We all go away for a day, on vacation or on a business trip. Going on a trip for people with diabetes is just that little bit different; there are a number of things to keep in mind. Good preparation is half the job! This way you ensure that you will not be faced with surprises during the trip. The tips below from diabetes nurse Daphna Karo help you to be well prepared.

Keep in mind that many things are different when you are on the road

• Due to a car or plane trip, you may sit for many hours at a time, causing you to exercise much less than usual and raise blood sugars
• It is warmer / colder than in your own environment
• The daily rhythm is different
• The food is very different from what you are used to
• There is a time difference
• Traveling can cause stress that disrupts blood sugars

Storing insulin

It is very important to store the insulin in good conditions during your trip and stay. Think of the following:

• The insulin should not get colder than 2^OC and not above 30^OC. Below 2^OC crystallizes the insulin and that causes it to flake. Above 30^OC, the effect of the insulin is significantly reduced.
• In a stationary car it is quickly above 40 . on hot days^OC. Do not leave the diabetes devices and insulin in the car and do not place the pens in direct sunlight.
• The use of a cooling bag is recommended. Do not place the insulin on cooling elements, but use a suitable cooling bag. There are special cooling bags for cooling insulin for sale, even if you do not have a refrigerator at your disposal all the time.
• During the car journey, there is a good place for the cool bag under the passenger seat.
• Do not store glucose strips loose in the meter case, but always in a tightly closed jar.

Make sure you have enough resources

Always make sure you take sufficient resources with you when travelling. Even if you just go away for a day, nothing is more annoying than having to go home because you have forgotten your insulin or other aids.

During the car ride

• Always measure/scan the blood sugar before departure.
• Is your blood sugar below 6mmol/l? Then eat something. Is the blood sugar below 4mmol/l (hypoglycaemia)? First make sure that the blood sugar is above 4 mmol/l with fast sugar and then eat slow carbohydrates (for example a sandwich or a banana).
• Do you feel that your blood sugar is too low while driving or do you receive a hypoglycaemia alarm via the sensor? Then pull over your car and check your blood sugar. Is the blood sugar too low? Trade as described above. Do not leave until your blood sugar is above 6 mmol/l again.

During the flight

• Check in advance where diabetes aids can be obtained at the holiday address in case of emergency.
• Take the contact details of your diabetes practitioner with you.
• If necessary, arrange a holiday insulin pump.
• Take pictures of your inulin pump settings and the advice in your diabetes diary.
• Take the diabetes aids with you in your hand luggage and if possible divide them between two bags of your own hand luggage. Then you don't lose everything right away, if a bag gets lost.
• Bring a customs declaration with you, which can be obtained from your diabetes nurse. Also consider a printout of your medication, which is available from the pharmacy.
• Are you using an insulin pump or sensor? Report this to security and inquire whether you can pass through the security gates without causing a malfunction. If this is not possible or is known, ask for an individual body scan without a gate.
• Be aware that sitting still and eating different foods on the plane can raise your blood sugars. Check your blood sugars regularly.
• Drink well, but no alcohol. The humidity in an airplane is low, which causes you to dehydrate faster.

How to deal with time difference?

Traveling to the West
When you travel west from the Netherlands, the day gets longer. This can be compensated for up to 4 hours with short-acting insulin.

Traveling to the East
Flying from the Netherlands to the east will shorten the day and the long-acting insulin injections will overlap.

Discuss with your diabetes nurse how to overcome this.

Use pump
Do you use an insulin pump and/or a glucose meter? Adjust the time on departure, to the time of arrival. Do you use a smartphone for your sensor or insulin pump? This will automatically take over the local time.

Take care of your feet

Do not walk barefoot to avoid foot injuries. Wear flip flops on the beach and possibly water shoes on a rocky bottom in the sea or a lake.

Questions or concerns?

Do you have any questions or concerns? Please contact your diabetes nurse.