Travelling with diabetes

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Travelling with diabetes

Holidays, business trips, road trips — without the trip going wrong.

Diabetes shouldn't stop you from travelling. People with diabetes climb mountains, run safaris, take cruises, and fly across the world. What it does mean is a bit more planning than other travellers. Insulin doesn't pack itself. Time zones don't adjust your dose. Pharmacies in foreign towns don't always stock what you need.

This article walks through the practical side of travelling well with diabetes — what to do before you leave, what to take, how to handle airports and flights, time zones, eating on the road, and what to do if something goes wrong far from home. By the end you'll have a packing list, a planning checklist, and the confidence that travel is something you do as a person with diabetes, not despite it.

Before you read on

This article applies to anyone going further than half a day from home. Day trips and weekend stays usually don't need this much preparation, but if you're going for a week or more, are flying, are travelling in remote areas, or are crossing time zones — read carefully.

Plan months ahead, not weeks

The biggest mistake people make is planning travel and diabetes care separately. Three things should be decided early:

• Talk to your clinic at least 6–8 weeks before you leave. Especially for long trips or anywhere with limited healthcare. They'll review your routine, write up your supplies, and tell you about vaccines.

• Sort travel insurance before you book accommodation. Most policies cover diabetes — but you must declare it. Undeclared pre-existing conditions are the most common reason claims are rejected.

• Order extra supplies with enough lead time. You want twice as much insulin, twice as many strips, and double the medication you think you'll need. Pharmacies sometimes don't have stock.

Vaccines and pre-trip health

Diabetics are at higher risk from many infectious diseases. Common travel vaccines worth discussing with the clinic:

• Flu (annual — get it before you leave)

• Pneumococcal (especially if over 50)

• Hepatitis A and B (most international travel)

• Yellow fever (some African and South American countries require proof)

• Typhoid (parts of Africa, Asia)

• Tetanus booster if more than 10 years

• Malaria prophylaxis (any malaria zone — including parts of South Africa)

• COVID-19 boosters per current guidelines

Some vaccines need to be done weeks before travel to work properly. Ask early.

The complete travel pack

The general rule for travel with diabetes is: pack twice as much as you think you need, and never put it all in checked luggage.

Medication and supplies

• All your insulin — twice the trip duration's worth

• All your tablets — same rule, double up

• Spare prescriptions on paper (some pharmacies abroad need them)

• Glucose meter PLUS a backup meter if going somewhere remote

• Twice the test strips you'd normally use

• Lancets and a spare lancet device

• Insulin pens or syringes (if you use one type, take some of the other as backup)

• Ketone strips (especially Type 1)

• Glucagon kit if prescribed (Type 1)

• Alcohol wipes

• Sharps container or small hard plastic container for used needles

Sugar and snacks

• Glucose tablets — at least 10

• Sweets like Smarties or jelly babies as backup fast sugar

• Snacks with protein and slow carbs — biltong, nuts, dried fruit, peanut butter sandwiches

• Some sachets of oral rehydration salts (Rehydrat, Energade)

• A water bottle you keep filled

Documents

• Letter from your doctor confirming you have diabetes and listing your medications (with both brand and generic names)

• Letter explaining you need to carry needles and syringes (essential for airport security)

• Travel insurance details — policy number and emergency phone number

• Copy of your prescriptions

• Your clinic's phone number and the contact details of a diabetes specialist if you have one

• An ID card or medical bracelet that says you have diabetes

• List of emergency contacts back home

Keep diabetes supplies with you, not in the hold

Insulin should never go in checked luggage. Cargo holds can get cold enough to freeze it (which destroys it), or hot enough on the tarmac in summer to damage it. Always carry in cabin baggage.

Same for your meter, strips, and at least one day's worth of everything else. If checked luggage is lost or delayed, you must be able to manage.

Airports and flying

Airport security is the most stressful part of travel for many diabetics. The good news: airports deal with diabetic travellers every single day. Knowing the rules makes it routine.

Security screening

• All your diabetes supplies are allowed through security including liquids over 100 ml (insulin, glucose gel)

• You don't have to put insulin through the X-ray scanner — ask for a hand inspection. The X-ray probably wouldn't damage it but airline guidance is to avoid

• Insulin pumps and CGM sensors should NOT go through full-body scanners — ask for a pat-down instead. The scanner can damage them

• Pat-downs are normal for diabetic travellers. They are not personal

• Carry your doctor's letter. Some security officers want to see it. Most don't

• Allow extra time at security — 30 minutes more than usual

On the plane

• Tell the cabin crew you have diabetes during boarding — they will know what to do if you have a hypo and can help with meal timing

• Order a special meal if available — diabetic meals are usually a bit better paced than the standard option

• Stay hydrated — flying dehydrates you, which can spike blood sugar

• Walk around the plane every hour or two — sitting still raises blood sugar and risks blood clots

• Test more often than usual — flying changes your blood sugar in unpredictable ways

• Have fast sugar and a snack within reach on the seat in front of you, not in the overhead bin

Time zones — the insulin adjustment

Short trips across one or two time zones usually don't need major adjustments. Longer trips do. The general rules:

Travelling east (Asia, Australia)

The day is shorter. You may need less long-acting insulin on the travel day. Take your usual dose, and the next dose at your normal local time when you arrive.

Travelling west (Europe, Americas)

The day is longer. You may need a small extra dose to cover the extra hours. Your clinic will help you work out the specific adjustment.

The simple approach

If the time difference is more than 4 hours, ask your clinic for a written insulin adjustment plan. Don't guess. Stick to your home time zone for the first day, then shift on day two. Test blood sugar more often through the transition. Most importantly: don't double up or skip doses if you're confused — phone the clinic, even from abroad.

Insulin storage on the move

Insulin needs to stay between 2°C and 30°C. Some types are more sensitive than others. The practical rules:

• Unopened insulin: in the fridge (2–8°C) until you start using it

• Insulin in use (pen or vial): room temperature, away from direct sun, for up to 28 days for most types

• Travelling: a cool bag (the Frio cooling wallet is brilliant — uses just water, no power)

• Hot car: never leave insulin in a parked car in summer; pack it in the cool bag and take it with you

• Camping or remote travel: a small portable cooler box; or use Frio packs if you have electricity for refilling water

Eating on the road

Travel food is famously unpredictable. Three principles help:

• Carry your own backup snacks. When the train is delayed and there's no food, your bag has biltong, dried fruit, nuts, and a peanut butter sandwich.

• Choose familiar over fancy. A meal you've eaten before in a familiar form is much easier to dose insulin for than a new dish in an unknown portion.

• When in doubt, test more. Unfamiliar food = unpredictable blood sugar. Test before and 2 hours after meals more than you would at home.

If you're going to remote parts of Africa

Travelling outside major cities — into the Kruger, the Wild Coast, deeper into Africa — brings a few extra considerations:

• Power for fridges is unreliable in many places. Use a Frio cool wallet or a small portable cooler

• Mobile coverage may be limited — download maps and emergency contacts before you go

• Pharmacies stock less. Don't expect to refill insulin or strips in rural areas. Take more than you need

• Drinking water — sterilise or use bottled. Diarrhoea on insulin gets dangerous fast

• Tell the lodge or guide that you have diabetes. They are usually well-trained on emergencies

• Carry the contact details of the nearest hospital with diabetes care — not always the closest one

When something goes wrong

Despite everything, sometimes things go wrong. Common emergencies and what to do:

Problem What to do Lost or damaged insulin Any pharmacy can sell insulin — sometimes it requires a local prescription. Show your travel letter; private hospitals usually have a doctor on call who can prescribe. Lost meter Buy a new one. They are sold at most pharmacies; you can guess strips by brand recognition. Calibrate when you can. Hypo in a foreign place Eat fast sugar immediately as per the 15-15 rule. Find a quiet place to sit. Call your insurance hotline if you can't recover quickly. Stomach bug abroad Follow sick day rules from article 11. Hydrate aggressively. See a local doctor for anti-nausea medication if severe. Don't skip insulin. Hospital admission abroad Phone your travel insurance immediately. They can help find a hospital with appropriate facilities and handle billing. Running out of supplies Most countries have insulin available privately. Check IDF (International Diabetes Federation) for country-specific guidance before you leave.

The bigger picture

Travel with diabetes takes more planning. It also rewards that planning. People with diabetes who travel well bring back the same things every traveller brings back — perspective, fresh air, memories of unfamiliar places — plus the proof that their condition is something they manage, not something that manages them.

The next article in the series shifts away from medical content into stories — real people, real lives, real diabetes journeys in South Africa. Because reading about diabetes is one thing. Hearing how someone like you is actually living with it is another.

Where to get more help

Diabetes South Africa — diabetessa.org.za · 011 792 9888

International Diabetes Federation — idf.org — country-specific travel guidance

Your travel insurance hotline — programme the number into your phone before you go

Phila Today Diabetes Series — next: real stories from South African diabetics

Phila Today · Article 16 of 17 in the Diabetes Series