Holidays are great and you’ll be glad to hear, thoroughly recommended for people who have diabetes! Air travel is a therefore common occurrence for people who receive insulin therapy. This leaflet aims to discuss some of the planning which is best done before your trip.
These problems can be overcome by planning ahead for your journey.
Your diabetes supplies should be carried in your cabin bag. Cargo holds are subject to extremes of temperature which can cause insulin to deteriorate. Furthermore check-in baggage may get lost.
Security officials at airports may not always accept a written prescription or letter from your doctor, though it is recommended you carry one anyway.
According to aviation regulations all insulin vials/pens/cartridges should have a professional, preprinted pharmaceutical company label affixed which clearly identifies the medication.
Lancets for blood glucose monitoring should be capped and clearly labelled.
Glucagon kits should also have the original preprinted labels attached.
It is best not to request a ‘diabetic diet’ as the ‘diabetic’ meals may not have sufficient carbohydrate for your requirements. These may be suitable for people with type 2 diabetes rather than those with type 1 disease. Take the regular meal offered and supplement your carbohydrates if necessary with snacks.
When flying it is best that you do not change the time on your wrist watch. Travelling North or South does not require any change in your 24 hour schedule.
Travelling East will shorten your day and you may therefore need less insulin.
Travelling West will lengthen your day and you may therefore need more insulin.
This is a ‘rule of thumb’ which does not always apply especially on long-haul flights.
A basal bolus regime is probably the best insulin regimen to be on apart from insulin pump therapy. Ideally this should use HumalogR or NovorapidR as short acting insulin.
The Earth is divided into 24 perpendicular wedges known as time zones. The Greenwich time zone is taken as the reference zone and is referred to as Greenwich Mean Time (GMT). The more time zones you cross, the more complicated the insulin regime becomes.
For example if you are taking off from Heathrow Airport, travelling West to the New York in the United States. The time at your destination is five hours earlier in the day. Therefore when you arrive you have five more hours to get through before it’s time for bed.
If you are on a twice daily isophane and soluble:
If you are on a twice daily mixture e.g. Human Mixtard 30:
If you are on a basal bolus regimen:
These are simply illustrations as there can never be a comprehensive account of insulin management to cover every travel itinerary. Discuss your travel plans in detail with your diabetes nurse.
Dr Nishan Wijenaike
West Suffolk Diabetes Service