We’re traveling to China next month (my son, soon to be 15 and a pumper for 7 years) We’ve managed time change of a few hours before, but this will be the largest time change we’ve dealt with before. We leave Seattle at 9 pm and arrive in China at 11:30 pm (flight time of 11.5 hours).
A couple issues are running through my mind right now and I’d love to hear others experiences.
First of all, when to change to “local time?” Typically we’ve done this once we’ve got to our destination and that’s probably what I’ll do again. However, given the long flight and the chance that he’ll sleep, I’m wondering, should we crank back the basal sooner to his “nighttime rate”?
In the past on longer flights (of say, 5 hours) I’ve actually increased his basal as he’s just sitting there and goes high. But I’m wondering if his body’s natural circadian rhythm will affect this as we’ll be flying at night (that is, result in the need for a lower basal just he like does while sleeping).
The other issue is how long does it take for the body to “reset” itself to a local time? I remember the couple times we went to Hawaii it seemed like his body still thought it was on “Pacific time” for the first few days. Edited: He’d seem to experience his dawn phenomenon according to Pacific time and not local Hawaii time.
Thanks for any insights, tips!
I went to China a couple of years ago when I still on the pump. I’ve never noticed needing to increase basal while on a plane, but, if it’s been needed in the past, you should probably continue to do it.
I’ll address the time change thing in a second, but, first, a word of warning: Chinese food really screwed up my blood sugars. I spent 6 months there and, because food was cheap and I didn’t have a kitchen, I ate out most of the time. My sugars would go from really low to really high really fast, and I never managed to get them adjusted to the food. However, I’ve always had problems with Chinese food, and your son might not.
The time change: I was really nervous about this when I went. I actually left it on the original time zone for a few days. I experienced my dawn phenomenon at 2 in the afternoon instead of 3 in the morning. My body actually seemed to continue doing that. Eventually, though I created new basal rates and gradually changed them hour by hour. So, for example, if I originally got 2.1 units at 10 pm and 2.5 units at 11 pm, after a few days, I gave myself 2.1 units at 11 pm and 2.5 units at midnight. I don’t know that there really is any best way to do this. His blood sugars will probably be pretty wacky for the first several days, but it’s perfectly understandable, so don’t worry. I got my highs down by giving myself insulin. And twice I passed out on the street because of low blood sugars and was taken to the hospital - people knew what to do, even in a small, rural village. (Don’t worry, those severe lows had nothing to do with China; I just tend to give myself too much insulin.) So, even if things become really bad, it’s not the end of the world.
Great info, Anna. I feel better knowing that what I observed in Hawaii with the dawn phenomenon actually occurs with others. So I’ll be on the lookout for wacky numbers (we live in Denver, so I’ll do an exact time change calculation to figure out when it might be) We’ll only be there 16 days, so I’m sure by the time we get things in sync then we’ll be back home (and then he starts school a few days after that - help!)
By the way, his dad is Chinese so we eat a lot of Chinese food. In general, he doesn’t eat much of it (he only likes Panda Express Orange Chicken LOL!). For one week we’re staying in a American-based chain hotel in Beijing which has choices other than Chinese food. The other week we’ll be around relatives, but he’ll probably just eat rice and noodles, a little bit meat, and even less veggies.
I went to Spain (6 hour time change) last summer and I adjusted pretty quickly. I left my pump on home time for the dinner part of the plane ride since that was normal dinner time anyway. After I ate, I switched my pump 6 hours ahead and added a 35% increase of my basal to account for the inactivity and altitude. When we were served breakfast on the plane (which was about 11:30 pm body time but 6 am local time), I used my bfast ratio, but I had a low in the airport, so I should have stuck w/ my dinner ratio. Since I’ve been to Europe many times, I just stayed up that day, and I think we really only ate dinner that night and went to bed early. The next day, I had a low at around 5pm local time, which is my danger zone time at home too! I seemed to be totally adjusted. My advice would be to think about body and local time and try to mix them in the middle for the first few days. Lots of testing, always keeping snacks around and using some body hints is probably the best that he’ll be able to do. I wouldn’t worry about small BG excursions, just try to keep things in a 70-200 range most of the time.
I’m tentatively planning a trip to Kathmandu, Nepal next summer, so I’ll be needing to do an 11 hour time shift for that one. Adding the altitude (I have lots of highs when I’m in Wyoming) I’m sure I’ll be do a lot of the wild ■■■ guessing for a few days.
Thanks, Jackie. Great tips. We live in Colorado so that’s interesting about the highs. When we go to higher altitude (for us, that’s 10,000 feet and above! LOL) he actually goes low. We drove to Mt. Evans a few weeks back (a drive-able 14,000 foot peak) he lowered his basal and for the first time he didn’t go low. I’ve always wondered if the air pressure does something funky with his pump at the higher altitudes.
Your situation is more than likely due to dehydration. Here in Colorado a lot of visitors notice they have to drink tons of water, so that could account for your highs.
I’m thinking I’m going to keep my watch on local time for a few days just so I can track those danger times for lows (late afternoon is his time, too. Why is that?)
My best trick is to change time zones right before you get on the plane. It works well for non-diabetics too. You need to have a great deal of self control – but the flight is you “readjustment” period. Basically, trying to fake your body into changing time zones more easily.
It’s harder when you are going >10 time zones, but still can take the bite out of a long haul flight.
I live at sea level in Boston, so 300 feet is an altitude around here!
Hi PC,
I travel to China on occasion for business, and I agree that it is usually a better idea to change the time after you get there. Your body takes several days to catch up to the local time, so I would recommend changing it after the first night there in China. I’ve done this in the past and it seems to work well. Keep in mind that traveling east (back to the USA) is quite a bit worse than going west. I suspect your son (and the rest of the family) will adapt quicker to the change in china than when you get back to the states.
The important thing to remember is to check often and take action when necessary. No matter how well you plan it out, just the nature of traveling and spending time in a foreign place will create some problems. No need to stress out, just take the corrective action and move forward.
Also, in case you take juice along for lows, airlines in the US will allow you to go through security with them, but some Chinese security people won’t allow it. A much better option is to get a couple big bags of skittles before leaving home. They are very compact, and easy to count out for the right amount of carbs. No hassle from security that way.
thanks, Brett. My son and I were just talking about Skittles! It’s his fave thing now to correct lows. When he had braces he stuck to those liquid glucose drinks you get at Walgreens or other places. They were fine but now he’s sick of them. We keep a bag of Skittles in the car at all time!
Thanks for the travel tips! Much appreciated.
I don’t know if this will help since I’m on MDI. What I’ve done for time zone changes is force myself to be on local time with meals, sleep & injections. Usually this means losing sleep & taking increased doses the first day, but it helps my body adjust more quickly. I’m fine by the second day, but I’ve never traveled as far as China. Every international flight I’ve taken was overnight.
Have a wonderful trip!