16 hour jet lag


#1

Next week, I am going to Seoul, Korea and am faced with a sixteen hour jet lag factor. I have done this before (16 transpacific flights), only twice with a pump and still don’t know how to handle the basal change. One time, the lows were exciting, the other time, I somehow ignored it, don’t remember what I did. Has anyone else had this big a jet lag?
How did you handle it. This is actually flying the reverse direction of the jet lag, crossing the date line (with return flight, I will get back before I have left calendar/clockwise).


#2

Hi Susan: For about 10 years, every 3 weeks I would go from Boston to Shanghai (12-13 hr time change), 24 hours door to door trip and spend 2 weeks in China with one week trips within those 2 weeks to India as well with even a different time change (9 1/2 hr time change). Because of that travel schedule and the criss-cross of international date line I never went on to the pump and always stayed MDI. During that time, I found dosing to my meter was the only way to stay under control. With the advent of CGM, dosing became a breeze on these trips instead of doing 10+ finger sticks a day.

In all that time, jet lag did not affect my BG. The diet variation in Asia was what I really had to watch as sometimes difficult to guess carbs in a strange food. I am also wondering when you talk about jet lag effect, if this is not more of a hydration issue than jet lag. Hydration before flight, during flight and upon return did affect my BG as well as weight and had to be taken into account.

None of this may be of any help to you, but I posted as you may be able to extract something from my experiences to port over to your pump experience.


#3

I am flying eastbound and crossing 8 time-zones in a few weeks. My plan is to fast following breakfast of my travel day until I arrive in a connecting city that’s in the same time zone as my ultimate destination. When I get to this connecting city, I plan to eat two hard-boiled eggs for “breakfast” in my new time zone.

I’ve heard that fasting is helpful for the body to adapt to a new time zone. Breaking my fast with protein/fat only will help by not presenting my metabolism with the metabolic challenge of carbs.

I use a pump and will change my pump clock once I board the airplane in my originating city. I hope to get about 6 hours sleep on the outbound flight and will use melatonin to help with that. I also plan to walk and expose myself to as much daylight/sunshine as possible once I arrive at my destination.

I will resist taking a “nap” when I get there as my body will think it’s time for bed. If I can delay sleeping until 7 pm local time, then I think it’ll provide me the best opportunity to acclimate.

I presume you are flying westbound, a direction that’s usually easier for jet-lag effects. Coming home will likely be more difficult. Good luck with your travel!


#4

Most of my travel is across multiple time zones. Terry is right about the westbound trip being easier, which is good because you won’t waste vacation time and you can be more relaxed about acclimating when you get home. I found traveling with the pump easier than mdi because I didn’t have to figure out when to take my lantus. I keep my basals low during the flight because altitude makes me drop like nobody’s business, but I heard other people have the opposite experience. I change the time on my pump when I land, and I drink lots of water. I once threw up all the way from Heathrow to south Wales because of dehydration, and nobody needs that extra stress. And I ask for a pat down at security just in case.

Korea is amazing btw. I lived there for 18 months, and I would go back in a heartbeat. I hope you enjoy yourself!!


#5

Thanks for suggestions. What I meant by jet lag factor is the time difference. About going west…yes going west to get east and crossing the date line. That is what I mean by going in reverse direction from jet lag factor. It is hard for me to explain, but as I used to live there and have made 16 or 17 trips there, I know that going for me is more difficult than returning. On one trip there, I very carefully, with help of CDE, figured out how to carefully and slowly adjust basal…didn’t work, got exciting low. Maybe I should just not do any change until I get eating adjusted a bit to new time (and keep glucose tabs handy). Didn’t have so much an issue on return.


#6

I had a slight problem with even a 3 hour time difference. What caused the issue was my dawn phenomenon that still wanted to respond to my old sleep hours but slowly changed each night? I also use less insulin at night, so I had to make constant small changes to my pump as I adjusted. I just had to put up with some higher highs (mostly at night) than I liked to avoid some too lows.


#7

Were your small adjustments done in one day, three days? Part of the night, my night basal rate is twice as much as the day basal rate. I am not really worried about highs, but if my basal rate is on Calif time (say 3 am), and I am periodically sleeping during Korean daytime, eating who know what and when…I should just admit it, having done this 16 times, I just don’t do jet lag well. I think I will just ‘wing it’.


#8

We went for 10 days each time and the first night I didn’t know what to expect because of my dawn phenomenon. My need for insulin drops in the evening and most of the night until my dawn phenomena hits, then I use 3 times plus my “normal” insulin for a few hours. Sure enough it’s 3 hours earlier and it started spiking in the night 3 hours earlier. By the 3rd night I think it started to change. I was dropping the need for insulin earlier in the evening too. I dropped too much for a few days right before bed. My body didn’t change it’s time zone with a sleeping change immediately. So I made tiny adjustments each day, and carried a candy bar with me during the day. I just don’t remember how long it took? I remember having issues. Coming back I was back to completely “normal” within days.


#9

If you’re not concerned with highs, I would just use my lowest basal rate most of the time unless you’re getting pronounced, lingering highs. That’s normally what I do, and I rarely go high. Last vacation, I had 6 episodes where I went below 50 in 3 weeks, and 2 episodes where it was over 200. The lows were scarier, but harder to avoid since I was using my lowest basal all the time anyway. So, I know I go low during vacations. If you are like me, you might just go with a low basal to feel safer since being high for 3 weeks won’t kill you, but having a seizure in unfamiliar surroundings might. And of course, always carry sugar.