Traveling with diabetes: lessons and questions from our first 3 months

[Michel]

We have been on the road non-stop for the past three months, mostly but not only in hot weather, and have had to carry a year’s worth of gear in the car a lot of the time. Planning the trip was really time consuming. We made some planning mistakes, and execution mistakes as well. We have also encountered unexpected problems and issues, and a couple of mysteries.

Over the next few weeks, I am planning to start a thread per issue. This is what I am thinking of, right now, but I am happy to add other topics that anyone wants us to discuss:

• Planning for diabetes over multimonth trips
• Dealing with pump and CGM resupplies while abroad
• Carrying insulin around while traveling: during the day, in the car, on stopovers with and without fridge, in hot weather
• Basal and bolus changes in long trips (our experience)
• Maintaining a diabetes-friendly diet while on a long trip
• Dehydration management
• Keeping up with US schools while abroad (we made choices that not everyone might be happy with
• Diabetic travel misadventures
• Non diabetic issues

Feel free to add anything you want! For the sake of keeping a readable thread (and to make the forum more searchable), I will always try to spin off one thread per issue.

[Chris]

I think that is a great list. I am especially interested in the US school topic and of course the dealing with pump and CGM issues while abroad!

[T1Allison]

Ditto to what @Chris said. I’m very interested in basal rate changes throughout traveling. I’m always curious about circadian changes and basal impact, as well as sporadic exercise during travel, or extended sedentary periods.

[Aaron]

@Michel - I am also interesting in basal schedule and travelling.

I have done the 8 or 9 hour time change a few times, but it was always on a basal of NPH or Levemir so I did not really need to think too hard about. Ok - levemir was dead easy.

Now that I have a pump, I have only done short trips with 4-5 hour time zone changes so I just leave on my home timezone.

Curious to see your expereinced with the circadian rhythm changes

[TiaG]

Can’t wait to read about these topics! Especially the school issues and the pump resupply issues.

[Carol]

I’m also very interested.

[Katers87]

I’d also love to read these. Particularly the ones below. The pictures you’ve posted are beautiful! I’m totally envious, but also incredibly happy for you! Your trip sounds amazing!

@Michel

• Planning for diabetes over multimonth trips
• Dealing with pump and CGM resupplies while abroad
• Carrying insulin around while traveling: during the day, in the car, on stopovers with and without fridge, in hot weather
• Diabetic travel misadventures

[Michel]

My first report is here:

Travel surprise: dosing for sandwiches in hot weather

While traveling this summer, we encountered surprising problems in dosing for homemade sandwiches, leading to underdoses of 25-30%. When you move from place to place often (say, after 2-3 days), it is often convenient to rely on sandwiches on the way, or the first day after arrival. But, as we all know, it is pretty difficult to reliably gauge the amount of carbs in widely differing sandwiches provided by one-off delis or snacks (as opposed to well-known chains). Since we were traveling along n…

[Michel]

My second report:

Our experience of travel and time changes with insulin basal

[time change and insulin basal: we have been using an insulin pump all along, so this post may not apply directly to MDI users] For the past three months, we have been traveling non-stop, all summer. We left the US on June 8, arrived in Paris on the same day, left on a long 11-week driving tour the next day. We went South to the Mediterranean, then East to Hungary and Czechia, W and N to very far northern Scotland and the Orkneys, then back South to Portugal and Spain. We arrived in Granada, Sp…

[Mariana]

@Michel

• Planning for diabetes over multimonth trips

Definitely a life saving piece!!! Some of my diabetes peers in this part of the world are traveling to other countries, Canada, specially and most of us have no idea how to handle or even calculate diabetes needs. Would love to read about this.

[Michel]

My third report:

Effect of 3 months' travel on blood glucose levels (BG): summary

This is the summary of what we have observed over 3 months of itinerant travel this summer with our T1D teen. In a few words: his BG was better while traveling than during the school year. Background When our boy went from a child to a teen (shortly after he turned 12), we saw a radical effect. His time-in-range (70-120) went from 90% to 50%, his SD went from 30 to 50, and he went from no hypos to 15% hypo. During last school year, we were fighting hormonal peaks that would require 15-30 units…

[Michel]

My fourth report:

Planning for diabetes over multimonth travel trips: our experience

It took me a while to write up this report, as I found it difficult to organize. We left the US in early June 2018, for 15 months of continuous travel in Europe and Africa. We have now been gone for 8 months. For a bit over half of that time we were itinerant, moving every week or two, sometimes more often. We based ourselves in Granada, Spain in September, but still kept on traveling from here. In a bit over a month we will become fully itinerant again, this time in Africa and the eastern Medit…