Diabetic Travel Tips for International Travel – 2023

Last Updated on February 5, 2024 by PowersToTravel

While many people can buy a last minute flight, pack a quick carry-on, and zoom off to foreign lands, a diabetic has more to consider. Here are some Diabetic Travel Tips to review before buying that ticket or getting on that plane.

After each new and exciting trip I review this list to see if I need to update the travel tips. You’d be surprised how much more smoothly international travel goes after so many years; you’d also be surprised how many new considerations I continue to document each year.

It’s not difficult when it becomes second nature!

Suitcases in Kyoto

Here’s the Packing List to go along with my Diabetic Travel Tips

All (except for the Sugar Free Cough Syrup) go into my carry-on:

  • Pump Insulin
  • Frio insulin case
  • Infusion Sets
  • Reservoirs
  • CGM (Continuous Glucose Monitoring) Sensors
  • Glucose Meter & Kit
  • Glucose Test Strips
  • Lancets
  • Glucose Tablets
  • Ketosticks
  • Extra tape for CGM
  • Lantus (long-acting insulin)
  • Regular syringes
  • Extra Batteries (Pump, CGM charger, glucose meter)
  • Alcohol Swabs
  • Reglan Rx (vomiting)
  • Cipro AND Azithromycin Rx (antibiotics)
  • Gatoraid Zero packets
  • Acetaminophen (Tylenol) (fast-acting caplets)
  • Imodium (diarrhea)
  • Antibiotic ointment
  • “Steri-Strips”
  • Band-aids
  • Country-time Lemonaid Mix, tablespoon and small funnel to add it to water bottles
  • Frio pump case
  • Backup pump
  • Backup Glucose meter
  • Sugar-Free Cough Syrup (this one alone goes into the checked luggage)

Diabetic Travel Tip #1 – Vaccines, Malaria and Travel Clinic – before you travel

Of course, you don’t want to consider your vaccination status after you have left! I have a spreadsheet of all my vaccinations, when I have had them and when boosters are needed.

My first diabetic travel tip is to read up on the health issues of the countries you want to visit using the CDC Traveler’s Health website so that you can understand the general picture of health issues in that country.

Check out this great table of malaria risks by country, published by the CDC, or check out the FitForTravel website published by the Scotland National Health Service which has awesome malaria maps by country. They have countries organized by region, and displayed on maps, so it is wonderfully easy to navigate.

Once I have decided “Yes! I’m going!” then I consider whether or not to go to a travel clinic. Travel clinics are more expensive than a visit to my primary care doctor because my health plan treats it as if it were a “Specialist.” I base the decision to go to a travel clinic on two factors:

  • Are there diseases in that country which require vaccines which I need?
  • Is malaria a risk?

If I need a vaccine, well then, I need a vaccine. Some can be given by my primary care doctor or local pharmacy. Others require a travel doctor.

If malaria is a risk then I must go to a travel clinic because primary care doctors are not usually up on the strains of malaria and the appropriate malaria medication.

Go to the travel clinic a couple of months before the trip! It was my first trip to a malaria-endemic area and I didn’t try to get the travel clinic appointment until ten days before the trip! (I guess the word “clinic” made me think it was a walk-in affair!) That was really dumb. I couldn’t get an appointment and knew I needed anti-malarial medications. Luckily my endocrinologist stepped in, researched the area with the help of a specialist he knew, and wrote me the right prescription. It’s not a position I want to put him in again.

Diabetic Travel Tip #2 – Do your own research into the health risks of your destination before committing money and before going to the travel clinic

I also now consider any medications which may be prescribed to me by travel clinics in light of my current health situation. I do this BEFORE going to the Travel Clinic, and BEFORE committing to a trip. For example, I now have Chronic Kidney Disease (CKD) Stage 3A. I have to be careful about taking Acetazolamide, (aka Diamox) which is often prescribed for high altitude. I can take it in limited strength for limited time for real purpose. Should I decide I wanted to visit Tibet or hike the Andes, you can be sure that I would be visiting my nephrologist (kidney specialist) before considering the trip.

My husband too now takes heart medication. Specific heart medications can be contraindicated for specific antibiotics and specific malaria medications. Discussing a trip which might require different medications than we ordinarily take with our primary care doctor is often a cheaper way of resolving the issues than by the time we have paid for a travel clinic and put money down on a trip.

For these types of reasons, I have decided that Tibet is not on my bucket list. I’ll get my fill of the Himalayas by taking the scenic flight from Nepal! I’m not a trekker after all.

Diabetic Travel Tip #3 – Flying with Diabetes, your pump or your syringes

Whether you are a pump user like myself, or depend on needles, flying can be a challenge.

Since obtaining my first Medtronic insulin pump thirty-five years ago, many day to day activities have been made easier. However, flying has both been made both easier and harder.

What’s easier about flying with an insulin pump?

No more trying to get that needle into me discretely after dinner has been served. You just can’t inject your insulin prior to being served, because on an airplane, turbulence may or may not interrupt the meal service delivery. You just can’t take your insulin until that food is on your tray! And when the food is on the tray, you can’t discretely access your body to plunge that needle in. Even my arms were off-limits, because I’d always be wearing a sweat-jacket as I always froze on the plane. Once the meal is over, well, the stewards and stewardesses seem to leave you with that half-eaten dinner in your lap for seemingly hours! Meals on a plane were a total trauma to me.

Now, with my pump, I look back at those days and laugh a little. The tray is delivered, I take a bite to see if I’ll be able to eat it, and then reach down to my waist and reach my pump – fully accessible – and pump for the carbs.

What is more difficult about flying with an insulin pump?

Does flying affect blood sugar when using an insulin pump – check out Boyle’s Law

A few research studies have shown that insulin pumps deliver more insulin as the plane ascends, and less as the plane descends. Here’s a link to an authoritative article by the American Diabetes Association. If you don’t believe it, here’s a blog post from ASweetLife about insulin and flying – check out the forum discussion that follows the post!

It’s kind of strange for me in that when I fly long-haul flights, which occurs about two times a year, I always seem to have high blood glucose tests results during the flight (which is contrary to the concept that more insulin is delivered as the plane ascends – but could easily be attributable to the sedentary hours on the plane) and I frequently have what those in the ASweetLife forum call “Baggage Claim Lows.” And that is strange because according to science, I’m supposed to be experiencing highs after landing due to the descent and absorption of the air bubbles. Can’t figure it, but I do have to be very careful – I now disconnect when I feel the plane start its descent, even if the pilot has not yet announced it. Then I give myself an additional 45 minutes worth of insulin when we touch down to cover that period. I’ve had too many instances of staggering around airports after landing to not pay attention.

Getting my insulin pump and my diabetic supplies through TSA Security Checkpoints

Syringe users have an easier time getting through the TSA checkpoints because they don’t have an insulin pump or continuous glucose monitor plugged into themselves. Greg and I always give ourselves extra time at the security checkpoint and I always request hand screening. Sometimes I’ve waited fifteen minutes or more for that hand screener, but I figure it’s worth it when starting an international trip to not expose the device to any interference. Pump manufacturers can be so coy about the pro’s and con’s of exposing the pump to scanners.

What about syringe users and flying?

Syringe users must worry about time-zone changes and when and how they should adjust their long term insulin on flying days. I can’t help you out here, sorry. I seldom traveled back then when I was syringe-dependent.

Diabetic Travel Tip #4 – So much more activity than usual

When we travel my activity level is easily twice that of when I am home. I have to change my basal rates to anticipate the higher-than-normal activity – I tend to use alternate basal profiles because the Temp Bolus feature tends to alarm me too frequently. An alarm is meant to alarm you to an abnormal circumstance, however when traveling, running at a much lower basal rate is absolutely normal.

I’ll set up an alternate basal profile which exactly matches my ‘at-home’ profile. Then I’ll adjust it downwards a bit. Then I’ll set myself to run from it, as soon as the plane lands (no need to be running at a lower rate while lounging on a plane!) As the first days go by, I’ll generally find myself with many insulin reactions and many drops to the basal rate. Finally after about 3 days I’ll find that sweet spot and feel like all is normal, except that I’m walking now more than 3 miles a day, and up and active for 10 hours!

Diabetic Travel Tip #5 – Prevent dehydration

I’ve learned that dehydration can be very dangerous for diabetic, so much more so than for a non-diabetic. I’ve always known of the risks of dehydration during vomiting/flu illnesses but didn’t translate those same risks to simply being out and about in hot climates.

I always focused on keeping my insulin cold in hot weather, not on keeping myself hydrated.

However, in reading up on the Internet about dehydration I learned of the vicious cycle that diabetics could experience if dehydration starts. The cycle could end in kidney failure or death.

One risk that impacts this is the fact that tourists are touring for a reason – to see new sights and experience new adventures. The focus is on the wonders of the new country, and not on whether your mouth feels a little fuzzy or dry.

The emphasis here is to keep drinking water while out and about. Drink, drink and drink. Don’t wait until your mouth is dry, don’t wait until you feel a little light-headed. Just keep sipping and drinking and keeping the blood glucose and hydration levels balanced and preventing ketones from forming.

Diabetic Travel Tip #6 – Keeping my insulin cold while traveling

I’ve written an entire article about how I protect my insulin cool when traveling, both during the initial first day flying, and during the entire trip. Click here for more details.

Diabetic Travel Tip #7 – Keeping the insulin in my pump cold while traveling and sightseeing

Wear protective clothing

But you need also to keep your insulin cool while wandering around, if you are pump-user. When outside I would ensure that I wore my tropicwear shirts outside my waistband, so that the shirt would provide shade to my insulin pump at all times. I’m not embarrassed to show my insulin pump, and would do so if circumstances warranted it, but I tend to travel wearing LL Beans’ Short-Sleeved Tropicwear shirts (I am not compensated for this mention!)

The shirts are airy, light-weight, have breast-pockets for my glasses, tickets and what-all, and hang down over my pump to shade it at all times. I must have ten or fifteen of these shirts in all different colors. They are a bit expensive, and I tend to watch them come on sale, or go to the LL Bean factory store.

Every day I just pop on a different color, feel freshly dressed and in a new style even though it is the same “style”. They can easily be washed out at night and be ready for the next day if I have to hand-wash. They are so light weight that if I am lucky enough to get my clothes laundered, then they don’t make the kilos and costs mount up.

Frio Wallet solution

Recently I’ve discovered another technique for keeping my insulin cold while in my pump – the Frio Pump Wallet. I was heat-challenged like never before this past summer as I planned an anniversary getaway to Curacao. The trip had to occur in August, and had to be where JetBlue flew. I was immediately drawn to Curacao, but learned that it would still be in midst of a hot season – when temperatures were expected to be 90 or higher all day and every day. How would we get out and about and still protect my insulin?

I considered storing only a day’s worth of insulin in the pump each day, and replenishing my supply each night, but I’m hesitant to be out and about in foreign locations without a several day’s supply of insulin on my waist-band. I found the Frio Wallet via internet searches. This particular device fit my pump, and would fit my infusion set tucked up into it as well! The gotcha was that it required me to wear a belt, and I seldom wear a belt – I usually wear the pump on a clip on my waist-band. Oh well, I found the belt from my tropicwear pants, and figured, what with my shirts covering my waist-band, no one would know that I was wearing an extraneous belt.

The Frio worked like a charm, keeping the insulin cold all day, even in such high temperatures. I’m looking forward to using it this coming fall when we visit Dubai, at the end of their hot season, at the end of September.

Diabetic Travel Tip #8 – Eating and carb-counting Unusual Foods

Even eating out at home can be a challenge because you never know how many “Carbs” are in the food that is served, and you just never know how much sugar they have laced it with. However, with the pump it is easier to fix a mis-calculation. A quick blood sugar check a couple of hours later, and a corrective bolus, and I’ll be back on track.

Diabetic Travel Tip #9 – Avoiding the water – Update Oct 2023 – Investigate even bottled water!

I like to travel to unusual destinations, and unfortunately they often do not have potable water. Everyone has seen the warnings to avoid the salad and not to brush your teeth with the water.

This can get very tedious during a long trip, but entirely necessary. I’ve learned to have a thick skin and apologize profusely to guides who try to get us to eat unusual foods that may have water issues.

For example, in Cambodia, our wonderful guide Tia took us to a small house to learn how to make spring rolls. In my experience, spring rolls are fried and so I felt entirely confident in the activity. However, as we prepared the first rolls, it became apparent that these were to be “fresh” rolls. I have to believe that the lettuce and veggies placed in the rolls were washed in water acceptable to Westerners, and was too embarrassed to ask, however I just couldn’t be certain. I’ve gone on the hunch before and become terribly sick as a result.

I completed my spring roll and Greg, realizing my dilemma, took it immediately and said “Yum!” and ate it. He doesn’t seem to have my same sensitivities to water, and isn’t diabetic so doesn’t run the same risks. The guide seemed surprised and I just said, “I prefer the fried ones! Are they next?” (Which I knew they were.)

Update Oct 2023 – To my surprise and dismay, on our trip to Nepal we discovered that even bottled water can be contaminated! Whoever heard of such a thing? What do we do and what can we trust? Read my article “Is the BOTTLED water safe to drink in Nepal? No!” for the gory details. The bottom line is when traveling to a risky country, don’t google just “is the water safe to drink in…”, google instead “is the bottled water safe to drink in…” and don’t just stop at the first couple of articles. Turns out that Nepal has a terrible problem with contaminated drinking water – with their bottled water sources! See my article for our solutions.

Tip #9B – Carry two kinds of antibiotics

Updated Oct 2023 – I was sick twice in Nepal in one week, and used two Azithromycin Z-paks to recover. That certainly made me feel nervous, having used so much antibiotic so early in a long trip. (I usually don’t get too stressed because the travel doctor always prescribes antibiotics also for my husband, and he never uses his.) However, I fell sick again as we left Vietnam. Oh, how I regret that salad I ate at an “American-Style” restaurant we had eaten at several times and enjoyed. I had said to myself, “They feed Americans all the time and must know how to clean their lettuce.” Not so! That is, I fell sick the next morning on the way to the airport. I treated myself with Azithromycin because the travel doctor had prescribed it and and had said that the digestive bugs in the east were becoming increasingly resistant to Cipro, my old standby antibiotic.

To my surprise and for the first time, I didn’t get better! After two days of illness, and two doses of Azithromycin, I took Cipro. I had requested Cipro from my primary care physician in case I should get a urinary tract infection, and for sure, I was glad to have it along. It cured the digestive problem. In the future I’ll do exactly what I did this time – request and carry both Azithromycin AND Cipro. But if the Azith doesn’t fix the problem on the first dose, which it is supposed to, then I’ll go for the Cipro.

Diabetic Travel Tip #10 – Protecting my insulin and supplies from theft

Being a pump user has greatly increased my dependence on supplies – infusion sets, reservoirs, insulin, the pump itself. In the olden days, I used to carry an extra bottle of insulin in my purse and a clutch of needles and I would be all set, but now I need an entire kit. Add that to the availability issues of pump supplies internationally, and you will find me obsessing about theft.

I don’t worry much about theft in a hotel (since we generally stay in 3 star hotels with private rooms), or when our luggage is hidden from view, however I do very much if our suitcases cannot be hidden. It’s so frustrating when you rent an SUV and find it has no security panel over the luggage.

It was Costa Rica, and it was our second day sightseeing, and I’d planned a day out in Manuel Antonio National Park, on our way to our little cottage “home” in Uvita. This meant that all our luggage would be exposed in our vehicle – that luggage included all of my insulin and pump supplies. Warnings were everywhere on the Internet about petty theft occurring near the parks and at the beaches. It may be petty to some people, but when we’re talking about my insulin and supplies, it’s vacation-halting!

I created a second kit, with enough supplies to last me a week, as well as the insulin in a cooling package, put them in a backpack, put the backpack on my husband, and off we went! I supervised Greg to make sure he avoided standing in hot sun for long.

Our SUV was not broken into and all was well. Greg sometimes wonders at my over-zealous behavior, but he figures that if it makes me feel confident and worry less, who is he to complain, even if he is the pack-mule?

Now I will do a mental walk-through of our trip with our luggage to ensure I’ve properly planned for its protection throughout the trip – on trains, planes and automobiles!

Diabetic Travel Tip #11 – Coping with the diarrhea and vomiting that occasionally hits

I’ve written an entire article about how I cope with the problems introduced by water-born microbes. I’ve learned that I cannot drink “filtered” water offered by Eco Resorts. In fact, as much as I admire them, I avoid Eco Resorts. As sad as I am, I have to tell you that I must have water in factory-sealed water bottles. Anything less than that has laid me flat out for twelve hours. I’ve learned to handle this and reduce the downtime to eight hours, and I’m happy to share with you my real-life hacks!

As part of the treatment plan for diarrhea and vomiting, azithromycin or cipro antibiotics are key tools. Luckily I can get prescriptions for these at either the travel clinic, if I’m there for vaccines or malaria piils, or my Primary Care doctor.

Diabetic Travel Tip #12 – Avoiding the Mosquitos, Malaria and Dengue Fever

Disease hits diabetics hard, and a diabetic never wants to end up in a hospital in a foreign country. For that reason I obsess about mosquitoes.

I go to travel clinics ahead of time if the CDC mentions anything about malaria or other diseases as resident in our destination country.

I also check out these wonderful pages on the British websites: The Scotland National Health Services country-by-country health risks called FitForTravel. On a country-by-country basis they describe the risks, similar to the way the CDC does, however THEY INCLUDE MALARIA MAPS for each country.

I take malaria medication exactly and as long as prescribed.

I also worry about Dengue Fever, whose risks come and go seasonally. There are no pills to protect you; you can only protect yourself from mosquito bites. I see girls in their short skirts hanging out in restaurants in tropic locations and think, “They can risk it – I won’t.” I bring more than enough DEET to protect us.

I learned something new this past visit to the travel clinic about the biting habits of mosquitos: The mosquitos who carry malaria are most active in the evening and early morning. Check out this interesting article about the changing habits of mosquitos! The mosquitos who carry dengue fever are most active during the day time, (although they can bite at night) in urban areas and areas with standing water.

I wear tropic-wear shirts and tropic-wear long pants if at all possible when going out at night in mosquito infested locations. In fact, the zip-off tropic-wear pants are my best friends as the legs can be zipped off and stuffed in my purse (or backpack) when the weather gets hot, and then re-assembled to protect me at dusk.

I also pack and carry one long-sleeved tropic-wear shirt. You never know when the weather will turn, or when you’ll be out later than expected. Once again, it can be stuffed in your purse or backpack. Then you can put it on to protect yourself from unexpectedly strong or long sunshine, or from mosquitos at night.

Now that I have learned about the daytime antics of dengue mosquitos I need to reconsider my daytime protection!

An additional consideration for Dengue fever is packing sufficient Acetaminophen Fast-Acting Gel Caps. As a Kidney Disease Stage 3A patient, I’m no longer allowed to take Advil or NSAIDs. In any case, acetaminophen (Tylenol) is the recommended pain and fever reducer for Dengue fever. Specifically, they recommend the fast-acting gel caps to get it working as fast as possible. It is my understanding that Dengue can be a terrible, terrible experience – it’s not called the break-bone fever for nothing. Getting acetaminophen into you as fast as possible is best. For that reason I always carry not just a few caplets, but an entire bottle with me on every trip to Dengue-risk areas.

Google “bloggers experience with dengue fever” and check out some of their stories. Just be aware and be careful, especially as a diabetic. (Just don’t let a couple of bad stories keep you from your travels! I visited Southeast Asia quite successfully – I just made sure it was in the low-mosquito season!)

Diabetic Travel Tip #13 – If it bleeds – antibiotic!

Especially in the tropics, I am not hesitant about treating even the smallest of wounds. I’ve learned through the years that diabetics heal more slowly from wounds, and that the higher sugar levels in the blood just feed infection. I carry topical antibiotics, a large kit of bandaids and don’t hesitate. If I have a large wound, which has happened – I tore a huge, deep several-inch long gash in my toe/foot in Thailand – I use topical antibiotics, steri-strips and take oral antibiotics too – Cipro or Azithromycin.

Diabetic Travel Tip #14 – Strongly consider travel insurance

I don’t always buy travel insurance. My health insurance covers me abroad, but what if the local hospital abroad is not up to my standards for diabetic knowledge and care? Then I buy travel insurance.

I figure that the most important reason for travel insurance is medical evacuation. Medical evacuation insurance was required in Antarctica, recommended in Tanzania, and I, by that time, knew to spring for it for Myanmar, Vietnam, Laos, Morocco, Albania, Montenegro, Romania, Peru, Ecuador.

I didn’t buy travel insurance for Iceland, Australia, Japan, Portugal, Scotland, England, Norway – all places I could have reasonable confidence of having high health-care standards. Additionally, with an insulin pump, if I am conscious, I will be able to manage my glucose levels myself. If I am not conscious, then I depend on high-healthcare standards, and doctors who know what an insulin pump is!

Another consideration, and reason that this section might read “Buy Travel Insurance” instead of “Consider” depends on your location and home healthcare plan. I am aware that people outside the US, I specifically know the British, don’t benefit from health-care outside their own system. For diabetics among them, travel medical insurance is an absolute necessity. As well, people in the US may be members of plans which don’t cover them outside the US. Diabetics among them also need medical insurance while traveling. Luckily for us, our plan does cover us outside the US, so my key consideration is if the healthcare system in my destination country or countries is something I would be comfortable participating in.

Diabetic Travel Tip #15 – Don’t forget to pack your long acting insulin

Pumps can fail. Mine never has, but they can. I always bring enough long-term insulin (Lantus) to cover the entire trip. Unfortunately, if I’m not able to keep it refrigerated the whole trip, then it will lose its potency after 30 days, so it’s basically throw-away insulin if all goes well and I don’t need it. However, in some of the places we travel, that is the least of my concerns. I’m just happy to have the live-saving backup supply instantly available.

Diabetic Travel Tip #16 – Coping with Hard Beds

Did you know that as you age, one diabetic complication can be nerve constriction? I’m speaking of carpal tunnel syndrome, and other similar shoulder and wrist injuries. The “gates” through which your nerves slide became “sticky”; your nerves don’t slide as easily and become irritated and inflamed. I’ve had quite a few instances of wrist pain and tendinitis. The orthopedic doctor says, “Well, you are a diabetic…” For goodness sakes, nobody warned me about this! I’ve also had two instances of Frozen Shoulder. Again, the doctor says, “Well, you are a diabetic…” Arrrggg!

The bottom line for me is that I need a soft bed to both ease the shoulder and wrist pain (don’t I sound like an “old person”?) and to keep the nerves from become inflamed and worsen the situation. While in the US most adequate hotels advertise nice soft beds, that is not the case throughout the rest of the world and certainly not in Europe.

How to I solve this problem? I bring my bed with me! This bed to which I refer is a twin-sized “egg-crate” foam mattress, such as the ones typically bought at Walmart or Target. We lay the egg-crate mattress horizontally across the hotel bed, giving both of us the extra cushioning I need for my shoulders, and also supporting our hips so that our backs don’t get twisted. We then cover it with a twin sheet I also bring along. It would be nice to bring along a queen-sized foam, however that just won’t fit as a carry-on, and that’s how I generally bring my egg-crate.

A long time ago I purchased a very light-weight, rather flimsy duffle from Walmart. I roll up the egg-crate, fold in a twin flat sheet, and I’m ready to go. I’ve made the decisions on several trips not to bring my “bed” due to baggage restrictions and barely lived to regret it. Now, the bed is an absolute requirement. We simply find a way to bring it.

Diabetic Travel Tip #17 – Remember to pack the Sugar-Free Cough Syrup

I’ve gotten a cold on a vacation more times than I can remember. So many trip-related activities can trigger colds: over-exertion and stress as you pack and try to get out of the door on time, germs in airports and on planes, getting rained on and blasted with cold winds while out and about, pushing yourself beyond your usual limits to see it all!

Even in top medical countries I’ve scrambled to find diabetic cough syrup. Many countries just aren’t up to snuff on supplies for the diabetic. It’s fine to have a dose or two of sugared cough syrup and then watch your levels, but to be on it for days on end, while trying to balance all of the other diabetic stresses of strange food and differing levels of exercise?

I pack a full bottle of sugar free cough syrup in a baggie in the luggage which goes into my checked luggage. You can’t pack this one in your carry-on!

Diabetic Travel Tip #18 – Remember to bring a letter from your doctor / endocrinologist

Years ago, long after I’d been traveling internationally, my endocrinologist, asked, “You need a letter from me?” I’d never considered it before but thought it was a good idea. It is packed in my diabetic kit. I don’t refresh it every year. I’m not sure I need to since people don’t stop being Type I Diabetics. It says that I’m a Type 1 diabetic and that I carry xxx, yyy and lists all the supplies and medications I carry that she prescribes.

Once I have had to use that letter, and I was certainly glad for it! I was trying to exit Myanmar in 2017 with my carry-on full of 2 months supply of well, everything. The official started to really root about in my carry-on and got disturbed at all the medications. He clearly spoke no English and there were no other officials around who spoke English. I reached into my bag, grabbed my letter, and waved it in his face, “Diabetic!” (Like that meant anything to him!) “Doctor!” He peered at the note, obviously couldn’t read it, and waved me through.

I’m sure I would have eventually made it through, but am also sure that I would have experienced a much greater delay.

Diabetic Travel Tip #19 – Carry glucose during Watersports

My cousin recently gave me this fantastic idea for keeping safe while snorkeling. I love to snorkel but it is stressful since I worry about low blood sugars. After all, I’m exercising a bit.

I have to leave my pump behind in a ziploc bag in the boat, usually in my totebag. But then I’ll be in the water perhaps 45 minutes as a snorkel guide brings us from coral reef to coral reef. I wear a life jacket, and keep with my husband, but what happens if my sugar gets low?

I have a very old fashioned “fanny pack” from when fanny packs were not the fashion faux-pas they are today! It is made of nylon and dries easily. It straps around my waist and has a zipper section quite large enough to handle a full bottle of Hawaiian Punch or a couple of Capri-Sun juice packs.

It is fantastically easy to unzip the fanny pack and slurp while in the water. It’s all waterproof. I know it won’t come off me, and I know I’ll have all I need for that time frame.

What a wonderful cousin I have!

Diabetic Travel Tip #20 – Protect your CGM from monkeys!

You’ve got to be kidding! With our latest trip to Spain and Gibraltar I thought I would have no new tips to impart. However, I recently almost lost my CGM (continuous glucose monitor) to a macaque monkey on the Rock of Gibraltar.

I had followed all the instructions about securing my water bottle inside my purse, and in addition had covered my pump and infusion set completely and securely. However, I was not wearing one of my LL Bean’s Tropicwear shirts with the real short-sleeves – I was wearing a beautiful flowing tropical blouse with cap-sleeves. My CGM, unbeknownst to me, was peaking out. We walked by some monkeys who seemed more interesting in their self-grooming than in us, and suddenly a large monkey jumped on my shoulder, hung on with his hand in my hair, his other hand trying to scrape the CGM from my arm.

It would have been a wonderful and fascinating trophy for him, but luckily for me the tape was quite secure. I screamed and thrashed about and he let go of both my hair and my arms. Luckily he did not draw blood and all ended well.

Bottom line – when they say there may be monkeys about you need to protect your water bottle, your pump, your infusion set AND your CGM.

Diabetic Travel Tip #21 – Go to the hospital IMMEDIATELY if you get bitten or scratched by a Macaque Monkey!

Oh my! I told the story above to the travel clinic doctor just the other day, and he told me I was very lucky. He told me that macaque monkeys can carry a virus that is deadly to humans, the Herpes B virus. He told me that if a monkey bites me, I was to go immediately (not the next day!) to the hospital for antivirals or I might be toast, if the monkey carried the virus. Here’s the link to the CDC webpage.

So, my update to my bottom line – when they say there may be macaque monkeys about – is you need to protect YOURSELF!

The best news – it’s not difficult when it becomes second nature

The first few trips were stressful, especially those to water-challenged countries. However, having experienced and conquered some digestive issues when traveling, I feel so much more confident about future travel. I don’t have to be afraid to be sick, I just need to know how to handle it quickly and efficiently, and know that I myself can handle this!

The rest of it – the basal rates, the correcting for food and activity, the packing, the mosquito-prevention – it has all become second nature.

Being a type 1 diabetic and traveling – what a feeling of freedom!

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