Are you planning a family vacation? Or possibly a relocation? If you have a child with diabetes, travel may pose a unique challenge for the entire family. There are five very important things to consider, and plan for.

1. Planning where you will go
2. Documentations for airlines, if necessary
3. Medications and supplies
4. Meal planning
5. Travel and exercise

1. Planning where to take your vacation may not seem like an issue that would concern the diabetic, but it can be very important. The local cuisine may not be appropriate for the diet of your child. Or, it may be necessary to prepare in advance for food items that may not be readily available. Exotic destinations may offer foods that are high in carbohydrates or fat. These foods may cause serious changes in your child’s blood sugar. Some places may not have medical facilities nearby, in case of an emergency. Check with your travel agent, or your local library as you plan your vacation. When you arrive at your destination, it’s a good idea to find the nearest medical facility just in case you need it. Knowing where to go if there is an emergency could save you a great deal of stress and time. If travel out of the country is planned, and immunization shots are necessary, you should plan them for 3 to 4 weeks before you leave. Some of the shots may affect your child’s blood sugars. It is important to test his blood sugar with this in mind.

2. Documents concerning the needs of your child may be necessary. You should visit your child’s doctor before your trip. Discuss the upcoming travel, and ask for suggestions. You may want to prepare a list of questions or concerns before the appointment.
Questions such as:
· Should I increase or decrease my child’s insulin during travel?
· Will flying affect his blood sugar?
· How often should I test his blood sugar?
· What if he gets sick while we are away? May I carry your phone numbers in case?
· Should I prepare snacks for the flight? What kinds?
Some doctors never discuss such subjects as travel with their patients, but if you ask, chances are they will have information to share with you. You should ask for a letter from the doctor explaining the need for certain medications and supplies. Because of increased airport security, airlines may have an issue with insulin syringes, and some other necessary supplies. You may want to contact your airline to find out what documents they require, if any. A letter from your child’s doctor should help to clarify the needs for these items. By the way, it should be written on the doctor’s letterhead. If your child uses an insulin pump, the doctor should mention it in the letter as well. I use a pump, and it has never set off a screening machine, but I have been asked to show and explain it to a few screeners. If your child hasn’t had the pump for very long, it is important for you to acquire as much knowledge as possible about it before you travel. Keep in mind that if you are vacationing in a different time zone, the Basal Rates on the pump will need to be adjusted. Remember to reset these rates when you get home. Your child should also wear some sort of medical identification, such as a bracelet, or neck chain with a medallion, explaining his condition.

3. It is recommended that you take enough medications and supplies for the planned length of your vacation, and an extra week’s worth just in case there is a delay in your return home. Carrying extra prescriptions isn’t a bad idea, either.

The pump requires supplies that you must take along. Remember to pack the following:
Pump syringes
Infusion sets
Skin Preps, if needed
Transparent Dressing, if needed
The leading insulin pump makers have a toll-free hotline you can call if there is a serious malfunction. This number is on the back of the pump. They will ship a replacement to you within 24 hours. It’s a very good idea to take regular syringes in case of such an emergency. Remember to take enough insulin to last for the entire vacation, plus enough for at least one more pump change. Insulin will need to be stored so that it isn’t exposed to extreme temperatures. There are insulated insulin vial cases available that work quite well. Be sure you pack all supplies and medications in your carry-on luggage. Cargo holds are usually not temperature controlled or pressurized, and if your luggage is lost or delayed, you won’t need to worry about losing medications. Having a traveling companion carry some of the supplies is also a good idea.

4. Planning meals is also important since any change in routine may cause your child’s blood sugars to go too high or too low. If you are flying you may want to order special diabetic meals for him. These special meals may not be appropriate for the diabetic, so you may want to contact the airline to find out what will be served. If the selection is unacceptable, you should consider packing foods your child can eat. If possible, try to keep his meal schedule as routine as possible, taking into account any time zone changes. Be prepared to test often, and explain the reasons to your child, if he or she is old enough to understand. You will need to keep in mind the amount of activity your child will participate in. For instance, if a trip to a theme park is in the plans, his needs will change. Remember, the more activity your child participates in, the more food and/or less insulin he will need. This is another reason to check his blood sugar often. And have glucose tablets or bits of hard candy for lows. If you have traveled with your child since his diagnosis you should keep in mind that as he grows, he changes. Energy levels, appetite, and weight changes will alter some of his needs. What you needed to consider a year or two ago may not apply any longer, and may be replaced by other concerns.

5. Sitting still for extended periods of time, whether in an airplane or a car, will have an impact on blood sugars. The inactivity will cause insulin requirements to decrease. You will need to monitor his blood sugar closely during travel. Extensive travel may cause extended periods of inactivity. In order to maintain your child’s blood flow, assist him with tensing, stretching and relaxing exercises, as well as some massage, such as kneading the leg and arm muscles. Older children may be allowed to walk down the aisle of the plane.

The single most important thing to keep in mind-

Test as often as you can. Your child may not be able to tell you if he experiences highs or lows, so it is up to you to monitor blood sugars closely. Carry bits of hard candy, or glucose tablets just in case. And enjoy your vacation!