important that diet, oral glycaemics and insulin are adjusted to compensate.

Food and drink

The diabetic traveller has to be extra cautious to prevent infections which can cause gastro-intestinal upset. Vomiting and diarrhoea can lead to hypoglycaemia.

Insulin schedules

All international flights east or west involve crossing time-zones.
Some practical advice on administering insulin is as follows:
plan in advance
talk with a specialist
take adequate equipment and medication supplies
take adequate carbohydrate or glucose supplies since delays can alter mealtimes
monitor sugar levels especially on long journies
be prepared for delays
plan a schedule in advance but be prepared to alter it later if delays occur.

Insulin storage

Although some manufacturers state that insulin can remain stable for up to one month at normal room temperature, extremes of temperature can reduce its activity.
When travelling keep vials in a cool, dark place. Polystyrene containers, vacuum flasks, face cloths in a sandwich container,are all useful. Special travel-carry systems are available from specialist suppliers.

Holiday footcare

During the journey make sure shoes are not too tight as feet can swell. Take a walk each hour as exercise limit the amount of swelling. If hospital shoes are normally worn then also wear them on holiday. Changing to ordinary shoes could cause ulcers. Avoid walking barefoot; wear protective footwear on the sand and in the water. Avoid sunburn to feet and legs by using protective sunscreens or covering up.
Prevent dry skin by using moisturisers, especially on heels which crack easily. Moist skin can lead to infection. take first aid kit for minor injuries. Examine feet regularly and seek medical attention if any problems arise.