First time you've traveled by air since you were diagnosed with diabetes? Here are the basics every insulin-dependent diabetic needs to know before air travel.

Insulin-dependent diabetics should carry their insulin in a thermos in hand baggage on the plane. Diabetic travelers departing the United States and most other problems seldom have a problem with security inspections and are allowed to bring both insulin and syringes on board, but some airports in Europe have confiscated syringes from travelers not carrying a doctor's prescription. In a pinch, you can probably explain that the labels your pharmacy put on the boxes your insulin came in are the same as a prescription. Diabetic travelers should also carry their glucometers so they will know for sure whether blood sugars are high, low, or normal, and every diabetic should carry glucose tablets or snacks at all times.

Generally speaking, it's better to have blood sugars a little high than a little low when on board the plane. If you take "slow" insulin once a day, adjust the time of day you take your shot at your destination to match the time you take it at home. For instance, if you take slow insulin at 6 p.m. at home and you fly six time zones west, take your slow insulin six hours earlier (noon) while you're on your trip. If you fly east, take your insulin later (although it's usually OK to be late or early an hour on two). For instance, if you fly from Chicago to Moscow (nine hours east) and you usually take your slow insulin a 6 p.m., the ideal time to inject would be 3 in the morning. In those cases, early morning will probably be OK.

All diabetics need to carry diabetic identification at all times, whether a bracelet, necklace, or wallet card. Bracelets and necklaces are more likely to checked by emergency personnel. A wallet card is likely to be checked only if there has been an extreme emergency.

And if you live in a temperate or tropical climate and you are traveling to a more polar climate, get ready for unusual fluctuations in your insulin needs. Many adult diabetics with LADA or type II diabetes have some insulin production in their own bodies. Longer nights, for reasons scientists are just beginning to understand, sometimes increase that insulin production. If you live in Miami and you fly off to Norway, you may find that your sugars are lower than you would expect. Be sure to test your blood sugars even on the busiest travel days. You may enjoy your trip a whole lot more if you do.


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