Travelling with a child with diabetes

Travelling, whether it’s on a train, plane or by car, with children always takes planning and preparation. The more so when travelling with your child who has Type 1 diabetes. Consider these factors when travelling.

Travelling must:medical alert bracelet

Firstly, when travelling, your child should be wearing some form of indication that he or she has Type 1 diabetes. A medic alert bracelet, or even a letter from the doctor may suffice.

General travelling tips

• Before departure, it is important to make sure that the country or region to which you are travelling has medical services nearby. Find out where the closest hospital is and if they treat paediatric diabetic cases.

• Keep contact information for emergencies (e.g. pump helpline) as well as a prescription of supplies or a copy thereof on hand.

• Ensure your travel insurance covers the emergency treatment of diabetic-related issues.

• It is essential to keep a travel (cooler) bag with your child’s diabetic supplies handy. Ensure you pack more than enough insulin to cover the days of your trip and possible fluctuating glucose levels; a glucose meter and extra batteries for both the meter and pump; capped lancets; appropriate snacks; and glucagon.

• Always carry easy meals or snacks for unforeseen delays and unanticipated glucose levels.

• Remember heat and excitement can cause fluctuating blood glucose levels. Carry plenty of water and suitable snacks to address these fluctuating levels.

• If your child is on a pump, consider taking a spare pump along, or if this is unavailable ensure you have a spare prescription or supply of insulin pens, including short-acting and long-acting insulin.

• Glucose control may be affected due to changes in your child’s normal routine. Therefore check glucose levels more frequently. As a result, more strips will be used – make provision for this. Don’t forget to make provision for ketone testing strips.

• Ideally, split the supplies into two bags. If possible, give one bag to a travelling companion in case some luggage gets lost.

Flying and diabetes

These days airline security measures are very strict regarding the possession of diabetes supplies. The regulations require that all diabetic supplies are transported in original pharmacy packaging with prescription labels preferably intact.

In addition, you may need to prove that the syringes and lancing devices are specifically for your child’s diabetes care. The brand of the lancets and blood glucose meter must also match each other. It’s important that the strips have not expired.

When travelling within the country, enquire prior to the flight whether a meal is provided or not. Provision can therefore be made when this information is obtained. Taking your own meal may, however, be better accepted by your child.

When flying outside of your home country, it is recommended that you find out that specific country’s requirements when travelling with diabetes supplies. Also, learn phrases in the local language that may help address a crisis situation e.g. ‘Please help, my son/daughter has diabetes’; ‘Please give me something sweet’; and ‘Please call a doctor’.

For those children wearing an insulin pump, inform the screener that your child is wearing a pump. The pump should not be scanned by the X-ray machine along with all the other items. Therefore request a hand wand screen.

If you’re flying, don’t put any of your supplies in your checked-in luggage as the temperature in the hold can drop to freezing. Instead, keep everything with you in your hand luggage.

Altitudes and temperature

Check your child’s glucose meter manufacturing information regarding the altitude and temperature ranges that the meter may have altered accuracy. Keep meters close to the body for optimum temperature operation.

It is important to keep your child’s insulin supplies at the correct temperature. In a hot climate, it is a good idea to request a room with a fridge, or to bring your cold bag or Frio bag. Frio bags are activated by cold water and are reusable every 48 hours; but are only available online.

In cold climates, insulin should not freeze. In freezing conditions, keep your child’s insulin or pen injector in an inner pocket of your clothing or bag.  Examine the insulin for crystals and discard the insulin if any are found.

Adjusting insulin doses

You may find you need to vary insulin doses for very active holidays or holidays in unfamiliar climates. If your child is swimming for extended periods, test his/her blood glucose level regularly. Especially in the evening due to the occurrence of low blood glucose level after periods of prolonged exercise.

Insulin absorption is more rapid in hot climates so be careful for post-meal lows, which may be followed by a spike. If you’re on a pump, the dual or square wave function may be very useful in these situations.

Don’t allow the fluctuating glucose levels to get your child or family down. Do what you know and manage each situation best you can.

Avoid holiday tummy bugs

• Ensure to avoid tap water. Ideally, your child should not swallow the water even when brushing teeth.
• Avoid ice cubes in unclean environments because they’re generally made from tap water.
• Be cautious of milky, creamy and mayonnaise products or produce.
• Be cautious of diluted juices e.g. a concentrate mixed with water as this water may be from a tap. Rather choose water from a bottle.
• Be vigilant when feeding your child from buffet tables – food items have probably been washed using tap water.
• Avoid shellfish, for example sushi, salads and raw food.
• Carry plenty of bottled water, especially during hot weather, or if high blood sugars are being experiences and if your child is doing extra activities, to ensure they stay hydrated.

In summary, check your child’s blood sugar often, make smart adjustments based on their levels, and keep a positive attitude in the face of challenges when travelling with diabetes.