happy new year!!
i travelled to nyc for xmas and had to adjust my basal insulin to the different time zone. it was easy because i gained some hours and so just did an intermediate unit of basal in the middle of the longer than 24 hour day to cover.
now i am back. my flight was last night 7pm nyc time. i gave myself the regular evening dose of basal (5 units) and was sleeping on the plane. but the plane landed at about 330am nyc time. i had a layover in madrid and was a bit wired so i didnt sleep after that. i guess the dawn effect didnt happen because i wasnt sleeping, so ive been chasing lows all day, not even using fast acting to eat lunch. i didnt inject my 2 units of morning basal (2 units) either.
its now 7pm spain time (1pm nyc time). its time for basal again, according to where i am now. but im still low. the 5 units at night are needed for dp but i dont know if i should because i dont want to go low in th middle of the night. because i stayed up and didnt sleep i think a have 3 extra units of basal in me.
what would you do with regards to the basal scheduled for, oh, about 15 minutes ago??
thank you!
I would skip the NY basal dose. You are already low, just got home, jet lag.... You can straighten it all out tomorrow when you are awake.
I have a pump, but here is what I do. As soon as I board the plane, I change the time on the pump to the place I am traveling to--immediately. It basically means if I going to Europe, that at 5 pm EST, I move ahead 7 hours to 2 am in France. I find this method leaves some "holes," but I am traveling and expect weird glucose numbers. I have also used this successfully flying to the west coast, a four hour time difference.
I would reorient your basal for local time after tonight. If you need to catch up with some correction doses, just do it carefully.
I always switch to destination time sometime when it's convenient before I depart, although I've only been a couple of time zones away. That way, when I land, my schedule is already where it should be. I'd eat to correct your current low, figure out how much IOB there is, if any and probably take maybe 75-100% of the basal shot. In those sorts of situations, I will sacrifice a couple of pounds to keep my BG ok and get back on schedule as smoothly as possible.
I fly to Europe and just set my pump to local time when I get there, and I do the same coming back it's 7 hours later in Amsterdam but my body is not short any insulin. When I was on MDI I would just try to give myself some basal every twelve hours until I'm on the local time schedule, Amsterdam, Frankfurt, Paris, Rome, and Barcelona, are all in the same time zone. London is just one hour less at 6 hours difference...
Flying wrecks my BG so I never worry about my basal being spot on...I just try to get my bags and get through customs without having a low BG event.
So true! I love to travel, but travel days are hard--insulin, stress, time changes, tired. I just figure it will be weird and move ahead.
I've been to Japan,NZ several times,read long a** flights,date changes in effect.
Endo told me to reset the time upon arrival.
YES,flight stress,jet lag,airline food,etc does affect your numbers. I go with the flow,testing more frequently is the mantra.
thanks for your replies. i had dnner without any fast acting and gave myself 3 instead of 5 units of basal. and woke up with....wait for it...a 95! i should travel across time zones every week!
Sorry, this is probably a late post. This information is adapted from a good article "Have Insulin, Will Fly: Diabetes Management During Air Travel and Time Zone Adjustment Strategies" in Clinical Diabetes. This is for MDI. I have also found that Elizabeth Stouffer has a great description of how to manage with a pump.
Bolus remains unchanged, keep ICRs same for meals, breakfast, lunch dinner as usual
Abbreviated day (eastward) – Less Insulin, decrease basal insulin in proportion to amount of time lost
Example:
2 shot /day basal (each covers 12 hours), each 16 units (3 hr eastward flight)
Reduce next basal injection by 16 units * 3 hrs / 12 hrs = 4 units
Next injection should be 16 – 4 units = 12 units
Reset to local time and return to normal basal schedule (local time) after that
Extended day (westward) – More insulin, increase basal in proportion
Example
1 shot /day basal (each covers 24 hours), each 30 units (12 hr eastward flight)
Increase next basal injection by 30 units * 12 hrs / 24 hrs = 15 units
Next injection should be 30 – 15 units = 15 units
Reset to local time and return to normal basal schedule (local time) after that
brian, thank you!! something mathematical! this will be useful for future trips!!