In three weeks (Dec 15) we leave westward for some weeks in Israel. No pump; I'm on humalog/meals and lantus/ bedtime. Your travel-adjustment advice? or what extra to pack? I find not much helpful online re: actual adjustments made for flight (8 hrs) and first couple days there. When making internat'l travels before I find WAY LOW HYPOS a problem and with 42 yrs of Type 1 and neuropathy have little advance warning of hypoglycemia, even with freq. monitoring. With just 3 wks to go, I have no time to start CGM. Okay, my gluc control has much to be desired, even at home, in general. (Don't chide me, please. I see anyt chiders seeming to be -- mostly -- stroking their own accomplishments or egos.)
Have you traveled FAR distant w/ insulin shots (no pump) ? jet lag, timezone weirdness, etc? insulin cooling? running out of supplies?
Traveled to France once and England once on shots, and Germany, Scotlandā¦ a few other places on the pump. Iād like to be flippant and tell you to get a pump, but I wonāt.
as soon as wheels are up on the airplane, it is whatever time it is at your final destination, act that way immediately. Set your watch and your shot schedule accordingly. I assume you will be leaving early in the morning, but that will be evening in your final destination, so donāt take your full Lantus shot, take a smaller one. You might want to take 3/4 of one the night before you leave, the 1/4 ānighttimeā at your new location. This really is going to be your only problem. Do your best to set your brain as well.
test often the first 2 days, more for the jet lag than anything else
I went to Europe on Lantus/Humalog,and adjusting the lantus was tricky. I took one shot of lantus usually around 11PM. In the weeks before, I started moving it forward by one hour each night, so that by the time I left I was taking it around 4PM my time, which I think was 11PM over there. I tested more, especially at night. Control was maybe not as good as usual, but all was fine overall. I did bring a big supply of glucose tabs, etc. Have fun!
The lantus is simple I take 2 shots per day every 12 hours and just keep doing that based on the time at home. The humalog I guess you use the same insulin/carb ratio as at home. Eating low carb is a good idea as it makes control more predictable. We went to Turkey with daytime highs of 90 F and I kept the insulins in a Frio bag in the tour bus and it did not spoil.
I have done multiple trips to Europe from the USA on injections. It takes some planning and some extra blood sugar checks, but it certainly can be done!
By my estimate you will be going 7 hours ahead in terms of time zone. If you will be awake 7 hours AFTER you usually take your Lantus, then you could just switch and take the Lantus in the morning while you are there.
When I traveled across times zones, then I started adjusting my Lantus a few days in advance. I would take it 1-2 hours earlier than usual and just be sure to check for lows during the night. So if you usually take it at 11pm, then take it at 10 pm one night, 9 pm the next, 8 pm then next night, ā¦ then by the time that you get to Israel, you should be taking your Lantus at your usual time (Israel time).
Always take twice as many supplies as you need. I use Frio wallets for keeping my insulin cool while I travel. I love them.
Also take an extra meter & extra batteries. Batteries die at the most inopportune time. I travel with all my prescriptions, just in case, & lots of jelly beans because glucose tabs are too bulky. Like Kristin, I love Frio wallets. I pack double the amount of insulin (in carry-on), syringes & strips.
I donāt have a pump. I take two doses of Levemir & not 12 hours apart. One in the morning & another before bed. Iāve only taken international flights departing at night. So, I take 1/2 dose of Levemir at night while on the plane & then the usual dose upon arriving in the morning. For returning morning flights back home, I havenāt done much basal adjustment. Sorry, not helpful to you taking one dose of Lantus.
I immediately get on local time with sleeping & meals. Usually exhausted the first day from lack of sleep, but then fine after that.
Thanks for your ideas! re: # 1) that makes the most sense to me too, and is what I and husband have always done for internatāl and domestic travels (and stay up until the next {foreign} bedtime) so it is the online advice (several sources) of keeping oneās watch set to the home-clock which confuses me. Wouldnāt keeping the hometime just delay the adjustments by one day? anyway, Thanks. I think Iāll switch to the new time immed as weāve done and youāve suggested here.
Thanks! ya, nighttime totallyLOWS is what Iāve found before, and crashed, so I indeed need check BG more at night/ night-day/ whatever, until adjustment happens. Luckily weāve got a few days in Germany for relaxing before the more strenuous schedule in Jerusalem. A ton of glucose tabs is a great idea. Will do.
Thanks for reply! Iām planning to add more protein and fats to ākeepā my carbs more level. Luckily, winter in Munich and Jerusalem will keep my insulins happy and not cooked. Iām putting a spare set of vials, etc,etc, in cargo JUST IN CASE I somehow get separated from my Carry-on Always kept meds; anyone had vials explode (or freeze) in cargo area?
Or maybe having my husband carry the spares in HIS carry-on makes more sense ā¦ Hmmm.
Thanks ā good ideas for me to consider. In the six Europe trips weāve done I always seem to have trouble 1.) in the stress/ rush of airports and 2.) during nighttimes. Weāre flying late at night. So ānighttimesā can be flexing with ādaytimesā (old and new times) until things settle clockwise! And I/ we insist now on enough time for airport connection times so Iām not as run-stressed. Iām currently working with insurance co, etc, for vacation-exemption for doubling all my meds. And I need get a couple Frio wallets; I lost the cooler-pac part of my old one ā¦ (sheesh.)
Thanks ā good ideas. I have the 2nd meter but hadnāt thought of spare batteries! Great reminder; thanks. Iām a one-lantus-at-bedtime gal and, ya, will travel east the overnight method. We always stay up til the new countryās next sleeptime and walk-walk-walk in the sunshine to help adjust and force ourselves to not sleep til then. Tricky but possible.
Wow ā your insulated cannister is impressive; never seen similar before. Thanks for ideas ā you are clearly frequently doing this adjustment / so experienced in your needs. You and others (ABOVE) have given me much to consider/ sort out. Ya, airports and I donāt get along either, and now that Iāve next-to-no warning before reactions (and my reactions to hypos can be severe so Iām successfully medād to avoid the grand mal seizures triggered by LOW-LOWs) we keep my husband on close-watch-alert to āreadā if Iām fading fast before a glucose check can be done; also the flight attendants are alerted. I wonāt go solo without a travel partner on internatāls anymore; too many troubles with such. Even the domestic stuff is getting to be a challenge these recent years. I really need to be ready, after initial adjustment time in Munich, as the grandkids in Jerusalem will need me be āup to snuffā (? thereās an odd idiom) when I get to Israel! My husband can and does regularly teach and present the day after arrival (an impressive feat) but admittedly hasnāt the medical-health juggling processes, bless him, so he helps me with the particulars of adjustment.
THANKS, EVERYONE, FOR YOUR POINTERS and SUGGESTIONS!
Do not put your insulin in checked luggage! It will freeze & also be subjected to stronger X-rays through security. Much more likely for checked luggage to be lost.
OOOOHH ā SO TEMPTING to sleep once a body gets to the new land! I agree, thatās a biggie to be avoided at all costs. Thanks for link ā Iāll order twoā¦ ;^)
Thank you ā I needed that input. Iāve put it in the checked bag before and YAH, I think it lost some quality. I hadnāt thought about the xray effect ā honestly! Iāll ask John (husband) to carry-on the spares.
Really - I Much like hearing from a community of folk WITH diabetes re: daily realities. (I tire of advice from those not living it.) So thank YOU Colleagues for your expertise on real stuff.
I completely missed the mark when I took what I thought would be a quick napāha! I was in Madrid & my first time in Europe. Woke up hours later & thought it was the next morning because the sun was bright. It was 9 PM, but I thought it was 9 AM. Got dressed for breakfast. No one eats dinner in Madrid until 11 PM. It was cocktail hour, everyone was dressed up & I couldnāt get anything to eat for hours. Talk about messing up my internal clock.
This is exactly what I was looking for, so Iām waking this thread up! I used to live abroad and travel a lot, but I moved back in 2009 and am totally out of practice. Iām also on a pump break and am back to MDI, so needed a primer on Lantus. I figured I had a bit more flexibility as I dose twice a day. I also wear a CGM, so I have a safety net.
Iām going abroad for two weeks to the UK and France, so itās only one time zone to deal with. Iāll just figure out what time is what there. I take Lantus twice a day at 9:30am and 9:30pm. I usually work remote, so I really donāt want to be whipping out a needle in the middle of meetings. However, bumping it to 5:30am and 5:30pm their time should allow me to avoid the awkwardness even if Iāll have to get up early for the shot (then I can just go back to sleep.)
