International travel on insulin

Hi - I was just diagnosed with type 1. I am still planning to go on a safari in Africa in a couple months, but it seems a bit more complicated now. I was wondering if anyone had travel tips, specifically ones related to traveling in hot climates and developing countries. Any recommendations for keeping insulin at a good temperature on this kind of trip?

Well, Paris isn’t a developing country, exactly, but I did live overseas (in France) for eight months while on Lantus.

I found that my little MediPort zipper bag (insulated, with room for a small ice pack) made the international travel a breeze, and I did travel in 90 degree heat (it was hot that summer!!!) to Brussels and down to Dijon. However, for more long-term travel without a refrigerator waiting for you at the end of the day, you’ll probably need to look in to the evaporation-cooling insulin containers, such as the one made by Frio.

One important recommendation: Have a type-written, signed prescription and letter of medical necessity for each of your medications, preferably in English and professionally translated into the colonial destination language (e.g. French, Portuguese) of the country where you’ll be staying, if applicable. I was able to get my prescription for Lantus refilled while in Paris using an American doctor’s prescription. This would be useful in an emergency, so leave copies with your family – they can FAX them to you in an emergency, e.g. if you were mugged and had to seek help and shelter from the American embassy. The odds are excellent that you’ll be fine, but it’s a good idea to have quick access to your prescriptions in case all h3\ breaks loose.

Also be sure to have plenty of the stuff you use for your D-care and to the extent possible, have it scattered among various bags. I got to Paris and discovered to my dismay that one cannot purchase rubbing alcohol or alcohol prep pads in France! The only thing close to rubbing alcohol that they sell is mixed with camphor (e.g. for massaging sore muscles) and there isn’t a BD alcohol prep pad to be had for love nor money. During a hot, sweaty day of hiking, riding filthy trains, spelunking in sooty Metro stations and the like, I wanted to be able to sterilize my injection site (or my finger-stick sites) before poking, but I had to make do with the stinky camphor-laced stuff to do it. Yuck.

Oh, well, it’s all part of the adventure, right?!?

Jessica - This idea is probably covered in travel portion of this website. I use a “cooling envelope” made by Frio to store the insulin that I carry with me every day. It works by way of some “seeds” within the walls of the container that absorb a good deal of water and then keeps the insulin cool through evaporation. I definitely would carry some of these on a trip to a tropical region like Africa.

Thanks Danny - I just joined that group and am enjoying reading the posts

Thanks Jean!

Thanks Terry - I’ve read a couple negative reviews of the frio packs (i.e., they work fine a couple times and then stop working). Have you had any such trouble?

Frio bags work well in DRY climates because they work by evaporative cooling of water. For 100% humidity you need a thermos bottle with some ice water.

You didn’t mention how long a trip you plan, that would definitely make a difference, and if you are staying longer times you might be able to rent apartments or houses that are better equipped with refridgeration and cooking facilities which make it easier for us to manage food.You might want to do some checking on what is (and isn’t) available in the countrie(s) you plan on visiting, especially if it is a long stay that you have planned. I lived in Guatemala for 2 years where I could buy Lantus and Apidra pens, as well as needles, or actually any medication in the drug store without a prescription, though if I had a list of 4 things I needed they would be out of 2, so it was always good to plan ahead. You could also get lab tests cheaply and without a doctor’s order just by going into any lab and then coming back two days later for your results. Many things you wouldn’t expect like that might be easier (less regulated) in the countries you will be visiting, other very common things may be unavailable or hard to find unless you go to the nearest big city or capital. Another thing you want to know about.

To gather this kind of information, my first suggestion is to run a search on here first and see if any members are living in the countries you plan on visiting. If not, then I suggest you go on the Thorntree message board which is a part of the Lonely Planet website. There are threads (or “branches”) for each country or area. On there you can post a question and either someone who lives there or who has spent significant amount of time there will be able to answer.

Thanks Zoe. Those are good suggestions. I am just going to be there for a couple weeks.

I lived in Ghana for a summer (3.5 months), during the rainy season, so it was super humid & hot. Depending on what country/countries in Africa you will be in, you may or may not experience quite that much humidity, and then a Frio pack would work well for you. I didn’t use one in Ghana, but I had access to a secure refrigerator most of the time. Also, if you’re only going to be there for a few weeks, I just suggest bringing all your insulin and supplies with you, plus a little bit extra. It’s better to over pack than under pack. Also, just make sure you have your medications & supplies secure at all times, like bring a good luggage lock or something. Don’t freak out if your insulin gets exposed to extreme temperatures. During my trip, my insulin was both SUPER hot several times and actually froze once, and it was still OK to use, I just had to test more. I think the extreme temps. can make it less effective, which would require you to take more. So, in a worst case scenario, just make sure to test a lot and adjust your dose accordingly.

Some tips on “roughing” it: Make sure to stay well hydrated. Chances are, depending on where you go, you’ll need to drink bottled water. It’s really easy to get dehydrated in the heat, especially if you get traveler’s diarrhea, which, in my experience, was easy to get in Africa. :slight_smile: I had it pretty much the whole time I was there. It was never debilitating though, just uncomfortable & annoying. It never affected my diabetes too much, but I think that is because I just forced myself to drink water even if I didn’t feel like it. Just be careful about what you eat & drink, and you should be OK.

I agree with others about doing your research on the country you’ll be headed to through the use of a good guide book. Also, make sure to get vaccinated for whatever you need to get vaccinated for before you go.

Other than that, if you have any specific questions, feel free to message me. I love talking about Africa. :slight_smile: It might seem overwhelming travelling to a developing nation with a disease that needs so much “modern” intervention, but don’t let that keep you from going. You’ll just have to plan a little more in advance. :slight_smile: And above all, HAVE FUN!!

I got to Paris and discovered to my dismay that one cannot purchase rubbing alcohol or alcohol prep pads in France!
Bit late now but if you're in the same situation again. To swab cannula sites and the tops of vials, I get prescribed 'solution antiseptique, chlorhexidine 2%' , it comes in 5ml unidoses, and is applied with compresses de gaze (gauze) which come in sterile packets. You can also buy individually wrapped antisceptic wipes which are fine for cleaning hands when out and about.

I use a frio all the time for walking, traveling in hot weather. I've had mine for about 5 years now and it continues to work well.It's best carried on the outside of a rucksack so that it can evaporate properly, my rucksacks got a couple of elasticated 'netting' pockets which are ideal.

I was going to second the frios. I haven’t had any problems with them yet, but I’ve only used them for 2 vacations (both 2 weeks long) and a couple of extra hot days at the beach

It’s not ice cold, but it keeps them cooler than if its just in your purse.

I gave up swabbing a long time ago and no negative impact

me too I never do it - my Doctor said if I am clean (shower daily) not necessary

another negative review of the frio pak USELESS - probably too late for you but I stayed in the USA for 3 months travelling and only one place, the Holiday Inn at Chicago would even touch my freezer block - Amtrack a big NO NO they gave me ice which melted all over the floor - on a cruise I had to give my insulin to the Medical centre ---- here is Australia our diabetes centre said oh its ok if under 26 no need to put in the fridge!!!

So now I am going to write to the manufacturers of the insulin (Lily and Sanofli) because they say to sore under 8

I can imagine the stress for anyone like me - it has just put me off going on a holiday -

HELP anybody else got a solution, e.g., one of the small refrigerated portable packs - I am going to investigate these and worth the few hundred dollars not to be stressed - just hope they work.

Wow, I am so glad I found this thread and so glad I searched 'diabetes and africa'. These comments have been so useful already.

I was recently diagnosed (11/26/13) with type 1. I was supposed to leave on January 1 to live in Kenya for 10 months on a grant. With the holidays and only four weeks between diagnosis and departure my medical team advised against the travel. There is still a very slim shot that I could leave in March but the granting organization seems wary having me travel despite my endocrinologist's letters stating that I would be medically able to leave early March.

I'm wondering if there are any good resources for finding diabetes doctors abroad or even literature that I could pass on to this board (along with notes from my doctors and my own letter advocating for my placement) in favor of my case?

I've been to and lived in Africa previously as well as Eastern Europe. My professional plans have long assumed that I would be living in the developing world with some unpredictable circumstances. For the last month I've felt like the whole outside world is telling me that that isn't possible. Any insight or advice you'd be willing to share would be so helpful.