It’s all in the planning – by Helen May

It’s that time of the year: time for a holiday. Diabetes is never part of the decision making process when I book a holiday: diabetes does not dictate where I go, when I go or what I do when I get there. However, as the holiday approaches, diabetes adds to the planning. Diabetes UK has some great pages about travel but for me there is more I consider before I get on the plane…

• I would never travel without insurance. One of the frustration of getting diabetes was seeing my travel insurance premium soar. Ok, so I could take an insurance that does not cover diabetes complications but, in my mind, this is the thing most likely to go wrong so I won’t. I’ll take a deep breath, put my hand in my pocket and pay the price.

• Like anyone, weeks before I go away, I need to check whether I need any holiday jabs or anti-malaria tablets and, if I think it’s likely, I’ll book an appointment to see my local nurse. The difference is that I always have to remind her I have diabetes and between us we check the side-effects. So far, I’ve been lucky and the only side effect I have ever experienced from a holiday jab is a dead arm (and I got that before I had diabetes).

• As the holiday approaches, I start to work out the time difference between home and where I am going. When I’ve had a night’s stop over, I ignore it and focus on the time in the destination. The reason I care is because I try to take my basal insulin every 24 hours and I usually take it when I go to bed. I don’t fancy staying awake until 4am every night when on holiday just to take my insulin. If I’m travelling East, I start to move my dosage time by about an hour each night until I’m within an hour of my bed time in my destination country. I also have to remember to start making corrections when I return home. If I’m flying West, I’ll make the changes the other way: when I get to the destination and before I return.

• Another thing I have to check is that I have enough supplies. I always have some spares in the cupboard but when I go away, I always take twice as much as I need so I have to remember to top up my spares a week or so before I pack. For example, I use four or five needles a day, so I need to make sure I have 140 needles for a two week holiday.

• And then it’s time to pack. I’m pretty organised: I’m a last minute packer because I have been making a mental list for days before. In addition to clothes, passport, currency, … I need to add the diabetes paraphernalia:

o Sealable polythene bags of needles and lancets and test strips. As I mentioned, I always take twice as much as I need. Although I carry my paraphernalia in my hand luggage (to make sure it gets to my destination at the same time as I do even if the rest of my luggage gets lost), I always bag needles and lancets up into multiple bags: when I get to my destination, I can keep them separated in case I lose a bag of needles somewhere on my trip.

o Insulin is kept out of the polythene bags in Frio Wallets. I find these great for keeping the insulin cool without the need to carry a fridge up a mountain on my back. Again, I take twice as much insulin as I think I need. I find this hard to calculate because I don’t know what I’ll be eating so I have to take an optimistic guestimate.

o As I discussed in a previous post, I take a few moments to consider The Orange Box. If I’m going with friends who will have the confidence to use it and if I’m going to be in the middle of nowhere, I’ll pack it. But if I’m going for a city break, I’ll probably leave it behind.

o Unfortunately, nine times out of ten, I forget to pack something to put my sharps in. Luckily, I’ve always managed to pick up a water bottle at the airport on the way out as an ad hoc sharps container. But now I’ve added it to this list, perhaps I’ll remember it on the next trip.

o Managing my diabetes when I am holiday is more of a challenge than managing it at home. My life is not always the most predictable at home but when travelling in an exotic country, eating food I’ve never tried before, drinking a bit more than during a typical week, doing more exercise than usual… I know I’ll get it wrong. So every bag I take (hand luggage, case, friends bags, …) will contain at least one packet of dextrose. These are also accompanied by some cereal bars to supplement the dextrose.

o Finally, I dig out the letter from my doctor explaining that I must take my kit on board the plane. Thankfully, I have never experienced problems taking any of my paraphernalia but I have been asked a couple of times to explain what I have so it is good to have an official letter to justify my extra luggage.

Until I started to write, I hadn’t realised I had so much to think about. But if I do it without thinking, I assume it is not much of a drag. And not only has diabetes not stopped me booking a holiday, it has never stopped me enjoying a holiday: it must be all in the planning.

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