Diabetes and holidays: preparation is key!

In the UK, more than 3.5 million people are currently living with diabetes. Type 2 diabetes is the most common one, accounting for more than 90% of those affected and the numbers are increasing rapidly worldwide, so it is now referred to as an epidemic.

If taken care of early and managed well, diabetes can be lived with quite normally. It also depends on the patient's response to treatment, on treatment monitoring, as well as on the knowledge of the disease, of the body's reactions and of the means of control and adaptation on a daily basis.

Thus, going away on holidays is a normal part of the daily life of people with diabetes. To make the most of your holidays, however, you should follow a few rules and recommendations. It is also important to assess the impact of your trip on your blood sugar levels due to:

• Possible changes in diet at your holiday destination,
  
• Unusual physical activities (cycling, hiking, etc.),
  
• New schedule (different time zones, queuing),
  
• Different weather conditions (sudden cold or hot weather).
  

How to plan for holidays when you have diabetes? 

Here is what you should do before going away: 

Gather as much information as possible about your holiday destination 

In order to be prepared for unforeseen events, it is important to identify pharmacies, hospitals and other medical facilities that could be useful on site. If you are going abroad, you should find out about recommended vaccinations, as well as get the contact details of the UK embassies and consulates in your country of destination, as well as diabetes clinics or centres where you can find help, if necessary.

See your GP or diabetes doctor 

Consulting your doctor before going away on a holiday allows you to carry out a health check-up, to go through the details of your stay with a healthcare professional and to ensure that there are no contraindications linked to it. If possible, you should plan your medicine intake with your doctor, and discuss any necessary adjustments.

Have your medical records and your medication at hand 

In addition to your identity papers, a number of essential documents should be kept with you at all times (and also photographed on your smartphone), such as:

• Your travel insurance certificate,
  
• Your European Health Insurance Card (EHIC) or your Global UK Health Insurance Card (GHIC), if you are travelling to Europe,
  
• Your blood group card,
  
• Contact details of a relative,
  
• Your renewable prescriptions. If you are going abroad, it is possible to ask your doctor to write them with the international non-proprietary name (INN),
  
• Carrying or wearing some form of alert about you being a diabetic, especially if you are subject to hypoglycaemic attacks,
  
• If you use an insulin pump, your insulin pump card, provided by your health care provider,
  
• Your blood glucose monitoring booklet.
  

If you are travelling by plane, transporting medication and medical equipment (syringes, insulin pumps, etc.) is subject to strict customs control. To board the plane, you must present your doctor's prescription listing all the treatments you are taking and authorising the transport of insulin. Most companies require you to contact them several weeks before your travelling date, to let them know you will be carrying diabetic equipment and supplies with you on board the plane. Because of temperature variations, you should avoid putting your insulin in your drop-off baggage.

Prepare your medical equipment 

In addition to an emergency kit for more common ailments (wounds, stomach aches, etc.), it is necessary, depending on the type of your treatment, to have a few essential items to carry with you at all times. It is also vital to have enough replacement accessories, and supplies.

For diabetics treated with insulin pumps, the pump, insulin and glucagon, reservoirs, catheters, spare batteries, anaesthetic patches and replacement equipment are needed. It is recommended that the basal rate pattern and bolus assistant data are recorded so that the replacement pump can be programmed if necessary.

For people treated by injection, insulin is needed in the form of vials, cartridges and/or pre-filled or refillable pens, as well as needles or syringes.

You should also remember to pack your blood glucose monitoring equipment, twice the quantity of medication needed for the entire stay (in case of delays), a cooler bag, disinfectant materials and extra snacks, suitable for people with diabetes.

It is advisable to pack your supplies of equipment and medication in different bags, so that you have some available in case of theft or loss.

Anticipate emergencies 

It is important to check that the clauses of your insurance contract are appropriate in the event of the need for assistance or repatriation.

How to manage your diabetes while on holidays? 

The journey to the holiday destination can be demanding. It may involve an increase in physical stamina. This is why you should take regular breaks, stay hydrated, check your blood sugar levels and eat snacks if necessary. When you arrive, if there is a time difference of more than 3 hours, you should adjust your insulin intake.

Once you have settled in, you should pay attention to everything that can have an impact on your blood sugar levels, such as your diet and activities.

Here are some recommendations:

Watch your diet  

It is important to maintain good eating habits, to eat at regular times and to be careful about new foods without a minimum of information on fat and carbohydrate content. Also, staying hydrated is essential. Diarrhoea is a frequent symptom of insulin-dependent diabetes, and represents a risk of decompensation, as it dehydrates and prevents the assimilation of food and can therefore lead to hypoglycaemia.

Adapt your physical activity 

With exercise comes the risk of blood sugar imbalance. It is recommended to check your blood sugar levels before and after your activity in order to adjust your treatment quickly and to have a snack, if necessary. It is also important to be aware of signs and symptoms, such as excessive sweating or dizziness.

Monitor blood glucose levels more frequently 

Blood glucose monitoring will help you keep track of your diabetes and adjust your treatment if necessary. More frequent testing than usual will limit the risks related to changes in daily habits.

Monitor your stock of medicines and medical equipment

You must not run out of insulin or glucagon, hence it is vital to know the exact quantities of your supplies and equipment. You should also check the storage requirements (temperature, etc).

In order to protect insulin pumps from damage, they can be disconnected from the mains for a maximum of one hour, e.g. at the beach or in the swimming pool. Afterwards, your blood sugar levels should be checked again.

Take care of your feet 

People with diabetes are at risk of foot complications. It is recommended to avoid the slightest risk of infection by always wearing shoes (no walking barefoot), limiting friction in shoes and taking care of your feet daily.

Holidays are a time for relaxation, and chronic health conditions should not prevent people from enjoying them. Nevertheless, it is important to be well prepared before leaving and to follow the few precautionary rules mentioned above in order to fully enjoy your holidays while continuing to manage your diabetes and to take care of your health.