Travelling and holidays should be planned in advance and advice sought from the diabetes team when necessary.
Using Insulin Abroad
- Patients should find out what types and strengths of insulin are available in the area in which they will be travelling (refer to Diabetes UK or the relevant pharmaceutical company).
- Most insulins used in the UK and many other countries are of the strength U-100. In some countries insulin may come as U-40 or U-80 strengths. These insulins are not interchangeable. If they are to be used, the appropriate syringes are required.
- Insulin should be kept out of direct sunlight and kept cool.
- Insulin should never be allowed to freeze, therefore when travelling by air, insulin should always be carried in the hand luggage.
- Insulin may be absorbed faster in warmer climates. Regular blood glucose monitoring is important, to allow any adjustments in dose to be made safely.
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Equipment: What should be taken
- Twice as much insulin, syringes or pens, needles or tablets as will be needed.
- If travelling with a companion, advise to split the amount between each passenger's hand luggage.
- A cool bag for storing insulin.
- Blood glucose monitoring equipment - along with adequate supplies of strips, lancets and either a spare meter or a spare battery for meter
- High altitude, heat and humidity can sometimes affect meters and test strips. Patients should be advised to beware of false readings.
- Dextrose tablets, Glucagel, Glucagon injection and ketone monitoring equipment if appropriate.
- A diabetes identity card or jewellery.
- Carbohydrate, in the hand luggage to cover any travelling delays.
- Do not advise patients to order a special "Diabetic" meal on the plane, as these often contain very little carbohydrate. Instead, patients should be advised to carry extra carbohydrate in the form of sandwiches, fruit, cereal bars etc.
- A letter, from either a GP or Hospital Diabetes Team, with a contact telephone number and address confirming the need to carry needles and syringes. Travel Letter is available in SCI- Diabetes
- A basic first aid box.
- A list of all current medication - e.g. a copy of up to date repeat prescription request.
Vaccinations
Patients should be advised to find out what vaccinations are required for the proposed destination. Occasionally these can cause sickness or flu-like symptoms and it is best to have them performed 4-6 weeks prior to travelling.
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Coping with holiday illness
If sickness or diarrhoea develops insulin or tablets should never be stopped even if solid foods cannot be tolerated.
Sick day rules for patients on tablets
Sick Day Rules for patients on insulin
- Carbohydrate intake should be maintained in the form of regular sugary drinks.
- Monitor blood glucose levels frequently.
- If sickness or diarrhoea persists medical advice should be sought.
Adjustment of insulin
Effect of Alcohol: Diabetes and alcohol
Feet care: Diabetes and looking after your feet.
Hypo: Having a hypo
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Insurance
- Travel insurance is vital. Patients should inform the insurance company that they have diabetes and ensure that the insurance package provides adequate cover. This should include cover for emergency transport home and recovery of charges for replacement of insulin or equipment
- The European Health Insurance Card (EHIC) can be used to cover any necessary medical treatment due to either an accident or illness within the European Economic Area (EEA). Free or reduced cost emergency treatment is available in countries in the European Economic Area. The Form E111** The European Health Insurance Form must be completed. You can apply online, by telephone or at the Post Office.
Long Haul
- If crossing time zones or travelling for many hours, specific advice regarding adjustments to insulin regimes can be obtained from the hospital team. Diabetes Specialist Nurses
- Patients should bring along a flight schedule and information on time zone changes to help plan the timing of injections.
- Travel to areas of high altitude can cause insulin to expand and contract, resulting in air pockets within the cartridge or pen. Patients may need to do a few "air shots" to make sure that there are no air bubbles present when they inject.
- Give advice on avoidance of DVT as for any other patient group.
Driving
- If patients are planning to drive while on holiday, they should ensure that their licence is valid for the duration of the trip and that they are covered by their insurance policy for driving, especially when abroad. Diabetes and Driving leaflet
Further Information
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