Travelling to America - Looking for Advice!

[DTPhelan]

Hi all!

Just looking for any information and advice please.

I was diagnosed with diabetes in February, and I'm still waiting for official confirmation as to whether it's T1 or T2 (been referred to diabetic clinic which I have an appointment for on 17th April). Currently being treated as T2 with Metformin and Gliclazide.

I'm due to travel to Texas for 10 days in a few months, flying out on July 1st and returning July 11th (land back in UK on 12th), and I was just wondering what tips and advice people could provide regarding adjusting times of medications etc. for the flight and when away. It's a 10 hour flight with a 6 hour time difference. So on the 1st I'll leave UK at 12:00 but arrive in USA at 16:20 local time (22:20 UK time). And on flight back will leave at 18:30 as Texas time, arriving back on 12th at 9:20 UK time.

I've already looked into what to take with regards to copy of prescription/letter from doctors to state why I need the medication etc. And obviously cool bag and the like for insulin if I do end up being T1. So I'm more after advice for actually dealing with the change in timings of meals and doses.

As I am still waiting for confirmation of my type, and advice regarding T1 or T2 would be appreciated!

Obviously, once I know what type I am I could always get advice from my GP/Diabetes Nurse, but thought I'd get some info from the community first.

Thanks in advance!

 

[Tng1971]

I typically take my morning meds a couple of hours later than normal and then evening tablets early evening local time. Then for the rest of the trip morning and evening as per local time zones. For return journey I would take evening as per local and then morning just before landing.

 

[Wjohn]

Hi all!

Just looking for any information and advice please.

I was diagnosed with diabetes in February, and I'm still waiting for official confirmation as to whether it's T1 or T2 (been referred to diabetic clinic which I have an appointment for on 17th April). Currently being treated as T2 with Metformin and Gliclazide.

I'm due to travel to Texas for 10 days in a few months, flying out on July 1st and returning July 11th (land back in UK on 12th), and I was just wondering what tips and advice people could provide regarding adjusting times of medications etc. for the flight and when away. It's a 10 hour flight with a 6 hour time difference. So on the 1st I'll leave UK at 12:00 but arrive in USA at 16:20 local time (22:20 UK time). And on flight back will leave at 18:30 as Texas time, arriving back on 12th at 9:20 UK time.

I've already looked into what to take with regards to copy of prescription/letter from doctors to state why I need the medication etc. And obviously cool bag and the like for insulin if I do end up being T1. So I'm more after advice for actually dealing with the change in timings of meals and doses.

As I am still waiting for confirmation of my type, and advice regarding T1 or T2 would be appreciated!

Obviously, once I know what type I am I could always get advice from my GP/Diabetes Nurse, but thought I'd get some info from the community first.

Thanks in advance!

Before take-off take to airline ,ask about meal times ,menues for flights ,are there any diabetic meals ? What’s are the airlines processes for diabetics,will they serve your meals/snacks when you require them ? .Remember to inform the airports about your condition and medicines you will be carrying and security requirements for smooth passage through the search process ,
Having got these ,then plan for a comfortable flight ,
Enjoy Texas ,wjowen

 

[Deleted member 101090]

i think your doctor should be able to tell you or at least point you to the info you need.

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm484154.htm

 

[shonagh]

Hi, I have T1 & have traveled on both injections and pump. Overall I've not had too many problems when traveling. I would definitely recommend bringing double the medication you'll need for the days you're away, and splitting them into separate bags just in case one bag gets lost or stolen you'll have a backup. Drink lots of water, I personally get especially dehydrated on long flights and in the heat so I usually take a few rehydration sachets with me. Be extra careful with food - I find American food has a lot of hidden sugars in it, I'll be eating something seemingly healthy and suddenly have a sugar spike. With the time-difference and meal times, I am not familiar with Metformin and Gliclazide, so I can't really advise there - the only thing I would say is to potentially set an alarm during the night to check your bloods and snack if needed. As far as I can remember I may have reduced my background insulin injection for the first night to even things out - but your diabetes nurse will definitely be able to tell you what to do there.

Hope you have a good trip!

 

[Julesan]

Hi, lots of good advice above, I’m now on an insulin pump which can make time differences a lot easier to deal with (I’m in Australia at the moment)! When I was taking quick acting insulin injections with meals & 1 background insulin injection, I used to adjust the insulin time for my background insulin by around half an hour each day for about a week leading up to my travel, so that by the time I arrived in the country I was travelling to, I wouldn’t be having to inject my background insulin at a ridiculous time of day which wouldn’t be convenient. This obviously applies to countries with a bigger time difference such as the USA etc. I’ve had T1 for over 37 yrs & do quite a lot of travelling, I’ve never found it an issue. With regard to insulin cool storage, look at products such as Frio, I now use them all the time when abroad.
Enjoy your trip!

 

[milesrf]

In the US, diabetic meals tend to be based on obsolete ideas on what diets help those with diabetes. For example, they tend to be no sugar, plenty of starches, and low fat. Those labelled low-carb or low-carbohydrate are better, but airlines tend to find that these are too expensive to prepare at the same price. In the UK, most diabetic supplies are free once you have been diagnosed, In the US, they are not.

 

[Emu Rob]

Hi

I have had insulin controlled type 2 for 28 years and I travel overseas on business world wide about 10 times a year. Never had a problem taking my insulin through customs or immigration and don't bother taking documentation now. Security sometimes pick up my cool bag in my briefcase but normally OK after they re x ray. Main thing is food you don't know what you are eating so always have some glucose tabs by your bed side for night time problems. Could never work out the dosage for curried dog in China or other weird foods so I tend to slightly overdose the insulin at meal time and check just before sleep and remedy the situation. Re food on flights I never eat on the plane. I get a sensible meal before the flight at the airport and I can go 12 hours without **** airline food. watch drinks a bit more carefully. Remember if things go wrong in the USA then its passport and credit card first before they treat you. I had 5 hour nosebleed in Tucson needing hospital treatment and thanked the lord for my Amex. And i carry heavy travel cover. Remember to tell your travel insurers you have diabetes. Main thing is to get on with it and enjoy the trip. That's what i do but then I have never let diabetes rule my life always the other way round

Hope this helps

 

[Bluetit1802]

I think one very important thing is good holiday insurance, being totally honest about your condition.

Enjoy your trip!

 

[Deleted Account]

There is great advice on www.diabetes.co.uk.
For example, this page tells you a lot about what to consider: https://www.diabetes.co.uk/travel.html

 

[malky39]

Take double the amount of medication you think you will need and split it between you and travelling partners if you are travelling with someone else. You dont want to have try and get medication over there its not cheap, £650 for two 10ml vials of novo rapid, make sure you have insurance that covers you medical conditions.

 

[Munsa]

Hi, lots of good advice above, I’m now on an insulin pump which can make time differences a lot easier to deal with (I’m in Australia at the moment)! When I was taking quick acting insulin injections with meals & 1 background insulin injection, I used to adjust the insulin time for my background insulin by around half an hour each day for about a week leading up to my travel, so that by the time I arrived in the country I was travelling to, I wouldn’t be having to inject my background insulin at a ridiculous time of day which wouldn’t be convenient. This obviously applies to countries with a bigger time difference such as the USA etc. I’ve had T1 for over 37 yrs & do quite a lot of travelling, I’ve never found it an issue. With regard to insulin cool storage, look at products such as Frio, I now use them all the time when abroad.
Enjoy your trip!

Having recently returned from Australia, I find it easier to change my watch to the place I'm flying to eg Glasgow to Singapore, then Singapore to Perth then Perth to Melbourne. I also avoid diabetic meals on plane journeys. They usually don't work!

 

[Gnat]

Since diagnosis 18 months ago I have travelled quite a lot on my own, up to 4 x a year from NZ to Europe and all around Europe. I still have a tiny amount of beta cell activity which seems to kick in sometimes. This is what I have done and it has worked well - no hypos in my travels as yet.

I normally drop my Lantus dose down (eg from 10 to 8) but I keep to the same time in NZ as I would normally dose, as it is too hard to change things around for 10 days or 2 weeks away. So I dose at night in Europe and morning in NZ. This doesn't seem to cause any problems.
I limit wine to a glass at night - when I have had a couple I can see on my Libre a dip overnight and I prefer not to have this when away.
The libre helps as you can much more easily see what is going on and looking frequently is better than occasional blood tests when food, circadian timing (day-night body timing) and exercise and stimulation are all different.
I no longer go through the body scanner with my libre - I did it once and the sensor read really low on the flight afterwards and that continued and it was so unreliable I had to take it off. I just say I have a medical device and you have to wait for a pat down. So far that has been ok to say that. I didn't take a spare sensor with me so that was unhelpful.

Watch out for where they have a full flight and offer to put your hand luggage in the hold - I forgot my spare insulin was in that bag and it went in the hold instead, not good, might have frozen.

Going to Australia I take the frio packs to keep it cool and that seems to work well.

I take food for the flights with me - tricky with low carb. The diabetic meals tend to be high carb, so I request a normal meal but sometimes there is absolutely nothing I can eat. Best to assume there won't be. I take packs of nuts, small easy open cans of tuna (liquid so need to be in a plastic bag on the main flight) and vegetables (but note some countries you can get fined for taking vegetables in, so remember to dispose of them if you need to). I always carry food with me during the day also as many places don't do low carb so well, especially cafes for lunch.

I find low carb is really good for travel - makes the chances of hypos lower. Always have jelly beans or similar kept close by.

I keep a bag of my essentials (insulin, food, testing meter) and running shoes near the hotel door in case of an emergency so I can grab and run, e.g. fire, earthquake.

Taking a spare meter is a good idea, I've had a meter fail before when away skiing.

If doing a lot more exercise than usual that can affect levels that day and the next.

I have a medical alert bracelet with details on it, name, type 1 diabetic, with my partner's number. He has all my dosing details.

I take a letter saying I am diabetic and my medicines - but no one has ever wanted to see it.

Typically travel insurance costs quite a bit more, **** it.

 

[DTPhelan]

Before take-off take to airline ,ask about meal times ,menues for flights ,are there any diabetic meals ? What’s are the airlines processes for diabetics,will they serve your meals/snacks when you require them ? .Remember to inform the airports about your condition and medicines you will be carrying and security requirements for smooth passage through the search process ,
Having got these ,then plan for a comfortable flight ,
Enjoy Texas ,wjowen

The meals for the flight do include a "diabetic" option, but I will have to check exactly what they have. I'll definitely get in touch with the airline

 

[DTPhelan]

Since diagnosis 18 months ago I have travelled quite a lot on my own, up to 4 x a year from NZ to Europe and all around Europe. I still have a tiny amount of beta cell activity which seems to kick in sometimes. This is what I have done and it has worked well - no hypos in my travels as yet.

I normally drop my Lantus dose down (eg from 10 to 8) but I keep to the same time in NZ as I would normally dose, as it is too hard to change things around for 10 days or 2 weeks away. So I dose at night in Europe and morning in NZ. This doesn't seem to cause any problems.
I limit wine to a glass at night - when I have had a couple I can see on my Libre a dip overnight and I prefer not to have this when away.
The libre helps as you can much more easily see what is going on and looking frequently is better than occasional blood tests when food, circadian timing (day-night body timing) and exercise and stimulation are all different.
I no longer go through the body scanner with my libre - I did it once and the sensor read really low on the flight afterwards and that continued and it was so unreliable I had to take it off. I just say I have a medical device and you have to wait for a pat down. So far that has been ok to say that. I didn't take a spare sensor with me so that was unhelpful.

Watch out for where they have a full flight and offer to put your hand luggage in the hold - I forgot my spare insulin was in that bag and it went in the hold instead, not good, might have frozen.

Going to Australia I take the frio packs to keep it cool and that seems to work well.

I take food for the flights with me - tricky with low carb. The diabetic meals tend to be high carb, so I request a normal meal but sometimes there is absolutely nothing I can eat. Best to assume there won't be. I take packs of nuts, small easy open cans of tuna (liquid so need to be in a plastic bag on the main flight) and vegetables (but note some countries you can get fined for taking vegetables in, so remember to dispose of them if you need to). I always carry food with me during the day also as many places don't do low carb so well, especially cafes for lunch.

I find low carb is really good for travel - makes the chances of hypos lower. Always have jelly beans or similar kept close by.

I keep a bag of my essentials (insulin, food, testing meter) and running shoes near the hotel door in case of an emergency so I can grab and run, e.g. fire, earthquake.

Taking a spare meter is a good idea, I've had a meter fail before when away skiing.

If doing a lot more exercise than usual that can affect levels that day and the next.

I have a medical alert bracelet with details on it, name, type 1 diabetic, with my partner's number. He has all my dosing details.

I take a letter saying I am diabetic and my medicines - but no one has ever wanted to see it.

Typically travel insurance costs quite a bit more, **** it.

This all seems like good advice which I'll be sure to keep in mind. Yeah, I've not sorted travel insurance yet but I know it'll be higher than last year before my diagnosis, which sucks. I will be doing a fair amount of walking every day whilst over there so I'll have to keep an eye on my levels. Thanks a lot

 

[kre8tiv1]

It will be extremely hot and humid in Texas in July. Usually over 35c. Make sure you stay well hydrated.