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Newly Diagnosed and travelling to India

S

selya

Member
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Hey everyone!

I am newly diagnosed type 1 (21 years old) and its been about 2-3 months since my diagnosis. Currently, on novorapid and lantus (8 units) but with novorapid I was recently told by my DSN to adjust to 1:10 ratio and provided some advice on how to do correction doses. I have been following this new regime for a week now and my morning levels are pretty good within the range of 5-8mmol/l. I have had occasional hypos like around 4 where I would feel very bad dizziness along with other symptoms but nothing major as of yet. However, due to family wedding I would be travelling to India in few weeks time and I am not sure how to go about with the travelling because now its summer in India and by the time i go in end of May it will be peak of their summer at temperature of 40-45 degree. So is that bad for people with type 1 diabetes to travel in such weather? what about the insulin? since i am going to a wedding i will be doing lots of shopping and i noticed that walking reduces my glucose readings. I am waiting for my DSN to give me an appointment before I book the tickets etc but I really want to go and I don't want my diabetes to stop me from going. Please could you guys provide me with some advice or share some of your experiences on how you handled travelling to hot countries and managing diabetes.

Thank you everyone!
 
Welcome to the forums.

Avail yourself of a Frio travel wallet from well known on-line vendors. They hold either 2 or 4 pens and once soaked in water they swell up and the exothermic reaction ( almost sounds like I know what I'm talking about) helps to keep your pens cool.

I have used Frio's in Manila in the mid 30's and they're pretty good.

Heat generally helps your body to absorb insulin so you may well require lowered doses whilst in India. Can't advise on numbers, just keep testing and take more (with you) than you think you will need - unless your insulin is easily available at your destination.
 
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Hi, @selya , you've already partly answered your own question when you said you've noticed that walking reduces your bg: if you are going to be walking a lot more than usual, reduce the amount of bolus, fast acting insulin you normally take for the meal before the walk.

Several things affect bg: amount of insulin; amount of carbs; amount of exercise; how hot it is; (there's many others, but let's leave it there for now).

Exercise, even if it's walking around a lot for shopping, drops bg because using muscles lets them use up glucose much more effectively.

Heat does that too: it expands blood vessels and lets insulin swim around and do it's job much more quickly.

The upshot of all that is that is if you were to take the same amount of insulin in hot India walking around a lot as you do in a cold UK sitting down in an office, it'll get messy - your bg would go too low.

So, I'd be thinking along the lines of tailing back the amount of basal insulin a little bit, and definitely tailing back the amount of fast acting by a fair bit. How much you tail it back is up to you and your dsn.

There's nothing wrong with running your bg a bit higher for a week or two just to keep you in the safe zone. If you do go hypo through walking about, remember that a small amount of carbs will pull you out of it ok.

T1 is all about adjusting insulin and carb amounts and taking account of things like exercise and heat. Reduce the insulin for exercise and heat and it'll generally be ok.

Don't cancel your wedding ticket! T1s don't say, "we can't do this", we say, "how can we do this safely."

In your case, I reckon you can do the wedding gig perfectly safely by reducing your insulin doses a bit to take care of the walking and heat, and making sure you've got some fast acting glucose to hand in case you get it wrong.

Enjoy the wedding!
 
@urbanracer Thank you for the recommendation! They sound very handy so I will definitely look into it.
 
@findthespot2 Thank you for replying! If you don't mind me asking, how did your partner manage hypos? Was the flight journey's hard any advice on it please?
 


@Scott-C Massive thank you for that detailed response! I feel a lot more reassured about going ahead with this travel. I will speak to my DSN regarding the insulin adjustments. You really have given that extra confidence through your response. I feel very excited for my travel to India!
 
One thing I would suggest is buy 2 Frio wallets and take spare insulin pens, a spare BG meter and anything else you need to manage your diabetes, including spare batteries for both BG meters. If a meter fails you may not be anywhere that you can buy another one and the same meters ate essential so the strips are right.
I've travelled a lot and this gives you backup. I've not needed it - yet, but plan for the worst!
Have a fantastic trip
 
Just a word of caution with hotel fridges in India. I found a lot of fridges didn’t work properly. Some were either not cool enough while others were too cold. If the soft drinks inside are frozen solid you’ll need to find an alternative because you don’t want your insulin to freeze and become ineffective. As others have mentioned a Frio bags are wonderful, just ensure they are always wet. I would take a lot of test strips and test constantly. Take a spare meter with you, just in case one develops a fault - mine did! Last but not the least always carry a supply of sugary drink or sweets with you. Hope you have a wonderful trip and enjoy the wedding.
 
@Lynne C J Thank you for replying! I have got couple of Frio wallets to use during the holiday but I have got few questions please do you think I should keep the insulin am using everyday in the frio wallet as well or it will be okay in the normal cases? and also I was given additional glucose meter (not told about changing batteries) so I have meter that I use along with an extra one given by my DSN for the trip in case of emergencies. Do you think I should keep both the glucose meters in the frio wallet? how do i store the test strips?

Sorry I know it's a lot of questions but its just am worried as it is the first holiday since my diagnosis. I would be very grateful if you could share some advice please.
Thank you
 
Hi Selya, I have been a T1 for 24 years and, until last year, lived in Africa. Heat will definitely reduce your need for your bolus insulin, especially if you are more physically active than usual. Most of that has been covered in the above comments. Keep your test strips cool but not refrigerated. Take extra strips for sure. Also remember to take glucose sweets which you carry on you at all times. That way you can quickly sort out a low BG wherever you are. Very important also to keep well hydrated. I have travelled many times as a T1 - and it is really fine. The biggest thing is to be well organised and not to let anyone make you anxious or rush you. You are on a big learning curve, take the time you need. I know it's daunting, but you will adjust and life will seem simple again. Go and enjoy your holiday and the wedding!
 
...I would keep your current pens in your frio wallet. Heat can denature it otherwise. Meters are pretty hardy but don't leave them in direct sun.
 

Thank you @Jacqui T it is really giving confidence reading all the suggestions! Do you think I can get away by not giving novorapid (quick acting) for one of my meals if i know I have done enough activities? or Do I still need to ensure that I take at least 1 unit to keep me going? The weather has really changed in the UK as we are heading towards our summer and I have reduced my lantus to 6 units now and I am starting to notice even if I take less novorapid for my carbie food I can feel the change in glucose through mad dizziness frequently. Therefore, I am quite confused as the weather in India is double the weather here so I was wondering if it is worth taking novorapid for some meals of my day?
 
Hi try not to worry too much.
Just make sure your Basal and Bolus pens are in date, keep them out of direct sunlight and also within your hand luggage not the hold,you'll need a letter from your Diabetic clinic saying you can carry insulin needles etc for when you go through security.

My advice for the hot weather is to regularly check your BG before during and after your walks. I'd possibly leave your background the same but adjust your bolus , I'm thinking maybe adjust your bolus by 1-2 units perhaps a little more on the hotter days.

I'd also suggest before you go that you should perhaps do some extra testing before you go away and maybe do a walk so you can see the effect it has and so you can see if there are any times in a normal day when your BG spikes or declines as it will give you a good pattern to work from. E.g. If your BG should decline between lunch and dinner normally, with walking and heat it will drop more so perhaps even adjust your Basal slightly too. But get patterns first don't just change as it might be for another reason. Do carb free lunches/dinners if your BG IS normal as this will tell you that your Basal is working correctly.

I've been to Australia in extreme heat and I was on Mixtard insulin before Basal Bolus.
It was fine but regularly check your BG'S that is key here.
Also when you go for your walks take a bottle of orange juice with you as it is a quick way of coming back from a hypo and then eat soon after but remember to include it in your next bolus so your BG doesn't spike too much later on.

Diabetes shouldn't stop you from doing the things you want to do you just have to be more aware and prepare for it.

It's a lot of info to take in however I do suggest at some point on your return if they run them that you ask to be able to do DAFNE as this will tell you everything you need to know. I'm on the pump now and was very apprehensive at first but doing the course was a great help learnt a lot especially the OJ bit.

Good luck I'm sure you'll be fine.
 
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