I recently took a 2-week trip to Australia and New Zealand, a belated milestone birthday and wedding anniversary celebration with my husband. Every time I take a long trip, I’m reminded of how much more challenging traveling is when you have diabetes, particularly when crossing multiple time zones and/or sitting for hours on end. Here’s how that recent experience went for me as an insulin user.
Insulin Management: First off, I will say that having an easily varied basal insulin regimen makes traveling a little less challenging when it comes to blood glucose management. Over the years, I have traveled using Lantus, Tresiba, and an Omnipod pump with Lyumjev insulin, and using an insulin pump is the easiest by far when it comes to making changes in real time over multiple time zones and during 12- to 14-hour flights with little physical activity. However, I really have to stay on top of my blood glucose management to change insulin dosing when forced to be sedentary for so long and eat foods that I may not normally eat. There’s a lot of trial-and-error involved and frequent monitoring of my glucose status.
Food and Eating: Nothing about traveling with diabetes—especially when you use insulin—is that easy, but I find eating the hardest of all. At home, I have food available that I like to eat and know how to cover with insulin. For me in particular, traveling causes me to spend way too much time trying to anything to eat that won’t mess with my blood glucose. I normally eat a lot of plain veggies—broccoli, cauliflower, green beans, salad greens, and more—and it’s really hard to find those in the quantities I normally consume at a restaurant; and when I do find some, they’re usually covered with extra calories in the form of oils, sauces, cheese, etc. Just give me half a plate of plain steamed broccoli with a side of something protein-based and a small amount of starchy carbs or some whole fruit and I’m a happy camper! (I almost never find a meal like that when eating out.) It’s frustrating as well when almost any restaurant meal requires 2-3 times my usual doses of mealtime insulin. Traveling always reminds me that I am totally not a foodie. Food always has physical and mental consequences with diabetes, which takes most of the enjoyment (for me) out of eating or trying new meals.
Dietary Restrictions: I also have a food allergy to celery and all its related products (celery seed, salt, and root, Mrs. Dash, Old Bay seasoning, and even squeezed celery juice), and I also choose not to eat red meat (and haven’t for the past 45 years). Having to be careful about what I eat when traveling just makes it that much more challenging. Over the years, I have had to visit emergency departments for immediate celery-related items and pharmacies for Benadryl. To compensate, I travel with a lot of my own snacks on hand, including nuts, protein bars, string cheese and, of course, glucose sources like tablets and Smarties candies. But snacks are not meals and worrying about celery when traveling takes a lot of the fun out of not having to cook for myself while on vacation.
Exercise: Did I mention how hard it is to try to get in my normal amounts of physical activity when traveling? It’s not just I’m spending all my time traveling; it’s also about access. I’m used to swimming laps, cycling, doing resistance training, and walking my dogs every morning. Whenever I arrive at a new location or hotel, I try to locate the nearest fitness facility. I often select my hotels by which ones have them—but it’s hard to know in advance how good each facility is. On our latest trip, I just ended up trying to get at least 10,000 daily steps! It worked most days, thankfully, but left me less fit at the end of our travels.
Diabetes Supplies: Finally, let’s talk about how many diabetes supplies—and backup supplies—I have to fit into my luggage when I travel. Not only do I have to take extra CGMs and Omnipod insulin pumps, but then I take extras to back up my extras (in case of technical failure, which happens to me frequently with my CGM and even with my pumps), along with multiple vials of insulin, backup basal insulin of a different type, spare syringes, alcohol wipes, Tegaderm, and loads of Smarties and glucose tablets. Since my husband was traveling with me, I also made him carry some extra Smarties, more backup supplies, and a ton of snacks. Even on every excursion lasting more than a few hours (like to see the 12 Apostles along the Melbourne coast in Australia or the thermal pools in Rotorua, New Zealand), I have to pack extra diabetes supplies and snacks in my backpack on the tour bus and hope for the best. So much for traveling light!
That said, am I glad I had the opportunity to travel halfway across the world on vacation despite having type 1 diabetes? Most assuredly! It would just be nice someday to be able to travel and take a vacation from diabetes at the same time.
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