Are there any type 1 diabetics that travel regularly across multiple time zones (more than 4 e.g. transAtlantic)? If so, do you have tips on how to mitigate the obvious implications of halving or doubling your days. Also, is there anyone that has had to stop regular longhaul travel because of their diabetes?
Back when I was an honest working man I travelled a fair amount, to Europe, Australia, South America and Asia. Europe is easiest – you compensate for the time difference by planning the first day in the “other” time zone, f.ex. when you travel to Europe you try to get a couple of hours of sleep in the mid-morning when you arrive, and stay up as late as you can in the evening to make the switch from US time easier. Latin America isn’t so difficult, because the time difference is relatively small, Australia/New Zealand are the real challenges. I never developed any firm formula, but always tried to get a good long nap in the morning when I arrived there, and tried hard not to schedule any work until Day 2.
Insulin and food intake you handle by applying common sense and measure your glucose religiously. CGM makes the entire process a lot easier.
I make regular trips across the Atlantic and have no major problems!
I currently use the pump, which admittedly makes things a bit simpler, but I have also done it on shots.
How to do it depends on the length of your trip. For a short trip, I would not move the timing of your injections, unless it would interfere with sleeping. For a long trip, what I did was to move my long-acting insulin (Levemir, Lantus) to 1-2 hours earlier/later per day starting a few days before the trip.
If you change time zone by 6 hours ahead (i.e. EST to continental Europe), that means that in three days you will have your Lantus/Levemir at the normal time.
Say you usually take your Lantus at 10pm EST (4am European time), then a couple days before your trip start the following routine:
DAY 1- take your long-acting insulin at 8pm (EST) and check for lows (since you will have slightly more insulin in you than usual)
DAY 2- take your long-acting insulin at 6pm (EST)
DAY 3- take your long-acting insulin at 4pm (EST), which is 10 pm European time (you’re set)
A few points:
- if you want to be more careful, then just adjust by 1 hour… to avoid mroe highs and lows
- CHECK your blood sugar often during the adjustments
- when you move your injection time to later (more than 24 hours since the previous injection), perhaps give a small bolus to insure that you have SOME insulin in you (no DKA!!!)
- when you move your injection earlier, then eat a little something to make sure you don’t go low
Hope this helps! Don’t let diabetes stop you from changing time zones!!!
I appreciate your advice. In February I may be traveling to California for a weekend training program. I live in NJ and my concern is how to adjust my meals ( I use Novolog ) and Levemir dosage/timing. With all the restrictions on what can be carried on board I am also worried that I will have little control over the timing of my meal. Any insights on that?
With injections, if you are going for only a few days, it might be best just to keep giving the Levemir at the same time (NJ time). For the meals, you should be able to adjust with no problem. Just take the Novolog boluses according to your new schedule.
I always bring a sandwich or meal-replacement bar with me. So that I don’t need to depend on the timing of the plane food. Check if there will be food on the plane. If there is, I often order a diabetic meal, which is not at all low carb, but at least it gets delivered first and usually includes fresh fruit!
Hope it works out!
hmmm, this summer I did a lot of cross country red-eye flying. three time zones, were a non-issue for me. But, even then I planed to stagger my lantus ahead of time to keep the curves smooth.
The messy part for me has been the long cross country driving events. 17 hour and 27 hour car drives by your lonsome are a pain. If you run high you end up stopping to fix it, if you run low, holy crap it might result in ending up dead at 80mph on some lonesome road in Montana. Also, good luck finding non stomach turning food on highway 90 in Ohio, or again Montana. 8^P
don’t let this put a damper on your trip! i find that if flying to the west coast, i can leave my levemir at the same time, but will sometimes push it back about 2 hours to fit the time adjustments for when i’m waking up and going to bed. (ie, i’ll take it at 10 p time, instead of 11 eastern time, if that makes sense…) and i just take the fast acting with meals regardless of what times they are. for flights longer than 10 hours or so, like to australia, i’ve had a harder time, but in those cases, the wider the time difference, the easier i find it is to just keep taking the long acting at the same times, ie if i leave europe in the morning, and land in australia at night, even though it’s the next day date wise, i’ve already taken my levemir 12 hours apart, and just keep on taking it before bed and when i wake up. sometimes this puts me off schedule for a few hours the first days, but i adjust with mealtime insulin to keep my numbers more or less normal.
i find that on long long flights i tend to go really low, so i try to make sure i have plenty of meal bars (i like the extend and glucerna bars, but the luna bars taste a bit better), or trail mix with some nuts and raisins, and i usually take a box of those little tubes of powdered ice teas or sugar free gatorades, bc you can always get water and i get sick of diet sodas after the first 12 hours…
if you have a letter from your dr. stating you’re diabetic, you can bring juice etc. through security with you, though they try to give you a hard time; you just have to stick up for yourself.
good luck and have fun!!