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Traveling by Air with Diabetes
To ensure optimal management of one’s condition while traveling with diabetes, it is imperative to engage in thorough preparation. Whether traveling for business or leisure, adequate preparation can make the journey more enjoyable without compromising one’s health. This involves ensuring that necessary supplies are stocked, managing insulin, monitoring blood sugar levels, and maintaining adequate hydration. Traveling by air when diabetic is not very different than travelling by road. When travelling by air there are many aspects that are beyond your own control.
Traveling with Diabetes
Air travel results in encountering a change in cabin pressure. During air travel, passengers are exposed to variations in cabin pressure. Our organism experiences a pressure of 1 ATM at sea level. The average altitude during a flight is between 10,000 and 13,000 meters (30,000 and 42,000 feet), and the compartment pressure is 0.75 ATM, or 75% of the pressure recorded at sea level.
There are specific effects of reduced cabin pressure on our body and related to traveling with diabetes. Changes in altitude have been documented to have an impact on certain glucometers. The administration of insulin via syringe or device is impeded for various discernible reasons. Additional physiological effects result from reduced cabin pressure:
1. An air bubble dissolved in a liquid composed of water will begin to escape when subjected to low atmospheric pressure.
2. Submerged air pockets within the liquid will undergo expansion in response to a decrease in atmospheric pressure. During the ascent, these bubbles will expand by 36%, displacing insulin.
3. The level of moisture is also extremely low inside the cabin. The air used for air conditioning is the ambient air outside the aircraft which is dry and cold.
4. Gas will expand within the stomach and intestines.
5. Sleep disturbance.
6. Oxygen saturation in the blood.
7. Time-zone crossing
We shall now examine each factor affecting traveling with diabetes.
Air Bubble and Insulin Pump
Scientists have issued a warning regarding the detrimental effects cabin pressure can have on insulin dispensers. According to one study, cabin pressure fluctuations during flights may cause insulin pumps to deliver an inadequate or excessive amount of medication, putting at-risk diabetics especially those who are more sensitive to insulin are at risk.
It is advisable to detach the insulin pump prior to taking off and verify that there are no air pockets present in the solution prior to reconnecting it at cruising altitude. Similarly, the injector should be disconnected prior to descent and landing. The research discovered that as cabin air pressure decreased during takeoff, the insulin pumps administered approximately trace quantities of additional insulin. As the pressure increased during landing, a portion of the insulin returned to the pumps, resulting in insufficient delivery of the insulin.
Level of moisture in the Air Cabin
The relationship between dehydration and blood glucose levels is complex, as alterations in hydration status have the potential to impact blood glucose levels, especially in those who have diabetes. An elevation in blood glucose concentration occurs when the body is dehydrated. As a result, the insulin concentration required for effective blood sugar management may also fluctuate. Dehydration may result in an increased concentration of insulin within the circulation, which may have implications for the absorption and utilization of insulin by the body. This will impact insulin sensitivity while traveling with diabetes.
In general, the relative humidity of aircraft cabins is lower than that of the majority of indoor environments. Frequently, aircraft cabin humidity is maintained between 10 and 20%, which is significantly lower than the average indoor humidity of 30 to 60%. Consequently, passengers may encounter:
- Skin and nasal congestion
- Dryness of the mucous membranes and throat
- Ocular dryness and discomfort
- Fatigue
Bloating
Elevating an aircraft to greater altitudes results in a reduction in atmospheric pressure. The decrease in pressure facilitates the expansion of gases within the organism. Nitrogen is the most prevalent gas in the digestive tract and constitutes a substantial proportion of the air we breathe.
A decrease in atmospheric pressure can induce the expansion of nitrogen within the gastrointestinal tract, thereby forming more sizable gas pockets.
This expansion of gas may cause discomfort, increased flatulence, or bloating in certain individuals. Air ingestion, carbonated beverage consumption, and the consumption of foods that produce gas can also contribute to the accumulation of gas in the digestive tract.
Sleep Disturbance
Sleep disruptions that occur during air travel, especially when traversing multiple time zones, have the potential to affect a range of health parameters, such as blood glucose levels. Insomnia and irregular sleep patterns may potentially exacerbate insulin resistance, thereby impeding the body’s ability to efficiently utilize insulin. Variations in insulin sensitivity can lead to fluctuations in blood glucose levels among individuals traveling with diabetes.
Blood Saturation with Oxygen
Blood sugar levels and blood oxygen saturation (SpO2) are two distinct physiological parameters that do not typically exhibit a direct cause-and-effect correlation. Sufficient oxygen saturation in the blood is essential for the optimal operation of critical organs, most notably the brain and heart. Energy production and cellular metabolism both require oxygen.
Blood oxygen saturation indicates the efficiency with which the respiratory and circulatory systems deliver oxygen to the circulation and transport it to the tissues, respectively. Generally, the normal range for blood oxygen saturation is between 95% and 100%. Values below 90% may indicate hypoxemia, which is characterized by low oxygen levels. Such conditions can result in severe adverse effects on the body.
Time-Zone Crossing and Traveling with Diabetes
Adapting insulin to variations in time zones
It is advisable to consult with a medical professional or a diabetes educator before modifying one’s medication regimen or dosage.
When traveling east, one will experience a shortened travel day. You may require a reduced dosage of intermediate or long-acting insulin if your time loss exceeds two hours. You may transition from premixed insulin to basal-bolus or pump therapy, which provides greater administration flexibility, on the advice of a healthcare specialist.
It is advisable to implement these treatment modifications a few weeks prior to your trip. Dose meals and refreshments with rapid-acting insulins such as Humalog® or NovoRapid®, just as you would at home. (see Reference)
The duration of your journey westward will be extended. You may be required to consume additional units of short-acting insulin and consume more sustenance if your gain exceeds two hours. The day for westbound passengers will be extended. You should consume more food and greater quantities of rapid-acting insulin upon reaching your destination. This assists in the management of blood sugar levels throughout the day for four to six hours. Your routine can be resumed at the time of your destination.
How to Prepare yourself for traveling with diabetes?
It is recommended that you apprise your healthcare provider of your travel plans and seek any essential guidance prior to your departure. While traveling with diabetes, it is critical to ensure that adequate quantities of prescription medications, insulin, and other essential supplies are brought along for the duration of the journey. When traveling with diabetes, it is recommended that you bring with you a letter from your physician that details your medical condition in detail, including the necessity of prescribed medication and any medical devices you plan to convey.
General checklist
1. Doctor’s prescription. The letters must be composed preferably in English.
2. Is the patient diagnosed with type 1 or type 2 diabetes?
3. Pharmaceuticals (generic names and dosages) should be specified, along with the insulin pump’s settings and a basal-bolus fallback regimen in the event of pump malfunction.
4. Rescue supplies, including glucagon pen, tablets, and glucose gel.
5. Provisions, including volumes specified (including batteries, glucometers, testing strips, lancets, and syringes or pens).
6. Protective box to carry sharp objects (needles and lancets).
7. Medication and associated products
- Name and contact information of the physician;
- Details of the health insurance policy or card;
- Medications and prescriptions for diabetes;
- A medical alert bracelet;
- Emergency medications (glucose gel, tablets, and glucagon pen);
- Provisions (syringes, lancets, test strips, and sharps container);
- Two glucose meters (in the event of one malfunctioning) with spare batteries;
- Two times the quantity of pump supplies that may be required;
- Insulin wallets or coolant packs;
- A first aid kit;
- Comfortable footwear;
- Weather-appropriate protective clothing, contingent on the destination climate;
- A selection of snacks to avert hypoglycemia
Medication and Insulin Monitoring
Insulin should be protected from exposure to excessively high temperatures by being stored in a cool container or sack. In the event of misplacement, medication and provisions should be segregated between checked and carry-on luggage. It is recommended to remain cognizant of time zone fluctuations and adjust one’s medication regimen accordingly.
Monitor Blood Glucose: Maintain your blood glucose monitoring device in a convenient, easily accessible location at all times. It is advisable to consistently monitor one’s blood sugar levels, especially when there are changes in routine or time zone. It is advisable to carry additional batteries for the glucose meter.
By planning your meals and refreshments in advance, you can guarantee that you consume a balanced diet. Please ensure that the airline personnel are informed of any dietary restrictions or special meal requirements. It is essential to stay hydrated, but sugary beverages should be avoided in favor of water.
Security checks and X-ray: Notifying security personnel about your medical condition and the presence of supplies related to diabetes is of the utmost importance. In the event that a manual inspection is required, choose that over subjecting your medical devices and medications to the X-ray machine. The majority of diabetic patients who are managed with oral anti-diabetics or insulin can travel safely while maintaining acceptable glycemic control by adhering to a few essential rules during flight.
It is recommended that all passengers carry their medications with them throughout the flight. Medicinal liquids, including insulin, are allowed in quantities exceeding 100 mL, contingent upon the completion of identity verification.
Emergency Preparedness: It is recommended to wear a medical alert bracelet that clearly displays one’s diabetes status. It is recommended that you carry emergency contact information and have knowledge of the locations of the nearest healthcare facilities at your intended destination.
Physical Exertion: While it is recommended to include physical activity in one’s travel plans, it is crucial to remain vigilant for possible variations in blood sugar levels. It is recommended to bring walking-appropriate, comfortable footwear and to plan breaks during lengthy flights or car journeys.
Advice and Approaches: Conduct advance research on pharmacies and healthcare facilities in the intended location.
Pack intelligently: Carry medications and supplies in your carry-on bag for easy access. Maintaining knowledge regarding the carbohydrate composition of regional foods is crucial for individuals to efficiently regulate their dietary choices.
Initiate Communication: It is imperative to distribute pertinent details concerning one’s medical condition and emergency procedures to fellow travelers.
Obtain Sufficient Rest: Maintaining a regular sleep schedule is of utmost importance for the effective management of stress, given its potential to impact blood sugar levels.
It is imperative to consider that the management of diabetes can differ significantly among individuals. Consequently, seeking guidance from your healthcare provider will enable you to tailor these recommendations to your specific needs. It is possible to successfully manage diabetes while traveling in a secure and gratifying manner with sufficient preparation.
Please consult the FAQ section before you contact Northerninsulin. Insulin and diabetes medications, which are prescription drugs, must be handled, stored, and shipped properly due to their temperature sensitivity and health risks. Insulin goods may have strict return and refund procedures. Additionally, see our Facebook posts.
