GENERIC ADVICE TO TRAVELLERS
Travellers should advise their airline that they have diabetes in case of unexpected
hypoglycaemia, and should carry a letter from a doctor confirming the need for insulin
and needles on the ‘plane.
A request for specific diabetic in-flight meal is unnecessary, as these are usually
insufficient in carbohydrate and might increase the likelihood of hypoglycaemia.
A vegetarian meal that contains complex carbohydrates such as rice or pasta might
be a better option.
Travellers should be advised to store their insulin in hand luggage and to carry
extra carbohydrate and insulin in case of unexpected delays. They are also advised
to check glucose concentration regularly, ideally every 4-6 hours. Glycaemic control
can be relaxed during air travel to avoid hypoglycaemia due to increased activity
such as carrying luggage to check in etc. Gastroenteritis is common during foreign
travel and management of this is essentially replacement of fluids with frequent
checks of urine for ketones and blood glucose and attempting to consume soups, snacks
etc. If food cannot be eaten, sugary drinks should be consumed. Insulin and oral
medications for diabetes should not be stopped under any circumstances, although
doses may need to be decreased. Those who are unable to eat or drink, and who are
becoming ketotic should be managed in hospital.
