Travel to India - when to inject

[linkecodes]

Hi all,

So I'm travelling to India for business in a few weeks and the time difference is +4.5 hours.

My dsn told me to stick to uk times for my Lantus as although they used to advise to try to calculate different doses, they don't anymore and tell you to stick to what you did already.

By my calculations, this will mean giving my lantus between 3am and 4am.

Now, as it's travelling east I'm fairly sure I'll be suffering a bit of jet lag whilst somehow trying to turn up to work each day, so There's little chance I'll be able to wake myself at 3:30 each morning!

What I'm looking for is advice, especially (hopefully?) from a fellow t1 who has made this journey.
How and when did you choose to do your nighttime insulin? Did whatever you did affect your sugars much?

As a side note .. I'm slightly concerned for carb counting too - as I believe the food will not resemble that which I eat at a uk Indian restaurant. And if you got "Dely-Belly" how did your sugars and keystones survive?!

I'm excited to go, but also a bit nervous what with this annoying disease to carry with me!

Thanks in advance for any advice

Lins

 

[GrantGam]

Hi all,

So I'm travelling to India for business in a few weeks and the time difference is +4.5 hours.

My dsn told me to stick to uk times for my Lantus as although they used to advise to try to calculate different doses, they don't anymore and tell you to stick to what you did already.

By my calculations, this will mean giving my lantus between 3am and 4am.

Now, as it's travelling east I'm fairly sure I'll be suffering a bit of jet lag whilst somehow trying to turn up to work each day, so There's little chance I'll be able to wake myself at 3:30 each morning!

What I'm looking for is advice, especially (hopefully?) from a fellow t1 who has made this journey.
How and when did you choose to do your nighttime insulin? Did whatever you did affect your sugars much?

As a side note .. I'm slightly concerned for carb counting too - as I believe the food will not resemble that which I eat at a uk Indian restaurant. And if you got "Dely-Belly" how did your sugars and keystones survive?!

I'm excited to go, but also a bit nervous what with this annoying disease to carry with me!

Thanks in advance for any advice

Lins

Hello

How long are you going there for? If it's a decent amount of time (which I assume it will be) it may be worth having a read of this:

http://www.diabetestravel.org/time-zones/

As for the food, if you're eating food in which you're not used to (and it's either pre-prepard or contains no nutritional info) - then it's going to be no different than how you count your carbs in a restaurant at home.

I hope you have a good trip, I'd love to visit India

 

[Deleted Account]

Typically when I travel anywhere with a large time difference, I gradually shift my basal injection time. If you normally take it at 11pm (which I think is what you do), a week before you go, take it at 10pm, the next day, take it at 9pm, ... until you reach 11pm India time. (Because India has that extra half hour timezone, you may end up moving your injection time by 30 minutes one day.) Given one hour makes little difference to most people, you may want to move it to 10pm as you may be feeling tired when you arrive in India and not want to stay up so late.
And, when you get home, you want to reverse this until you are back to your usual time.

Regarding eating in India, the advice is usually avoid salads which may be washed in local water, avoid ice in drinks, avoid anything which may be undercooked (such as fish or chicken), and eat in the popular places where the food has a high turn around rather than sitting around for a long time. I have travelled to India a number of times and never experienced any tummy problems. I think it helps to eat vegetarian food and find the food amazing - not like the greasy mega hot Indian take-aways we have at home.

If you are unfortunate to succumb to Delhi-Belly, follow the usual illness strategy - take plenty of readings and drink lots of water (sealed bottled, not tap).

Often when I travel, if I am concerned by the food (usually whether I can get vegetarian food), I take a large selection of muesli-type bars as back up.

Finally, enjoy the experience.

 

[Deleted Account]

Hello

How long are you going there for? If it's a decent amount of time (which I assume it will be) it may be worth having a read of this:

http://www.diabetestravel.org/time-zones/

As for the food, if you're eating food in which you're not used to (and it's either pre-prepard or contains no nutritional info) - then it's going to be no different than how you count your carbs in a restaurant at home.

I hope you have a good trip, I'd love to visit India

That link suggests adjusting the amount of basal you take on the day of travel. Have you tried this? It seems weird to me as my understanding is 20 units of basal will last for the same length of time as 10 units: the difference being you get half as much throughout the day. And it seems complicated.
I'd be interested to know if it works.

 

[GrantGam]

That link suggests adjusting the amount of basal you take on the day of travel. Have you tried this? It seems weird to me as my understanding is 20 units of basal will last for the same length of time as 10 units: the difference being you get half as much throughout the day. And it seems complicated.
I'd be interested to know if it works.

It just means that you'd take slightly less insulin at 7pm in the UK (for your last basal injection when at home) as your next basal injection will be 4.5 hours earlier in Indian time.

It suggests (from my calculations) that you'd take 14u at 7pm (for your last basal injection when at home) and then revert back to 20u at 7pm when in India.

I've not tried it, as I've not had to cross more than a couple of time zones since diagnosis. The theory seems solid though and I would if I were to fly a fair distance.

 

[Deleted Account]

It just means that you'd take slightly less insulin at 7pm in the UK (for your last basal injection when at home) as your next basal injection will be 4.5 hours earlier in Indian time.

It suggests (from my calculations) that you'd take 14u at 7pm (for your last basal injection when at home) and then revert back to 20u at 7pm when in India.

I've not tried it, as I've not had to cross more than a couple of time zones since diagnosis. The theory seems solid though and I would if I were to fly a fair distance.

Yeah, I understand what it is saying. I am surprised that it works. My understanding is regardless how much basal you take, it will still last the same length of time. So you have less basal available for the travel time and extra basal available for the first 4.5 hours in India.

 

[GrantGam]

Yeah, I understand what it is saying. I am surprised that it works. My understanding is regardless how much basal you take, it will still last the same length of time. So you have less basal available for the travel time and extra basal available for the first 4.5 hours in India.

The reason behind the reduction in your last basal dose before flying East is to avoid potential hypos. As far as I understand, if you were to make no reduction in your dose prior to travel, then you'd end up with an overlap of basal insulin and you'd have too much on board.

Your approach is easier to understand and would probably be a better bet for the OP. I'll need to book a holiday so I can try the fancy calculations out

 

[Jaylee]

Typically when I travel anywhere with a large time difference, I gradually shift my basal injection time. If you normally take it at 11pm (which I think is what you do), a week before you go, take it at 10pm, the next day, take it at 9pm, ... until you reach 11pm India time. (Because India has that extra half hour timezone, you may end up moving your injection time by 30 minutes one day.) Given one hour makes little difference to most people, you may want to move it to 10pm as you may be feeling tired when you arrive in India and not want to stay up so late.
And, when you get home, you want to reverse this until you are back to your usual time.

Regarding eating in India, the advice is usually avoid salads which may be washed in local water, avoid ice in drinks, avoid anything which may be undercooked (such as fish or chicken), and eat in the popular places where the food has a high turn around rather than sitting around for a long time. I have travelled to India a number of times and never experienced any tummy problems. I think it helps to eat vegetarian food and find the food amazing - not like the greasy mega hot Indian take-aways we have at home.

If you are unfortunate to succumb to Delhi-Belly, follow the usual illness strategy - take plenty of readings and drink lots of water (sealed bottled, not tap).

Often when I travel, if I am concerned by the food (usually whether I can get vegetarian food), I take a large selection of muesli-type bars as back up.

Finally, enjoy the experience.

This is good advice..
Been to south India backpacking a number of years ago.. (16/18 years back?) Yep, went veggie..
I found the heat made me a little more insulin sensitive.
I have to admit. I also used bottled water regarding the rinse On the oral hygiene teeth cleaning too?
I also seem to remember waking early mornings to the sound of stone carvers... The gentle tapping & chipping was musical.

Ooh, now I wanna go back..

Enjoy the trip @linkecodes !

 

[linkecodes]

Thanks for all the advice!
@helensaramay I like the idea of moving my normal time by an hour for a week or so before I go!
I think I will do that one as I'm rubbish at maths! (Yes not so good for a carb-counter, but that's what they invented smart phones for eh? Hehe)

I am a life long vegetarian, so no issues with that one - hopefully I won't get sick!

Got my visa and passport back today, starting to feel a bit excited!

 

[Chandradev819]

Hi @linkecodes
Welcome to you in India, I hope you will enjoy the trip. you will get all type of food. There will be no problem. Just take care yourself, Don't try to go outside in night time. Everywhere there will some good and bad people.

 

[linkecodes]

Well I did it! (Posting whilst waiting for last plane home to take off)

The advice to slowly change dose to match time zone worked a treat! In fact my sugars were far better than they normally are whilst there!

Anyone thinking of travelling there who ever reads this, I'd say the only difficulty was in the carb counting ... the food there was so very different from the "Indian" restaurants I've visited back in then uk, and many of the courses I did not recognise! I was lucky to have a team of locals with me to advise on the ingredients of some of the things so managed to make an educated guess sometimes, although I'd say that there's probably a lot more sugar in their savoury foods as the first few days i tended to run high during the evenings after my main meal of the day until I got used to it!

It was the trip of a lifetime and the people were the kindest I've ever met - I'm so glad I did it

 

[Robinredbreast]

Good luck and I hope all goes well with your business trip, especially with your diabetes management.
Take care

 

[Nikmumof3]

Can anyone help with this one please

I'm flying on 18th September this year and wondering where do I put my insulin when I fly is it in normal luggage or do I put it in my hand luggage and what's the limit of pen needles I can take (I'm on insulin 4x a day )

 

[GrantGam]

Can anyone help with this one please

I'm flying on 18th September this year and wondering where do I put my insulin when I fly is it in normal luggage or do I put it in my hand luggage and what's the limit of pen needles I can take (I'm on insulin 4x a day )

Hello @Nikmumof3

Never put insulin in the hold luggage as there is the risk of it freezing which will render it unusable.

All your diabetic supplies can be carried in your hand luggage, and it's often good advice to split them between you and another's hand luggage in case of a lost bag... You're also entitled to an extra bag, providing it is solely for your medical equipment. So one bag for hand luggage and one extra bag for diabetes stuff, should you need one

You should also get a letter from your doctor which outlines your condition and your need to carry diabetic related paraphernalia. There are no limit as to how many needles you can carry either.

 

[Nikmumof3]

Hello @Nikmumof3
Thank u so much for your help

Never put insulin in the hold luggage as there is the risk of it freezing which will render it unusable.

All your diabetic supplies can be carried in your hand luggage, and it's often good advice to split them between you and another's hand luggage in case of a lost bag... You're also entitled to an extra bag, providing it is solely for your medical equipment. So one bag for hand luggage and one extra bag for diabetes stuff, should you need one

You should also get a letter from your doctor which outlines your condition and your need to carry diabetic related paraphernalia. There are no limit as to how many needles you can carry either.

Tha

Hello @Nikmumof3

Never put insulin in the hold luggage as there is the risk of it freezing which will render it unusable.

All your diabetic supplies can be carried in your hand luggage, and it's often good advice to split them between you and another's hand luggage in case of a lost bag... You're also entitled to an extra bag, providing it is solely for your medical equipment. So one bag for hand luggage and one extra bag for diabetes stuff, should you need one

You should also get a letter from your doctor which outlines your condition and your need to carry diabetic related paraphernalia. There are no limit as to how many needles you can carry either.