Managing Time Zones & Insulin: Traveling with Diabetes

Whether you’re going on a vacation or traveling for work, getting to your end destination can be stressful. Between flight delays, security, time zone changes, and all the things that can happen with your luggage, the relaxation doesn’t start until you get to your room.

And when you’re traveling with diabetes, there’s even more that can go wrong. There are a huge number of factors that can raise or lower your blood sugar— and you’ll encounter a lot of them when you travel, like lack of sleep, stress, sunburn, altitude, and exercise.

Here, we’ll discuss some potential pitfalls of traveling with diabetes and how you can prepare for them to make the most of your trip.

Time Zone Changes

If you’re traveling with insulin or an insulin pump, time zone changes can be especially challenging. The pump won’t update automatically to the new local time, like your cell phone does, so you’ll need to manually change the time yourself or risk getting doses at the wrong times.

Changes in time zones can also affect your blood sugar levels. If you’re used to eating breakfast every day at 9 a.m. in New York and abruptly switch to eating at 9 a.m. in California, your levels will be off compared to normal. That normally isn’t a danger, but be sure to mention it to your care team, so they understand the changes when looking at your CGM data.

Delays

Traveling almost always means waiting. Maybe your plane arrives late, the shuttle to your hotel doesn’t pull up to the curb on time, or your luggage takes a while to get to the carousel.

For people with diabetes, those waits can lead to dangerous blood sugar level dips, especially if they push back meal or fingerstick testing times.

One helpful strategy is to purchase a soda and some snacks as soon as you get through TSA. On-flight drink service can be delayed for a number of reasons, so you can’t count on getting something when you need it once you’re on the plane. Having access to your own snacks allows you to treat blood sugar dips before they become dangerous.

On the opposite spectrum of waiting? Rushing — which is no better for your health. It’s always a good idea to give yourself plenty of time to get where you need to go. Stress can elevate your blood sugar levels, so not having to hurry will keep you calm and help you manage your diabetes.

Cell Service Interruptions

You might not think about access to your cell phone when traveling. If you’re on a trip abroad with friends or colleagues, you might be too busy to call home or check your email. And if you’re camping, that lack of connection and screen time might be the whole point of your trip into the wilderness.

But lack of cell phone service means you won’t be getting your CGM updates, which are usually delivered to your smartphone. That means you can’t adjust your food, exercise, and medication to address the blood sugar changes you’ll surely encounter by traveling. So, check with your cell phone provider to ensure cell phone coverage wherever you’re traveling.

Lack of Access to Your Supplies

Anyone who’s traveled internationally knows you can’t always count on ducking into a store to pick up your preferred brand of toothpaste or shampoo. Maybe it’s unavailable or prohibitively expensive because it’s imported. Or maybe you’re nowhere near a convenience store.

The same is true with diabetes supplies. For a whole host of reasons — TSA restrictions, overseas shipping rules, lack of availability of glucose tablets, or lost luggage — you might not always have access to the supplies you need. Luckily, there are a few handy tips to prepare for anything that might happen during your travels:

Pack Extras

You might lose your luggage, or a bottle of insulin could break. You could be visiting a location that doesn’t allow your medication or pumps to be shipped to you. So, bring extras of all your supplies. You can also buy travel coolers that keep your insulin refrigerated when you’re on the go.

Keep Your Supplies on You

It’s a good idea to have a set of everything you need in a small bag you keep with you. Here’s why:

• Your luggage might get lost or delayed.
• Your supplies might break as your luggage gets tossed around during transit.
• You might arrive at your hotel early and want to stow your suitcase for a few hours while you explore. It’s easier to bring a backpack or tote with your diabetes supplies that you can easily grab instead of digging through your suitcase before you check it.

Even if you stow your supplies in your carry-on, if you’re on a packed flight, your bag may be nowhere near your seat. If there’s turbulence, you won’t be able to get up to access your bag. So having supplies in a smaller bag you can easily store under the seat in front of you means you can always access what you need.

Notify Everyone

Flying with insulin doesn’t have to be a headache. A little bit of communication can make all the difference. TSA recommends letting an officer know you have diabetes and are packing supplies in your carry on or checked baggage. They also require that insulin be clearly marked, and pumps and pump supplies always be accompanied by insulin.

It’s also a good idea to wear a medical bracelet so you can get medical attention if your blood sugar dips so low that you become unconscious and to let your travel companions know of your condition and needs so they can assist you if needed.

Prepare for Blood Sugar Changes

Traveling usually means walking, whether you’re getting to your gate or exploring a new downtown. And that can increase or decrease your blood sugar levels. So can interruptions in sleep while changing time zones as well as adjusted meal schedules. Maybe you’re traveling to a place like Spain, where it’s common to have a large meal in the middle of the day, and you’re used to smaller meals more frequently. Maybe you want to treat yourself and indulge in the local high-carb delicacies (in moderation, of course). Even a sudden increase in altitude from flying can interfere with insulin pump rates.

All of these can affect your blood sugar levels. So, get advice from your care team before your trip, and follow their directions about behavior and medication dosage and frequency. It’s common to have to increase your insulin levels to address these factors while traveling. And use your CGM to monitor your blood sugar levels so you can make adjustments to control your blood sugar levels without missing out on anything.