Insulin Changes to Make When Traveling with Diabetes
Travel is one of my favourite things, and I jump at the opportunity to visit new places every chance I get. However, when you have diabetes, traveling can quickly become a huge pain if you aren’t prepared for all of the curveballs that may come your way. I didn’t grow up traveling internationally, so navigating multi-week vacations with type one diabetes was something I had to figure out through trial and error as an adult. I recently traveled to Spain to celebrate my fifth wedding anniversary, so I wanted to share some of the insulin tips I’ve learned about how to keep blood sugars relatively stable when you’re in a new place with a new time zone.
In my opinion, the key to successfully traveling with diabetes is all in your basal rates and bolusing strategy. Of course, these are tips from my own experience and I’m not a healthcare professional, so check with your healthcare team if you need to. So, without further ado, here are the ways I modify my usual insulin routines to ensure my diabetes doesn’t hold me back when I travel.
Adjust basal settings to your new time zone as soon as you land
Whenever I fly somewhere new, as soon as the plane touches down and everyone else is turning their phones back on, I’m always grabbing my pump and adjusting the time settings to match the local time of wherever I’m traveling. So, if it’s 3 a.m. in Toronto but 11 a.m. in Spain, I change the time on my pump to be 11 a.m. so my basal rates will match my new daily routine (e.g., my morning basal rates will align to my new breakfast time). Otherwise, my basal settings and activities will be off and will result in highs and lows throughout the day. This also goes if you’re on insulin injections, but check with your doctor about how to handle long-acting insulin if you already took a dose before/while flying. If needed, set an alarm to remember to adjust your time settings when you land.
2. Duplicate your normal basal profile and reduce everything by 5-10%
If you’re going on an active vacation where you’ll be walking or exercising a lot, I always find it helpful to duplicate my everyday basal profile and then reduce it by about 5% to start, and further if I find that’s not enough and I’m having consistent lows. Doing this helps keep your everyday basal rates untouched so you can easily switch back when you get home, and also helps to get ahead of any lows from ongoing activity that you aren’t used to (like a 2pm walk around the city when you normally sit in an office at that time).
3. Be selective when prebolusing for food you’re not used to
I always recommend trying food you’re unfamiliar with before you bolus to see if it’s what you expected (especially in places where there’s a language barrier and/or you can’t easily ask), even at the sake of not prebolusing (gasp!). For example, on the first day of this trip I ordered a slice of chocolate cake for dessert and mindlessly prebolused about 4 units based on what I thought I would be eating. However, what came out was way smaller than I expected and way less sugary than I thought, and I immediately knew I had bolused too much. As a result, I went low about 20 minutes later and had to eat more sugar, which was annoying because I was already full. It was a good reminder for me that prebolusing is so helpful in many situations, but can be tricky to navigate with new foods where you can’t get all the nutritional info.
4. When in doubt, err on the side of higher blood sugars
This one might be hard for those who normally keep a tight blood sugar range, but in my experience it’s almost always better to be a little higher than you’d like than it is to be lower. Having constant lows when you’re traveling really takes away from the experience, can make you very tired, and can even be dangerous if you run out of snacks or get lost somewhere. Assuming you’re not spending your whole vacation with very high blood sugars, allowing yourself room to have a bit more spikes than usual can ensure you aren’t dealing with annoying lows the entire time you’re traveling. Flexibility is key when traveling with diabetes, so don’t be too hard on yourself if you can’t maintain the same standards of your daily routine.
I have lots more tips for blood sugars and travel that I will share soon, but hopefully these will be helpful on your next big trip!
