There is no reason why people with diabetes cannot pick any holiday destination. Careful forward planning can ensure that diabetes will not disrupt your holiday.
Planning your holiday
Check the vaccinations that you may need when planning a holiday abroad. Most practice nurses at your local GP surgery run travel clinics and are used to advising about necessary vaccinations.
Always make sure that you carry identification that you have diabetes.
(See www.drwf.org.uk) for FREE awareness necklace) if you are carrying insulin and needles obtain a letter from your doctor or diabetes nurse specialist.
Always purchase medical travel insurance that covers you whilst you are on holiday and read the small print to make sure that you have adequate cover. Be honest and declare any pre-existing medical conditions before you travel; failure to do so may lead to difficulty if you need to make a claim. As with any insurance policy shop around to get the best deal that gives you good cover. Unfortunately, having diabetes can affect both your existing policies and many new policies that you may choose, but you should be able to find an insurance company who will provide you with affordable travel cover.
Make sure that you have a European Health Insurance Card if you are travelling to another European Union Country. This will ensure that you have easy access to healthcare in the country you travel to. You can obtain an application form from NHS. Remember this does not replace the need for travel insurance.
What to pack
- Have all your diabetes medication and equipment – also include other medications that you take.
- Pack some extra snacks in case your journey is delayed.
- Glucose tablets and fluids to treat hypos – remember these must be purchased after going through customs.
- Have all your documents tickets, money, passport, insurance details. If you are carrying insulin and needles you must have a letter from your doctor or diabetes nurse specialist.
Take plenty of medical supplies with you and it is advisable to take more than you are actually going to need. If you are crossing a time zone seek advice when to take your insulin or tablets from your diabetes team. If you are travelling to a hot or cold climate make sure you find out how this will affect your insulin and blood glucose meter and strips.
Air travel and insulin
Despite the new security restrictions people can still take insulin onto an aircraft. You should bring a letter from your doctor (please note some doctors may charge for this letter).
All diabetes equipment should be placed in a clear plastic bag. Up to 50mls of insulin may be carried on a plane. If you need to take more please contact your insulin manufacturer for the safest way to store your insulin. Check in staff and cabin crew should be aware of the need to carry insulin and diabetes equipment. It is advisable to check with the airline you are travelling with before you go.
Generally select from the airline menu rather than ordering a special ‘diabetic’ meal. Low calorie drinks, tea and coffee are always available. Make sure that you have extra ‘snacks’ in case of delays.
Coping with illness whilst away
It is very important to have clear information on how to cope with your diabetes if you are unwell, especially for those who treat their diabetes with insulin. The golden rule is never to stop insulin injections or tablets. Drink plenty of fluids replace your food with soup, fruit juice or milk but also drink plenty of sugar free fluids.
Frequent monitoring is essential as blood glucose levels may rise even if you are unable to eat. If you have type 1 diabetes it is important to check your urine for ketones. These may be produced if the blood glucose levels are high. If present seek urgent medical advice. If you pay for any treatment and plan to claim on insurance keep all receipts and proof of purchase.
Extremes of temperature
In very hot weather insulin is absorbed more quickly from the injection area so if you take insulin to avoid hypo’s (low blood glucose levels), whilst on holiday monitor your diabetes and be prepared to adjust your insulin dosage.
In cold climates insulin is absorbed more slowly. However many people find that the energy used shivering can lower the blood glucose levels, again insulin doses may need to be adjusted. In hot climates drink plenty of fluids to keep hydrated and remember to protect your skin with sun cream. Do not store insulin in direct sunlight or allow it to be frozen.
In general, insulin may be stored at room temperature for up to one month. When travelling in moderate climates you do not have to store insulin in a fridge, providing it is not exposed to direct sunlight (in a car or on a window sill). Insulin can be damaged in very high temperatures or in bright light.
As a nation we are tending to try different foods from different cultures making foods on holiday more familiar. If you are tending to eat more, blood glucose levels may rise and treatment may need to be adjusted.
If you have good circulation and no problems with your feet there are no special precautions that you should take other than checking your feet daily.
If you do have circulation or numbness in the feet and legs remember that on long bus or plane journeys you should exercise to make sure that your feet or ankles do not swell. Examine your feet for sores, swellings or colour changes. If problems develop seek urgent advice – delaying treatment will make foot problems worse.
For the latest information about the country you are visiting check the Foreign & Commonwealth Office website www.fco.gov.uk