Travelling with diabetes

New Zealanders love travelling to warmer climes during our cold winter months. Alison Pask, a New Zealand registered dietitian,gives some suggestions to help you enjoy your trip and stay healthy.

Hayden and his wife Ange on a long-tail boat in Thailand

Some of the common issues of travelling for people with diabetes include:

Delayed flights resulting in delayed meals
Changes in the type and amount of food eaten
Unavailability of appropriate food or drink
Use of unfamiliar ingredients
Different amounts of physical activity than usual - this could be less if you are sitting on a beach or more if you are sightseeing.

You may wish to test your blood glucose more frequently, especially if your activity and food routines are changed. Testing will help you adjust to the circumstances of different routines.

To keep in control of your diabetes, planning is the key.

Hayden Vink from Diabetes Youth Wellington (in the picture above), who was diagnosed on his first world trip, has never let having Type 1 diabetes stop him from travelling.

'To stay on top of my diabetes, I test as often as I can, and adjust my insulin doses until I've got used to the time zone, food and activity.

'This usually means reducing my insulin initially, but perhaps having an extra injection or two, especially on long flights. I also make sure I carry high-glucose food should I need it.'

Things to plan for

Your method of travel on arrival e.g. car, bus or plane. If you are driving once you arrive at your destination, you will have more control over stopping for meals.

Will you be in isolated areas where there are no shops? If so, carefully plan your food supplies to ensure you have adequate food for your stay.

If you are doing lots of walking, drink extra fluids, especially if you are in a country with a warmer climate.

Will you be eating out, cooking for yourself or relying on others to prepare your meals?

If you are going to a foreign country with different cultures, learn about the local foods and drinks. Find out which foods contain carbohydrate.

Always carry essential items with you including your medication, a letter from your doctor, blood glucose monitoring equipment, glucose tablets to treat a hypo, and some carbohydrate food e.g. a fruit bar. Ensure these are easily available at all times. Have a glucose tablet in your pocket - in the middle of a hypo you won't want to try to locate your cabin baggage and find your glucose.

Visit your health care team before you leave

If you are crossing time zones, you may need to adjust your medication or insulin. Make an appointment to discuss this with your doctor or diabetes nurse specialist. Remember to take your itinerary with you to the appointment.

Make an appointment to see your dietitian to discuss suitable foods. Jot down a list of questions to ask.

Ensure you have adequate supplies of medication, insulin, needles, test strips and any other medical supplies you may need. These may not be available in the country you are visiting.

Prepare beforehand

If you are overweight, losing just a few kilograms can make a big difference in your overall enjoyment of the trip.

Order a MedicAlert bracelet (0800 840 111 or www.medicalert.co.nz) as it's vital that you are identified in any medical emergency. Ask around and talk to people who have travelled to your destination as they may have valuable tips.

Discuss departure times and arrivals with your travel agent to find an itinerary suited to your needs. Or you can book on the internet to choose flights that best suit you.

It is generally accepted that people with diabetes don't need to order special meals while flying and you should be able to make wise food choices from the meals offered. However, if you have other conditions that require special meals e.g. gluten free, phone the airline at least a week before you leave to order your 'special meal'.

Or ensure your travel agent does this when booking your flight. You must order such meals before you fly, as the cabin crew will not be able to conjure one up once in the air.

Taking your own food on a flight

Find out if your airline has any restrictions on the types and quantities of food and drinks you are allowed to carry with you. If your flight is delayed and dinner ends up being served late, you will need to eat. To avoid such crises, take along some wholegrain crackers, cheese wedges, fruit bars and suitable drinks.

If you take insulin, it's a good idea to wait until you actually have your meal before injecting, this way you will not have a problem if your meal is delayed.

Some flights such as Freedom Air from New Zealand to Australia no longer serve food. Rather than relying on the food available to purchase onboard, take your own in a small chilly bag e.g. sandwiches, salads, bread rolls, fruit, bran muffins, wholegrain crackers and low fat cheese.

For something hot, take some dehydrated soup and ask for a cup of hot water onboard.

Many countries have very strict laws governing the importation of food, particularly fresh food such as meat and fruit. If you are going to a country that prohibits importing food, either make sure that you consume all your provisions before you disembark, or leave the uneaten food behind in the plane, but do explain this to the cabin crew first.

Drinks

For any flight lasting more than two hours, stock up on non-alcoholic liquids. Drink as much water and sugar free drinks as possible during the flight.

Take your own bottle of water along. By keeping your water balance positive, you won’t feel as tired and irritable when you reach your destination.

Alcohol contributes to dehydration so stay away from alcoholic drinks while flying. Alcohol could also contribute to your blood glucose levels falling below what is desirable, resulting in a hypo.

Once at your destination

Breakfast is the most important meal of the day. Even if you have slept in, ensure you start the day with a good breakfast.

Choose wholegrain bread, cereals, fruit, low fat yoghurt or a poached egg on toast. Instant oatmeal porridge is great to take with you or buy when you arrive. Just add water and your breakfast is done.

Follow these simple suggestions and you’ll enjoy your holiday and bring home happy memories to share with your friends and family.

Find out more on travelling with Type 1 diabetes ....

Find out more on travelling with Type 2 diabetes ....

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