I usually share what I have found that works for me when I travel with diabetes. But I had to make a lot of mistakes and learn what NOT to do in order to figure it out. Here’s my top 5 biggest diabetes mistakes while traveling. Hopefully you can learn from it to avoid making those same mistakes.
Dropping my insulin pump and meter in the ocean
Our first trip out of the country was a cruise to Belize, Honduras and Cozumel. We were inexperienced travelers at this point, and I didn’t do anything to prepare for a diabetes emergency. I mean, I had my basic stuff: glucagon, long acting insulin in case my pump broke, etc. Anyways, we were on a snorkel excursion in Belize and I was sea shell hunting along the beach. While I was looking at sea shells, I was not paying attention to my over-the-shoulder bag floating in the water next to me. The bag that happened to have all of my diabetes devices in it…
Insulin pump: ruined. Continuous glucose meter: ruined.
We got back on the cruise ship and I, thankfully, had my back-up insulin, but no back-up meter. As a last resort, I knew I could go to the cruise ship doctor, but I hadn’t checked with my health insurance company to see if they covered health care costs on a cruise ship. (Now I know that many don’t and you have to pay the high fees out of pocket.)
So what did I end up doing, you ask? I knew that statistically 1% of the general population has type 1 diabetes, so on a ship of 3,650 people, there should be 35 other people on the ship with type 1 diabetes. I ended up wandering through the dining hall looking for someone with an insulin pump. (I know, it sounds kinda creepy.) And I found someone! He was a really nice guy from Canada and he was totally understanding. I asked him if I could check my blood sugar on his meter to get a baseline blood sugar until we docked at another port to buy a meter. When I checked my blood sugar it came up as 4. Thankfully he was quick to share that they use mmol/L for blood sugars and that 4 is the same as a blood sugar of 72 mg/dl in the states.
I had a good baseline blood sugar for the night, then the next day in Cozumel I bought a meter and test strips at the Supermercado for ~$70. I ended up making it work, and coming out of it without any major issues or expenses, but it would have been so much easier if I had gotten travel insurance and thought of a back-up plan!
Breaking a vial of insulin
If you just screamed a little bit inside when you saw this photo, so did I. It’s always heartbreaking to break a vial of insulin, but especially when you are out of town. It always seems to be the loose vial in the butter compartment. amiright!? When we travel, I typically won’t put my insulin in there for this specific reason. (This one was totally my dad’s fault).
Other than just trying to be really careful, there are a few other things that can help. Last year I started having insulin pens prescribed instead of vials. Even though I usually us an insulin pump, you can draw up the insulin from the vial the same way and it has that extra layer of plastic to protect the insulin.
If the cost is higher for pens, or if you just prefer vials, another option is to us a protective case sold by Vial Safe:
Overbolused when drinking too much champagne
On one flight, my CGM was on the fritz and I was drinking the free champagne on the airplane. I accidentally overbolused for my snack and orange juice in the mimosas and didn’t recognize my low blood sugar until it was extremely low (37 mg/dL!) :0
I mistook my low blood sugar feelings as a champagne buzz and didn’t test my sugar. Now I am extremely cautious with my diabetes when I drink alcohol. I watch my sugars closely on my CGM, or at least every few hours if I don’t have a working CGM, and I test at any unusual feeling. I also make sure that people I travel with and drink alcohol around know that I am diabetic, what the symptoms of a low blood sugar are and how to help me if it happens. When you are of age, a word to the wise: pay close attention to your blood sugars when you are drinking because alcohol can affect your ability to recognize the normal symptoms of a low blood sugar.
Accidentally doubling my basal insulin
I often switch back and forth between using an insulin pump and using injections, especially when traveling to the beach or around water because I want to have more freedom and not have to stress about leaving an insulin pump on the beach. On a trip to Punta Cana, I came up with a genius solution: use long acting insulin (like Lantus, Levemir or Tresiba) as my basal insulin, but keep a pump site on to plug my pump in during meals and whenever we weren’t in the water to give boluses (meal-time insulin) to avoid having to give so many injections.
Here’s where my genius plan went wrong: I had set my pump at a 0% temporary basal rate, meaning the pump would be giving no insulin unless I told it to for food or a high blood sugar correction. Somehow the 0% basal rate got turned off, so my pump was giving me my normal amount of daily insulin IN ADDITION to the full dose of long acting Lantus I was taking. Hence the picture of all that yummy food. I was eating non-stop, hardly giving any insulin, and still having low blood sugars.
I finally figured out what the problem was, and man, did I feel dumb. But it happened and I learned from it. I still think it was a genius idea and now what I do instead is create a separate basal rate profile with 0 units/hr set for each of the basal rates. That way there’s no way for it to accidentally start giving me insulin unless I tell it to.
To read more about managing diabetes at the beach, check out this article on Beachin’ it with the ‘Betes.
Forgetting to change the time on my pump
Your body works like a clock. Your cortisol levels (stress hormone) fluxuates through the day with your sleep-wake cycle, and your insulin has to match up to that. That may be why you require more insulin in the morning. If you are traveling to a different time zone, you completely interrupt that schedule. It’s important to make your insulin “match” your new schedule.
I have had a lot of rough blood sugars on travel days when we are traveling somewhere with 7, 10, 14 hours time difference. I’ve learned that changing the time of my pump (or the timing of my long acting insulin) to “match” what my new time zone is/is going to be, is the most effective way for me.
To read all about managing blood sugars with time change, check out this article on Jet Lag and Diabetes.
So those are my biggest mistakes. I’m still making mistakes and learning every day. I’d love to hear some of your diabetes mishaps and what you’ve learned from them!