Diabetes and Travel

Travelling and holidays should be planned in advance and advice sought from the diabetes team when necessary.

People treated with Insulin

• People with diabetes who are treated with insulin when travelling abroad for an extended period of time should find out what types and strengths of insulin are available in the area in which they will be travelling (refer to Diabetes UK or the relevant pharmaceutical company).
• Insulins used in the UK and many other countries are of the strength U-100 (i.e 100 units per ml). In some countries insulin may come as U-40 (40 units per ml) or U-80 (80 units per ml) strengths. These insulins are not interchangeable. If they are to be used, the appropriate syringes are required.
• Insulin adjustment may be required for those on long haul flights. Anyone who requires advice on managing time zones should seek advice from their Diabetes Specialist Nurse in advance of travelling.
• Insulin should be kept out of direct sunlight and kept cool.
• Insulin should never be allowed to freeze, therefore when travelling by air, insulin should always be carried in the hand luggage.
• Insulin may be absorbed faster in hotter climates and lifestyle including diet and physical activity will probably differ when on holiday. Frequent blood glucose testing is advised to maintain good control and avoid hypoglycaemia.
• It is important to be prepared for any illness such as diarrhoea and vomiting which
  may cause diabetic ketoacidosis..  see: Sick Day Rules

Equipment: What should be taken

• Extra supplies of all medication including insulin,pens and syringes should be carried in case of delays, pen malfunction or lost hand luggage.
• If travelling with a companion, advise to split the amount between each passenger's hand luggage.
• A cool bag for storing insulin.
• Blood glucose monitoring equipment - along with adequate supplies of strips, lancets and a spare battery for the meter.
• High altitude, heat and humidity can sometimes affect meters and test strips. Individuals should be advised to beware of false readings.
• Dextrose tablets Dextrose gel, Glucagen injection and Ketostix if appropriate.
• A diabetes identity card or jewellery.
• Extra carbohydrate snacks in the hand luggage to cover any travelling delays in the form of sandwiches, fruit, cereal bars etc.
• Do not advise people to order a special "Diabetic" meal on the plane, as these often contain very little carbohydrate. .
• A letter, from either a GP or Hospital Diabetes Team, with a contact telephone number and address confirming the need to carry needles and syringes.
  Download letter template here.
• A basic first aid box.
• A list of all current medication - e.g. a copy of up to date repeat prescription request.

Vaccinations

People should be advised to find out what vaccinations are required for the proposed destination. Occasionally these can cause sickness or flu-like symptoms and it is best to have them performed 4 to 6 weeks prior to travelling.

See patient information leaflets:
Travel
Diabetes and Alcohol

Feet

It is important to protect feet from sunburn. Appropriate footwear should be worn at all times to prevent injury or blisters this includes the beach.

Insurance

• Travel insurance is vital. The person should inform the insurance company that they have diabetes and ensure that the insurance package provides adequate cover. This should include cover for emergency transport home and recovery of charges for replacement of insulin or equipment
• Free or reduced cost emergency treatment is available in countries in the European Union. The person will need a European Health Insurance Card.  Go to the NHS Inform website for more information on how to do this.