Diabetes type 1 (young people)
Travelling abroad with diabetes
Travelling is something many young people, including those with diabetes, feel passionate about. Many of the young people we talked to had travelled all over the world and had such a good time that they were determined to keep travelling - even though a few of them had lost their insulin or been taken ill when they were abroad. Several said they decided not to let diabetes get in the way of their plans.
He has travelled a lot including going to Australia for 4 months as part of his gap year. Even...
Also I had a situation where I was in Australia where I lost well I had my bag stolen with my diabetes, with my, all my kit in it and I was there just totally panicking, totally worried about it. Spoke to the police about it and they were like, right well you know eventually I managed to speak to the pharmacist, the doctor and they were like, 'Right well we can sort you out no problems.' Everybody was more than willing to help you. And as it turned out like my bag had got dumped and somebody, it turned up and the policeman had it, and I was only without it for about eight hours but I mean I, but within that eight hours I'd also realised that if I had, if I'd have lost all my insulin and all my blood tester kits, that there would've been people to provide replacement stuff straight away. And it was a bit of an eye opener really that, to know that there's, obviously there's diabetics right across the world and if I was to go and, I'm thinking about going and living abroad that I'm sure that like the diabetes care in sort of westernised countries like Australia, New Zealand, America, places like that, I'm sure that you know it's going to be quite easy to go and get the same sort of level of care as you're getting here over there so yeah.
She lived abroad for a year and travelled a lot and says it was helpful being able to email her...
Nothing. I didn't even for once think about not travelling. It was, I didn't once think that why couldn't I travel like anyone else. What's the difference, you know. Ok there's small things when I was in Iowa it was snowy and freezing cold. If I had my pen, like just outside it would, you know, start freezing. So there's small things like that. And in Israel it's very hot so I had to always keep things in a fridge. And it's small things but there's no problem, you know, no problem travelling. You can, you look after your diabetes here you can look after your diabetes there. There's no, there's really no difference in, you know the care there as long as you have someone there who you can contact, that you know like where you're staying there's a doctor nearby or, or you can be in contact with your nurse here in England. As long as there's someone where if something goes wrong you have someone to call. You have someone to, you know there's.
The team here did they give you advice?
Yes, they, yes they helped me to find doctors in the countries that I went. And also where ever I was abroad I e-mailed my nurse here. I had questions and things and she, you know. Even though I was in another country she was still my nurse. I was still, you know, in contact with her.
When she lived in Brazil her mother sent the insulin out to her in the post or with friends.
Yes, I love travelling.
[Laugh] Yes. How do you manage your diabetes? What do you have to do before you travel and while you are where ever you are?
Yeah. Well first of all is that my Mum always sent me my insulin from England, always. So I never, where I was, I never had to. Even where I was in Brazil they didn't even make the insulin there, the insulin that I use. They didn't even make it there. So my Mum always sent back to me my insulin from here, with friends who were coming or you know in the mail or something. Also it's very important I have, where ever I went I had a nurse or a doctor or someone where I could, you know, be in contact with in each country. So that was also very helpful.
What about did you have any language barrier in Brazil or no? Do you speak Portuguese?
Yeah well we had to learn how to speak a little bit, yeah. No one speaks English there. [Laugh] no one.
Were you [noises] sort of was it possibly good enough to talk to a doctor and discuss any symptoms or worries that you might have?
My doctor's English was about as good as my French or Portuguese so we, you know, we managed to communicate. You know. So it was ok.
She left her insulin behind in a hotel in Panama and had an eight hour trip back to get it.
It was fine. I never went for long enough. I was only away for three or four months and the NHS here can give you supplies for up to three months. So I never really had to go and get my supplies from, in a foreign country. Which was a relief because most places make you pay or, I think, in Australia actually they had a way of charging it back to the NHS, I can't remember. But generally it's been fine. I was in Costa Rica with my sister and I cleverly, I had, because insulin has to be kept in the fridge, or it has to be kept cool, I had these packs, called freo, what is it, you get, I can't remember what they're called, freo-something. They're like gel bags and you dunk them in water and they absorb the water and they're meant to keep your insulin cool for four days or something but I wasn't, I wasn't trusting them completely because they weren't that cool so whenever I got to a youth hostel I would put my insulin in the fridge which I guess is a good idea. But we'd been in Panama and then we crossed the border to Costa Rica, and we'd had a kind of eight hour bus journey and we'd had a nightmare crossing the border and we'd finally got to our destination and I went to see my injection and I was like, I'd left my insulin in the fridge in the hostel back in Panama. My sister wasn't happy at all. There were no, the nearest doctor's was about four hours away and I found out the insulin they have was completely different and it was just a nightmare. So I ended up having to go all the way back and get it. Which was actually fine. I had enough with me to last me a couple of days. But '
So you had to cross the border'?
Yeah, that was just me being dappy, should have, you know, it wouldn't happen to anyone else but me, I'm just dappy [laughs] so'
He lost his insulin in Spain and managed to communicate with a Spanish doctor in sign language.
So they had the same insulin that you take here?
It wasn't exactly the same but I had to somehow communicate like the short acting and the long lasting insulin and managed to get both kinds, like they were showing me these type, different types of insulin and like I was trying to, I was trying to show, show them like your hand gestures, things like that, with short and long lasting insulin. And I mean basically after about forty five minutes of trying to explain things to a doctor they'd worked out which type of insulin I was on at home and which types of insulin corresponded with the types that they had in Spain and they'd given me enough insulin, enough needles, enough a blood tester kit, enough blood tester strips to last me the holiday. And like I said all I had to do was just fax them my E111 when I got back so it was, it was a horrible situation but one that got sorted like within a day so it was fairly lucky really.
During summer holidays Katie uses insulin pens instead of her insulin pump. She starts using insulin pens a week before going abroad.
No I move back to my insulin pens. I find it nicer to not use my pump when I am on holiday. I don’t want a tan liner, nice little circles on my belly. And also it means that I get my basal rates right rather than if I’m sat around the pool and I don’t want my pump on because I can’t wear it in the swimming pool anyway. It means that I’ve always got my basal rates right rather than having to worry about when I’ve got my pump on or I’m not going to get that feed of insulin going through so my blood sugar is going to be high. So it just makes me have a bit more control I think.
Normally it’s alright. It can be a bit challenging for the first few days when you change. I’d say move on to your pens probably about a week before you go on holiday to make sure you get your levels right from when you’re abroad. But generally it, it’s quite an easy switch over. There are ways that you can manage to get your basal rates right. You just look on your pump and you kind of transfer it. If you’ve got any problems just contact your hospital to know how much to give yourself.
Ok, ok. That’s a very, very good tip. I mean to move kind of a week before you go on holiday.
Yeah there’s nothing worse than getting on holiday and realising that your blood sugar is not where you want it to be because you might be feeling a bit rubbish. So if you are at home it also gives you a chance to contact your nurses and things without having to worry, oh no I’m on holiday or like a time difference or something. So it makes it a lot easier.
He went to Rwanda to work on a project for 3 weeks and was worried when he went to places where...
They got good advice from their consultant about adjusting their insulin just before they left...
Interviewee 1' Well, I mean the last time we spoke to them, before we went, was on the day'
Interviewee 2' Day, day before'
Interviewee 1' Before we left.
Interviewee 2' 'we left.
Interviewee 1' Like, probably five minutes before we walked out the house.
Interviewee 2' We left it a bit too late.
Interviewee 1' Yeah, before, probably 5 minutes before we walked out of the house we were still talking to our consultant on the phone and like arranging how we'd adjust our insulin. So, she told us to cut our long-acting insulin, our Lantus, by 20%. So I went down to something like 45 and [my brother] went down to about 40. And then when we were up in the mountains we cut our ratios in half, so we went'
Interviewee 2' Down to 1'1.
Interviewee 1' 1'1 as opposed to 2'1.
Interviewee 2' And you're still carbohydrate counting. Eating a lot of carbohydrate. Obviously, keeping blood sugars up. Porridge every day, for breakfast which was horrible.
Interviewee 1' It was horrid.
Interviewee 2' But obviously breakfast is the most important meal of the day. So, hang on. OK. Well, yeah. Breakfast, the most important meal of the day'
Interviewee 2' Obviously. Porridge every day and then for lunch, it was a bit of an amalgamation of stuff but flatbreads, stuff that wouldn't go off. Tinned foods. And obviously we had to carry all the rubbish down with us as well. So we had to get lightweight stuff.
Interviewee 2' But stuff that would give us a lot of energy.
Interviewee 2' But we went on to 1'1 ratio so obviously I was happy we were doing something physical, something that would, that we could actually feel, like a 1'1 ratio rather than, 'Oh, you've got to watch your insulin intake.' Something that would stop us from going low. Rather than, 'Maybe you shouldn't do an injection here.'
When did this'?
Interviewee 1' It was much better.
In, this was the first time you went into something like this.
Interviewee 2' Hmm.
Interviewee 1' Yeah.
How did it make you feel? And '
Interviewee 1' It was brilliant. It was, it was'
Interviewee 2' It was such a sense, sense of achievement. It was absolutely excellent. Yeah, I mean'
He explains the plan he followed for his injections during a long flight to New Zealand and was...
And how did you manage your diabetes?
What changes you had to do, what you had to pack?
The most difficult part was the flight itself, because we went with Air New Zealand, and they fly the opposite way to everybody else. They fly via Los Angeles, so it's actually a longer flight. So going backwards through time, as well was a bit difficult. But what I did was I halved my insulin and then kept my watch on British time so every twelve hours I gave half my Lantus, which at that point, I think, was 24 units Lantus - so I was doing 12 units every twelve hours, basically, to cover the flight. I still had my watch on British time, so when I got to New Zealand, I did it every 24 hours from that point. So, with the time difference, instead of having my Lantus at ten o'clock, eleven o'clock at night, which I was previously, I think I was having it at eight o'clock in the morning. Yeah, but it was still on British time, and that meant that all through the trip I was just having it in the morning, but then my sugar levels and everything were fine. No problems at all with it. And then on the plane of course you get meals sort of every four hours, and they're always quite little, so during the course of the flight I probably injected six times with NovoRapid but they were all little portions, so it was sort of eight units here, eight units there'.
Okay, so obviously you talked to your doctor before you went and he sort of told you - he or she told you'?
Yeah, they sort of set a plan, and said, 'It's best to do it this way'. I stuck to the plan and it worked out fine. I didn't think it was going to work out that well, as it did. I was really pleased when it worked out really well.
She feels she has missed out though she may go abroad for her twenty first birthday and says that...
Do you feel that you have missed out on things that you could do, that you could have done because of your diabetes?
Yeah I haven't, I've never been on holiday you know never left England I know because there's a lot of organising you have to do as well as the money, it can, you know you have to go to your doctors to get a different kind of insulin if because of the time zones are around the world and the having diabetes doesn't stop you from going on holiday, it's a lot more organising you have to do that's all and you have to be extremely careful obviously with where you put your insulin because you know airports, you can lose your bags, so just make sure you've got it with you at all times.
Last reviewed December 2017.
Last updated December 2017.