5 tips for eating out abroad when you have diabetes

Having just returned from a trip away, I know how important it can be to plan ahead when eating. Here are some great tips from our guest blogger Patrice Lewis.

Planning a holiday when you have medical conditions can be tricky. There’s packing the right medications, concerns like eating out and finding an insurance package which will actually cover your condition. For those with diabetes, there’s no need for it to be a barrier to enjoying your overseas holiday. Here are five tips for helping you enjoy the cuisines of other countries:

1. Research the restaurants at your destination location

do your research

Just like eating out at home there’s no real way to know the exact ingredients of every dish placed before you when you’re on holiday. However, it’s possible to use the internet to have a browse of the local eateries before you travel. This allows you to get a sense of what food will be on offer, before you commit to your holiday plans. If the destination only has high carb, and high sugar offerings, it might not be the best place to eat out every night. There will nearly always be somewhere, though, where you can find food to complement your diet.

2. Use forums, blogs, and ask questions

Websites and blogs like the one you’re currently reading and others have a wealth of information for those with diabetes. Search for diabetes forums and you’ll probably find that plenty of people have already asked the questions you need the answers to. If not, there’s normally a friendly community you can join to ask about eating out at your preferred destination. Use the experience of others, and when you return from holiday, you’ll be able to share your own experiences and advice.

3. Consider how much exercise you’ve had that day

exercise

You might have a pretty strict diet at home, and be completely on top of managing your blood sugar levels. It’s worth remembering, though, that when you’re on holiday you might exercise a lot more than on a standard day at home. Swimming, hiking, walking on the beach and even souvenir shopping can all cause your blood sugar to drop to lower levels than you might be used to. Glucose tablets can be a real help with this, as detailed in this blog entry about eating out when on cruise ships. Consider your level of activity when thinking about how often you need to be sitting down to eat, and what sort of food you should be eating.

4. Plan your day out to include plenty of food stops

If you are out and about all day, have a think about how often you’ll need to stop and refuel to keep your blood sugar levels where they need to be. If you’re planning a whole day out in the back of beyond, you might struggle unless you carry loads of provisions. Check what restaurants and cafes there are along your route, and take advantage of them accordingly.

5. Mention your condition to restaurant staff

Don’t be afraid to tell the staff that you have diabetes. What looks like something very savoury might actually be full of hidden sugars that you will want to properly cover with insulin. Discussing this with staff could stop you from getting a very nasty surprise indeed!

To learn more about making your vacation memorable, see more tips on our travel page.

10 Tips for Cruising with Type 1 Diabetes

cruising with diabetes

by Rebekah Svensson

I am getting ready to head off for my first ever cruise so I was super excited when Rebekah Svensson of Awkwardyethealthy.com agreed to share tips on cruising with type 1 diabetes!

I have Type 1 Diabetes (and I have for the past 18 years) and I have been on exactly ONE cruise. A Disney cruise to be exact. Therefore, I declare myself an expert! Well, not really, but I do have some useful tips for my fellow Type 1’s who are looking to go on a cruise!

Type 1 Diabetes is no joke, and as we all know, things can go from just fine to really bad in the blink of an eye. And being on a ship in the middle of nowhere is probably not the best place for that to happen. Whether it’s you, your spouse, your child, or another member of your traveling party Diabetes can be a huge storm cloud. So how do we keep that nasty rain away?

1. Pack double the supplies. And then pack some more.

luggage to pack

This is one area I do not skimp on in any circumstances. Personally, I am a pump user, so I pack enough ‘hardware’ to get me through twice the length of my trip. And then I usually pack a few more just in case. If you’re a pumper you know that sometimes infusion sites don’t work right, or reservoirs get all wonky. I choose not to stress about it by bringing plenty. This includes batteries too. Oddly, on our family cruise I didn’t have an extra battery and Guest Service’s came to my rescues, but I did NOT enjoy being in that situation. Also, it’s a good reminder that there’s no REAL stores on board.

2. Bring extra insulin

Bring an extra vial if you can. I broke a vial of Lantus once while overseas. Thankfully I had another even though I technically wouldn’t have needed it based on the length of the trip. It can be a huge hassle, but you’ll feel a million times better knowing it’s there if you need it. Because on a ship in the middle of the ocean it’s going to be hard to come by.

3. Carry Glucose Tablets

One thing everyone told me about before our cruise was there is SO. MUCH. FOOD. But the thing is, the food is not ALWAYS available. Or room service might not be quick enough. There’s also the issue of the dining schedule not necessarily being YOUR schedule, which can mean unpredictable sugars. My solution? Always, always, always, carry glucose tablets. Carrying a small purse or backpack is a small price to pay. Throw some glucagon in there too for good measure.

4. Ask to see the menu in advance

food

At least in my experience (I also have Celiac Disease), the waitstaff has access to the next day’s menu at dinner time. Ask to see it! Also, don’t hesitate to ask for substitutions! We all know how hard it can be when you don’t prepare the food yourself, it makes carb counting nearly impossible. The best way to combat that? Knowledge.

Ask for all the information you can possibly have. Tell your waitstaff you have dietary restrictions (Yes, you do. No disagreements here. You need to know what’s in your food. You are NOT bothering anyone!). You can also request that there be something brought to you immediately or waiting at your table, like a glass of juice, just in case. If highs are more your problem, ask them to skip the bread course or give you half portions of certain things. Whatever you do, don’t just eat blindly. I think we all know how bad that can turn out.

5. Plan your day

I know, I know, it’s VACATION! Why should you have to plan!? But hear me out. Think about your meals. If you know that night’s dinner is carb heavy PLAN FOR IT. If you know you want the sugary margarita or you Type 1 kiddo wants ice cream, build it into your day.

Some of us diabetics are a lot stricter than others, so for the stricter folks this won’t seem so bad. For the rest of us who tend to wing it, this can suck. But you know what sucks more? A reading of 400mg/dl (22.2mmol) and getting sick hundreds of miles away from proper medical care. It just isn’t worth it.

If you know you have a physically demanding excursion plan your margarita that day. Lounging on the pool deck all day? Might not be the best time for that 100g carb dessert. It doesn’t have to be down to the minute, but just try and match your carb intake to your activities at the very least.

This is true for ANY vacation, but even more important on a cruise. Simply because you will have access to ALL. THE. TREATS but you might not have a chance to get off the ship for pleasure or medical care.

6. Take a note from your doctor

You will most likely be going in and out of different countries, on and off the ship through security, and traveling on a plane at some point. So have a note from a physician handy. Most security folks nowadays are familiar with Diabetes and the plethora of stuff that comes with it, but just in case it’s good to have a note explaining that you NEED it.

Traveling with needles, vials of medicine, and weird looking medical supplies can make some people uneasy, so this is a just-in-case that will pay off in the rare chance someone tries to take away your supplies. And ALL your supplies should be carry-on by the way. Always. Whether it’s on the plane or getting on the ship, keep them in your personal bag that stays with you.

7. Medical Alert ID: WEAR IT!

I am so guilty of this. I never wear mine, I loathe the thing. But a cruise is a very important place for a Type 1 Diabetic to be properly identified. If anything happens to you and you are not with an adult member of you party this will be what is used to treat you. If you are incoherent this is what will tell the ship’s doctor that you are not just drunk but might be in DKA. Accept the hideous tan line and wear it. While there are doctors on board, this will not be a full-blown hospital. So, if the worst is to happen it’s better to have the information on you and ready to go.

8. Set timers for blood sugar checks

set alarms

It may seem like overkill but set a timer for every 4ish hours during the day to check your sugar. I wear a Continuous Glucose Monitor, but I still checked more often while cruising because the swings could be so dramatic.

With today’s glucometers they are super-fast and super small, so throw it in with your glucose tablets and just take the time to check every so often. I found that we would be away from our room for very long spans of time, so it was easier to carry it with me in my ‘go bag’ rather than return to the room just for a BG check.

9. Talk about it

I know it annoys the crap out of my family and friends when I mention that I have Type 1 in conversations with strangers or servers. But guess what? The more people that know the more people that can help you. Unfortunately, this disease is not as rare as it should be and sometimes you run into a fellow Type 1 (or family member) and they have some good information for you. Or it’s a chance to educate someone. Or it helps remind YOU of what you need to be doing. If you talk about it, you can’t ignore it!

10. Loosen the reigns a bit and have fun!

If it’s you that it Type 1, you are probably fine with this. If it is your spouse or your child, you are likely not ok with this. But, for the sake of your sanity, broaden your range of acceptable sugars a bit. Not to the point of getting sick but expect some lows and just know that there will be more highs than you’d like.

Even with planning your days a bit, taking all the precautions, and counting the carbs to the best of your ability there will still be unexplainable swings. If you are prepared, they will be nothing more than a minor speedbump. But if you go on your cruise expecting perfection, you will be miserable. Type 1 Diabetes is not a disease to be taken lightly, but it should also not rule your life. Make sure you have fun and ENJOY IT!

have fun

Those are some of my thoughts! Of course, there’s always the drink water, eat your fruits and veggies, and get plenty of exercise that all Diabetics are hammered with every day. It still applies on a cruise y’all. Just do it. I know life isn’t fair, but we can handle it, we’re tough.

My personal experience on a cruise was that I had more frequent highs and occasional lows that weren’t very predictable. There was a ton to indulge in, and I did. Maybe too much. But the waitstaff was wonderful at being helpful and informative, the crew was very understanding and always willing to go above and beyond to help in any way, and while I did not have any experience with the medical staff on board, knowing they were there provided peace of mind. Cruising with Type 1 Diabetes is definitely worth it. With a little foresight and flexibility, it can be a truly great vacation!

If you’d like to learn more about me feel free to visit my blog Awkwardyethealthy.com!

Happy Cruising!

To make your next vacation with diabetes a little easier, why not download our complete toolkit for traveling with diabetes. It has packing checklists as well as a list of things to do before you go.

How to manage airport security with an insulin pump and CGM

insulin pumps

In May of 2012, after reading about a friend having problems getting their insulin pump through security at a US airport, I did some research on the subject

Should you put your pump through the x-ray machine? Can you wear your CGM through a full-body scanner? There were a lot of questions in 2012 and there still are in 2018 so I reached out to a few friends in the industry to see if things have changed at all.  Here is what you need to know when you are traveling with an insulin pump or CGM

Get our free travel checklist before your next vacation.

Air travel with a Dexcom®

The Dexcom® G5 is cleared to take through metal detectors, be hand-wanded and be worn during flights. There are a few situations to be concerned about, however.

NEVER put your receiver or extra sensors through an x-ray machine.  Ask the security personnel to do a hand-check of the items to avoid permanent damage of these devices.

According to Dexcom®, the effects of full body scanners on CGM components have not been studied. It is therefore recommended that you do not take your Dexcom® through one.

Once you are through security and on your plane waiting for takeoff, make sure to set your app to airplane mode, keeping the bluetooth on and leave your receiver turned on.

Flying with a FreeStyle Libre

The Dream Big Travel Far blog contacted the people at FreeStyle and asked what the guidelines were for air travel with the Libre.  This is what they reported.

“We recommend the user notify security personnel when going through airport security screening. the user can go through X-ray machines while wearing a sensor. We recommend the reader be powered off during a flight and not used for scanning a sensor. However, the strip port on the reader can be used to take blood glucose or ketone readings during flight. Turning on the reader with the Home Button will activate the radio. The user must turn on the reader by inserting a test strip so as to not activate the radio.”

Air travel wearing an Omnipod

Good news for Omnipod users! You can wear the pod through the metal detector, x-ray machines and full body scanners with no worry.  The PDM can also go through the X-ray. Insulet does recommend that if you are selected for a “pat down” you disclose that you are wearing the pod.

Flying with a Medtronic® insulin pump

Medtronic® insulin pumps can be worn through metal detectors and be wanded.  They should NOT be sent through x-ray machines however.

Medtronic® also notes that your sensor and transmitter must be removed if you are going through a full-body scanner. If you do not want to remove your sensor, you can ask to be pat down instead.

Flying with a Tandem® t:slim X2™ insulin pump

Tandem® t:slim X2™ can be worn through metal detectors and can be wanded.  They should not be sent through x-ray machines.

Changes in air pressure cause bubbles to form in insulin, and the related expansion can cause unintentional insulin delivery.  This is NOT a problem in the Tandem pump.

The pumping mechanism used in Tandem pumps isolates the insulin reservoir (bag) from the user line, so if bubbles are formed in the cartridge due to pressure changes, the internal bag will expand, but no insulin will be delivered to the user from the reservoir.  The only volume in line with the user at any given time is the insulin in their infusion set and cartridge tubing, and the contents of the 0.3 unit Micro-Delivery chamber.

There is no need to turn off your t:slim X2™ during takeoff or landing.  This system runs on Bluetooth which can operate during flights. If you are also using a Dexcom CGM that you are viewing with your smartphone, turn the phone on airplane mode and then turn on Bluetooth.

Flying if you wear an Animas® insulin pump

A detailed list of where you can and cannot wear your Animas® pump can be found in my May 2012 post.

Animas® insulin pumps can be worn through metal detectors and can be wanded.  They should NOT be sent through x-ray machines.

Animas® pumps should not be worn through full-body scanners.

Click here for more tips on traveling with diabetes!