Today’s post is a fun story mixed with some tactical tips for success on your next trip while traveling with diabetes. There can be so many things we have to think about on top of regular travel necessities, so when things go wrong it can feel scary and overwhelming. I’ve usually had great luck when traveling and am not prone to forgetting things or making simple oversights, but I flew too close to the sun on my latest trip. Makes for some great content though :)

The story

My husband and I planned a trip to Spain for our fifth wedding anniversary recently and took all the steps to prepare. I packed my supplies with extra to spare, I ordered a backup replacement pump, and made all the necessary insulin changes. We landed in Madrid for a three-day stay as the first leg of the trip so my husband could catch some of the soccer (*ahem* football) games for his favourite teams, and we did lots of sightseeing. Aside from a few low blood sugars from all the walking, my diabetes was well behaved and I didn’t think much of it. 

After leaving Madrid, we traveled to Barcelona and started our second leg of adventures there. It wasn’t until our second night that I realized I had left all of my insulin—my regular vials, plus the backup pens of short- and long-acting insulin I had brought—in the mini fridge in our hotel room in Barcelona. I was shocked as I barely remembered putting them in the fridge at all (thanks, jetlag). I had never done this before, both in terms of putting ALL of my insulin in one place (rookie move) and not checking the mini fridge before leaving the hotel. 

I had a bit of a panic attack, then assessed the situation and what I should do. I had about 30 units in my pump before I would need to refill the reservoir, so that would last me throughout the night at most. It was already 8pm in Barcelona, but luckily it’s a city where places are still open at night. I found a version of my prescription on my phone, grabbed my diabetes travel letter, and went out to hit up some pharmacies. I had no idea if they would help me or not and if I could even buy insulin over the counter, but I figured that since it was a touristy area someone would help me out eventually. 

The first two pharmacies we visited were a bust. Without a Spanish prescription, they wouldn’t give me anything, even though one of the pharmacies definitely had NovoRapid pens in their fridge that I saw. Finally, the third pharmacy we visited had the insulin and didn’t even ask to see my note or prescription, they just sold it to me over the counter for $66 CAD for five pens. I couldn’t run it through insurance, but I was pleasantly surprised by how affordable it was. Honestly, I would have paid whatever they wanted just to have insulin back in hand. It’s crazy how stressful it can be to know you don’t have any, kind of like realizing you’re out of water when you’re super thirsty. The five pens were more than enough for the rest of the trip, and thankfully, diabetes played nicely for the remainder of the time we were there. 

You can see the experience play out below!

How to get Emergency Insulin 

I really hope you’re smarter than I was and don’t find yourself in the same situation, but these things can happen for so many reasons that we can’t control. Your bags might get stolen (hello pickpockets), you might forget your supplies somewhere like me, or you might simply run out. In case you are in the same spot, here are some tips for getting through it! 

1. Don’t panic - this is easier said than done of course, but try not to panic. There are plenty of things you can do to get insulin in a foreign country, so chances are it won’t be a big deal or ruin your trip! 

2. Download your prescription before leaving, or ensure you can access your pharmacy app - My prescription was easily accessible via the Shoppers Drugmart app here in Canada, but in the future I think I’m going to print out a copy of my prescription and a picture of the insulin just in case. This is especially important if you think the internet might be unreliable where you’re going. In a pinch, you could try calling your doctor’s office or pharmacy and having them email you a copy if you don’t have one that’s already accessible.

3. Have a printed travel letter from your doctor - For each pharmacy that I visited, having a printed letter made it easy to show and explain that I had diabetes (along with showing my pump and making vague needle injection motions). I also think it made everything seem more legitimate than just having a document on my phone. 

4. Use Google Translate - If there’s a language barrier, use Google Translate or ask your hotel front desk staff to write down what you need in the official language to help with communication. We used Google Translate and it helped a lot. A friendly local could also work if they speak English and are willing to help you out. 

5. Show pictures of the medication - Brands will often keep their packaging and colours the same across all countries so their medications are easily identifiable. I used to work in pharmaceutical marketing, so I can confirm this! Even if the medication has a different name based on the language, the box will often look the same. 

6. Make do with a different brand, if needed - This isn’t ideal of course, but if your exact brand isn’t available, look for a suitable substitute. For example, I use Novorapid insulin but knew I could make do with any fast-acting insulin (although I might have cut back on my basal rates just a touch in case there were slight differences). In an absolute pinch, I also knew I could get by with just long-acting insulin by switching to injections instead of my pump and eating low-carb for the remainder of the trip, but I would only do that in an absolutely dire situation. 

7. Be prepared to pay - When you’re in a crunch, you’re probably not going to be able to run impromptu medical purchases through insurance if you have it. Ask for an itemized receipt showing what you bought so you can try to expense it when you get home, but be prepared that you might need to eat the costs out of pocket. 

8. Try many different pharmacies - As mentioned, I had to try three pharmacies in the city before finding one that would sell insulin to me. It was a bit stressful, but I figured one would eventually understand the urgency and take mercy on me, and they did. Don’t give up if the first place says no, and try different chains if that’s an option! 

9. Call the medical manufacturer - I didn’t have to do this, but it did cross my mind as a step I could take if needed. If all else failed, I would have called NovoNordisk to see if they could help me in some capacity, possibly by putting me in touch with a sales rep/someone who could broker a transaction with a pharmacy (who says diabetes isn’t exciting?!). I don’t know if they could have helped, but I figured it would be worth trying if I didn’t get traction with anything else. 

10. Go to the hospital - If you’ve tried all of the above and still haven’t gotten what you need, take a trip to the local emergency room and use Google Translate to explain the situation. They should have insulin they can give you for the moment, and then they can write you a prescription to be able to get more at a pharmacy for the rest of your trip.

11. Lean on local T1Ds - I would say this would be my last resort since I hate inconveniencing anyone, but if all else fails or you’re in a remote area with limited pharmacies, look on Facebook or Instagram, search hashtags like “#CITYNAMEType1, #CITYNAMEDiabetics” etc., and use Google Translate (if needed) to make a post about your situation asking for someone to spare you some supplies. In my experience, there are always kind people willing to help everywhere (I’ve helped a few fellow type ones in similar situations over the years!), but of course this is a bit harder to do than the other steps so I’d only go this route if all of the other steps had failed.

Again, I hope you don’t need to use these tips, but they are here if you do! I feel like diabetes is always throwing curve balls and keeping me on my toes, so I figured it was only a matter of time before something like this happened in my travels and I’m glad it all worked out!