It’s vacation time! In addition to packing your bags with all the usual must-haves for family travel, when you have a child with type 1 diabetes, there’s an added layer of packing and planning that needs to happen. But whatever your destination, taking type 1 diabetes along for the ride, flight, or voyage is totally doable. Here are some tips for terrific family trips with T1D.
A Different Kind of Travel Itinerary
Visiting the big city? Staying by the seashore? Headed to a theme park? As you start travel planning, begin by mapping out the basic logistics of your child’s type 1 care. “Before we travel, I make a list of what we will be doing every day and then picture caring for my child’s diabetes in those settings. It helps me make decisions. If one day of our trip will be spent at a water park, then I know we’ll switch to insulin pens so the pump doesn’t get wet. If the next day we’re doing a walking tour of a city, then I make a note to pack lots of extra low blood sugar supplies. For us, it’s like type 1 gets its own little travel itinerary,” explains Sadie, a mom from Connecticut. Her daughter Maddie, age 11, was diagnosed with diabetes three years ago.
During initial travel planning, Patty Beckwith, M.P.H., R.D., C.D.E., an outpatient pediatric dietitian at UCLA Mattel Children’s Hospital in Los Angeles, recommends parents take into account the possible need for emergency care. As a good rule of thumb, “identify hospitals and other medical facilities located at each of the destinations on your trip. If possible, book hotels that are close by or double-check that, if needed, transportation is available to bring you to the facility.”
Sadie also adds “find a pharmacy” to her travel to-do list. “On our first trip after our daughter’s diagnosis, one big relief was realizing that our same pharmacy chain had multiple locations that basically followed our driving route. I was never more than 50 miles away from access to refills. I always check pharmacy locations wherever we go because it simplifies things so much to know they can just pull up my child’s information,” she explains.
The Simple Secret to Packing Enough Supplies
Make a list of all the diabetes gear your child needs — and then multiply everything by two. As Beckwith explains, “You want to gather together enough supplies to divide into two separate carriers. It’s simple math: If one bag gets lost, you will still have ample supplies in the other.”
Every child with type 1 has different needs, but staples to pack include: meters, test strips, low supplies, insulin vials and pens, syringes, fresh infusion sets for pump users, adhesive patches for CGM (continuous glucose monitor) sensors, and extra batteries for each gadget that requires them. “It can seem like a lot, but when we get to the hotel, I create a ‘diabetes station’ in the room and organize everything. It makes it easy to pack up what we need each day,” says Erin L., a D-mom from Atlanta.
Special Care for Insulin and Pumps
Keeping insulin cool while traveling is important. Registered dietitian and certified diabetes educator Sylvia White, M.S., R.D., L.P.C., C.D.E., a Memphis, Tennessee, mother of three children, two with type 1 diabetes, recommends keeping insulin in a cooler during trips or using a special cooler bag designed just for insulin. Hotel room mini-fridges can be helpful for storing insulin, but as White cautions, “Be careful where the insulin is placed. If it’s too close to the freezer section, some fridges will freeze the insulin.”
Traveling by plane? You can still take all your supplies. Current Transportation Security Association (TSA) guidelines allow for passengers with type 1 diabetes to bring their supplies with them, including testing supplies, insulin, and other medications, juice, insulin pumps, CGMs, syringes, and related supplies. Containers of allowed liquids (i.e., juice and water) in carry-ons are allowed to exceed the standard airline limit of 3.4 ounces. TSA recommends that medications and supplies be packed in clear, sealable bags for easy screening. You can fill out a TSA disability notification to present at screening. A complete list of items allowed and security procedures can be found on the TSA’s website. The American Diabetes Association website also has a helpful section on air travel and diabetes.
Prepare for Lows — and for Highs Too
Checking blood sugar and having access to snacks and low supplies are important for preventing or treating lows while traveling. But on the flip side, don’t forget to be prepared that your child’s numbers could actually run a little high during parts of the trip, especially if your big vacation starts with a long flight, says White. Feeling nervous and excited, sitting still for several hours, and the dry air on the plane can all cause blood sugar numbers to creep up. To monitor for highs, check your child’s blood sugar during long travels. On the plane, you can carry out all your child’s management tasks as needed, including administering insulin, and can request water to help your child stay hydrated. You can bring your own water too as part of your child’s diabetes supplies carry-on.
Food Planning for T1 Travel
Family travel is as much about the places you see as it is about fun places to eat and trying new foods. Eating out when you have type 1 diabetes does require attention to carb counting and meal planning, so give yourself time before your trip to collect as much information as you can about dining options. For starters, “look into restaurants, grocery stores, and food markets near the hotel and check websites for menus and food offerings. Make a list of all these places and plan to keep it handy,” Beckwith recommends.
A mom-to-mom tip: “Have your child eat their usual breakfast. We spend a week at a Disney park every year, and I’ve found that starting the day with foods that I know my child’s body responds to well provides for a more stable foundation. We also tend to have a ‘standard’ lunch and then save the treats and adventurous foods for later in the day and at dinner. If I need to do some major corrections after dinner at least we’re back in the hotel and not in line for Space Mountain!” says Sadie.
Bringing Your Diabetes Alert Dog (D.A.D.)
When Lauren Burke, a person with type 1 diabetes and development manager at Early Alert Canines, travels with her diabetes alert dog, she informs the airline ahead of time to expect her service dog to accompany her. “Generally, [the airline calls] to talk about the dog with me. It’s important to know that if your dog misbehaves, service dog or not, you can be removed from the airplane. The Americans with Disabilities Act states that any service animal causing disruption can be asked to leave. It’s very important that your dog is well behaved and prepared to be on a plane,” Burke says.
Each airline has their own set of rules and policies for flying with a service dog. Generally, service animals are required to sit on the floor or on their handler’s lap and not block the aisle. You are not required to pay additional pet travel fees for a service dog.
As for the logistics of taking a D.A.D. on a long flight, Burke recommends to “make sure to relieve your dog before you get to the airport. Generally, don’t give them food for several hours before traveling to ensure their system is empty, and cut back on water for a few hours before leaving. Be sure to get them water once you’ve arrived though! Remember, dogs go all night every night without doing their business, so they can easily make long flights with the right preparations.” Burke also recommends taking along a clean-up kit of sanitizing wipes for hands and surfaces, poop bags, and paper towels.
Work with Your Team
Especially if this is your first trip after diagnosis, check in with your child’s care team about your travel plans. Your team will be able to help you determine if adjustments in your child’s management, such as insulin adjustments, are needed during your trip, and how to make them. They can go over how to recognize and treat lows, and give you information about how to respond to other common situations that happen when traveling.
“Our C.D.E. was so helpful in teaching us how to recalibrate my child’s pump when crossing time zones. I had thought that, like my smartphone, the pump would automatically adjust when traveling from the East to West Coast. Not so! We needed to reset the time and make some adjustments in basal rates on our departure and return dates. If we hadn’t come in for a pre-trip visit, this is information I never would have known,” says Erin.
It’s also key to work with your doctor and diabetes care team before you leave to make a list of phone numbers and email addresses where you can contact your care team members in an emergency. In return, give them the list of medical facilities at your destination to make it easier in case there’s need for communication.
Feeling a little more ready for your big trip? Bon voyage!
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.