10 Tips for Traveling With Diabetes
Some extra planning and research is all that's needed for a person with diabetes to enjoy an incredible family vacation.
Know Before You GoThis includes visiting the doctor before the trip and researching doctors, pharmacies, and hospitals at your destination. The American Diabetes Association (ADA), the Mayo Clinic, the Centers for Disease Control and Prevention (CDC), and the Diabetes Research Institute Foundation all provide comprehensive travel information. 960 1280
Plan Snacks and Meals in AdvanceHolley Grainger, a registered dietitian and culinary nutrition expert, recommends bringing meals or snacks that are rich in fiber and protein, such as individual peanut butter packets with whole grain crackers, dried fruit and nuts, or string cheese. Conversely, depending on your destination, some of these items can also be found at airports and convenience stores. When eating out, Grainger says to be mindful of portion control, and choose meals that offer a balance of protein, fiber-rich carbs, healthy fat, and a vegetable. Beware of alcohol; the ADA has a tip sheet that covers specifics.
On international flights that include meals, request a diabetic meal in advance if possible, since Grainger says many airplane meals include too many carbohydrates. 960 1280
Pack Enough Medical Supplies“Be over-prepared in case of every scenario that you can think of,” says Dr. Amber Champion, director of The Diabetes Center at Mercy Medical Center. For example, she recommends pump users bring a spare pump and an extra supply of basal (or long-acting) insulin. Other necessary supplies, depending on the type of diabetes, might include insulin, medication, rubbing alcohol, hand sanitizer, syringes, a blood glucose meter, and test strips. Be sure to pack these in a carry-on bag. A cooler for insulin is also necessary if traveling to the beach, an extremely hot destination, or for an extended period of time. Otherwise, Dr. Champion says insulin can last for 28 days at normal room temperature. 960 1280
Know Airport and Flight ProceduresAllow extra time for going through security and customs at the airport; review the Transportation Security Administration (TSA) guidelines for special procedures beforehand concerning medications, liquids, supplies, and more. Dr. Champion says the TSA doesn’t typically question items like pumps or syringes, but they’re less common in some foreign countries, so it’s best to bring a doctor’s letter. It’s equally important to be aware of what’s allowed through customs at your destination; certain prescription medications are illegal in other countries, like Dubai. The ADA provides a comprehensive guide to air travel and diabetes, as does the CDC.
During the flight, the altitude change during the ascent and descent can affect some pumps. Dr. Champion advises disconnecting it during take-off and landing to prevent it from administering extra insulin. However, speak with a doctor about your personal situation beforehand. 960 1280
Be Alert for High and Low Blood Sugar SymptomsSigns of hypoglycemia, or low blood sugar, can include nervousness, dizziness, and feeling shaky or light-headed. Grainger notes that symptoms can strike quickly and affect a person’s ability to think clearly, in which case the travel companion should carry glucose tablets as a quick fix. They’re easy to find at drugstores and supermarkets in the U.S., but carry extra when traveling abroad. Grainger notes that orange juice is a good backup too, and Dr. Champion says that small bags of candy such as Skittles or jelly beans are easy to carry and also work. For extreme hypoglycemia, a travel companion should know how to inject glucagon, a hormone that raises blood sugar. Dr. Champion recommends an app called Glucagon that walks you through the steps.
Signs of hyperglycemia, or high blood sugar, can include increased thirst, dry mouth, blurry vision, vomiting, shortness of breath, headache, and even stomach pain. Consult a doctor before a trip to discuss treatment options, which, depending on the severity, range from administering an extra dose of insulin to visiting an emergency room. Dr. Champion says to leave insulin injections to the paramedics. 960 1280
Make Sure Travel Insurance Includes MedicalSome travel insurance plans only cover financial losses. Check the U.S. Department of State for a list of recommended medical providers. Be sure to choose one that includes medical evacuation, or medevac, in case of an emergency; that option could be cost-prohibitive if insurance doesn’t cover it. It’s also important to research doctors and hospitals at your destination. 960 1280
Adhere to a Regular ScheduleBoth Grainger and Dr. Champion advise sticking to a regular schedule as much as possible, both with meals and insulin, especially when changing time zones. Those with Type 1 diabetes need to time insulin injections with meals, and injections need to be at set times. Eating at least every three to four hours can also help prevent any blood sugar dips. 960 1280
Monitor Blood Sugar Levels FrequentlyAn increased activity level, time zone changes, and eating differently can all affect glucose levels. Stay on track by checking glucose levels more than normal. Travel companions shouldn’t be afraid to remind those with diabetes to check it, since it can be easy to forget while on vacation. 960 1280
Wear a Medical Alert BraceletIt’s reasonable to assume that someone with diabetes will have periods when they’re alone, if even for a few minutes. In the event of an emergency, such as a rapid onset of hypoglycemia, a medical alert bracelet can help paramedics quickly identify the problem. In addition, Dr. Champion advises that everyone with diabetes should carry a card with them at all times that includes a list of medications, their doctor’s name and number, and medical conditions. 960 1280
Avoid Going BarefootDr. Champion says this is especially true for patients with neuropathy, a condition that causes numbness in the feet, which poses an infection risk if they step on something and cut their foot without knowing it. However, Dr. Champion notes even those with Type 2 diabetes don’t always realize they have neuropathy. It’s best to err on the side of caution and always wear footwear, whether indoors or at the beach. 960 1280
Peanuts at 30,000 FeetPeanut allergies are among the most severe, yet peanuts are synonymous with in-flight snacks. Many airlines no longer serve peanuts–check the airline website for policies–though other passengers may bring peanut snacks aboard. Airlines such as Southwest will not serve peanuts if contacted a few days before the flight. Speak to a gate agent before your family's flight and ask to pre-board in order to wipe down the seat and area where your family will be seating to remove any peanut dust and particles. Flight attendents can also make announcements before takeoff asking passengers to please not open peanut-containing snacks during the flight. 960 1280
Give Yourself Extra Time for SecurityIf you travel with more than 3 ounces of liquids, such as almond milk, peanut butter or apple sauce, it's helpful to have a doctor's note to present to TSA agents, if necessary. Give yourself extra time in security for additional screening of items, but you shouldn't have any trouble getting an exception. 960 1280
Epinephrine InjectionsThe TSA considers epinephrine injectors a medical necessity, and allows them to be carried aboard flights. Epinephrine injectors should be bagged with other carry-on liquids for inspection. At least two injectors should be available (consider one injection lasts for about 20 minutes), and if you're traveling alone, notify your flight attendent where your injectors are should you go into anaphylaxis. Make sure they are clearly labled and accessible. Airplanes carry at least one epinephrine injector in the onboard medical kit as well, and flight attendents are trained in their use.
Gluten Testers are Coming SoonDevices such as Nima Portable Gluten Tester will enter the market this year, allowing travelers to test food for gluten and other ingredients. Nima uses one-use capsules that are $5 each, and hopefully prices will come down as more products come on line. 960 1280
Pack More Snacks Than You Think You'll NeedIt sounds obvious, but many people get caught off-guard by flight delays, lack of restaurants that accomodate special diets and other hiccups while traveling. Pack more diverse, safe snacks then you think you'll need, or even full meals such as those from GoPicnic. For kids, pack extra special treats as something to look forward to during the travel day. 960 1280
Plan Ahead for Peace of MindFamiliarize yourself with medical facilities near your destination that can treat an allergic reaction, if necessary, and have your doctor transfer any prescriptions that you may need filled when traveling ahead of time. Consider how you would replace EpiPens used during a flight, for example. 960 1280
Translate Your NeedsIf you're not fluent in the language of your destination, create a translated card beforehand you can present at restaurants that lists ingredients you need to avoid, along with a brief explaination. Be aware that foods with which you're familiar with at home may use different ingredients abroad, such as types of flour or nuts. 960 1280
Reach Out to Local GroupsMany destination cities have organizations that share information about local restaurants that accomodate dietary needs, such as the NYC Celiac Disease Meetup Group and the Gluten Free Bay Area Meetup Group. Incorporate finding exciting diet-sensative restaurants into your travel plans, and reach out to people with similar dietary concerns for advice and recommendations. Locals are more than happy to share their knowledge with visitors, and you may even make new friends. 960 1280
Plan in AdvanceWhether you’re traveling with someone with a permanent or temporary physical disability, the challenges remain the same. The U.S. Department of State is a good general resource, while The Americans with Disabilities Act (ADA) details what accommodations should be made. Even though U.S. hotels, transportation, and cruise ships sailing in U.S. waters are required to be ADA-compliant, don’t assume that the foreign equivalent will be. If transportation, a cruise, hotel, or other lodging (such as Airbnb) isn’t ADA-compliant, call ahead to discuss what accommodations can be made.
Other planning resources include Mobility International USA, which has helpful articles on charging wheelchair batteries and taking a service animal abroad. Curb Free with Cory Lee blogs about traveling the world in a wheelchair, and is a comprehensive guide to everything from the most accessible destinations to the pros and cons of bringing a wheelchair. 960 1280
Try to Replicate the Home RoutineTimothy Holtz is the group travel director of Flying Wheels Travel, an agency specializing in trips for people with disabilities and chronic illnesses. When planning an itinerary, for example, he emphasizes the importance of factoring in the stamina of the person in the wheelchair. If that person has more energy in the morning, then plan sightseeing around that. Holtz says to avoid doing too much in a day. He adds that some people are resistant to taking naps while on vacation, even if they regularly take them at home, but that decision can make or break a trip due to fatigue. “If you require it at home, plan on requiring it in a vacation schedule as well,” he says. 960 1280
Make Sure Travel Insurance Includes MedicalSome travel insurance plans only cover financial losses, and Medicare doesn’t cover overseas travel. Check the U.S. Department of State for a list of recommended medical providers. Be sure to choose one that includes medical evacuation, or medevac, in case of an emergency; that option could be cost-prohibitive if insurance doesn’t cover it.
Use a Specialized Travel Agent or CompanyNowadays, everywhere from Bali and Turkey to Russia and India are accessible for independent and group travelers with physical limitations. A knowledgeable agent can craft an itinerary that works for everyone, advise on whether or not a hotel is fully accessible, and arrange private transportation in a less accessible destination. Holtz says he’s taken people to Machu Picchu, the Galapagos Islands, and more, and made adjustments in places that aren’t ADA-compliant, such as modifying rooms by adding grab bars in the shower. Agents also have firsthand knowledge of accessible destinations. For example, Holtz says London and Barcelona are among his top picks for independent accessible travel. Both cities are sensitive to special needs since each hosted the Olympics and Paralympics. Further, all cabs are accessible in London. Holtz says Italy is popular for group travel, “but you really have to know what you’re doing.” He notes that even Venice is accessible if planned right, since it has accessible wheelchair boats—plus an accessible Gondola just opened this year.
In addition to Flying Wheels Travel, other companies that run trips for those in wheelchairs include Accessible Journeys. The Society for Accessible Travel & Hospitality is another resource for finding agents and companies. 960 1280
Enroll in the Smart Traveler Enrollment Program (STEP)The U.S. Department of State offers STEP as a free service that allows you to share trip information with the local U.S. Embassy or Consulate of your destination; this way it’s easy to be notified in the event of an emergency. More importantly, there’s a section under Traveler Information that allows you to enter any relevant information about a physical limitation. 960 1280
Arrange Accessible AccommodationIf you're planning an independent trip, Holtz says to consider what you typically need to do at home. For example, if you have a roll-in shower at home with a shower bench, look for that in a hotel. ADA-compliant hotels should also contain grab bars. Holtz cautions that when contacting non-ADA-compliant hotels, “many people don’t understand what fully accessible means,” such as not realizing that one step can be a barrier to someone in a wheelchair. Other considerations to ask non-ADA-compliant hotels are whether a wheelchair can fit through the room and bathroom doors, and if there’s enough room to maneuver a wheelchair once in the room. 960 1280
Arrange Assistance While FlyingHoltz says to allow at least two hours for domestic and connecting flights, and three hours for international flights. He also recommends arranging wheelchair assistance with the airline ahead of time, and double check 48 hours beforehand. At the airport, remind the check-in counter that you need wheelchair assistance. Holtz says family members should allow assistance, since agents can help with luggage and get everyone through security faster. At the very least, review TSA guidelines for special procedures. Remind the gate agent that you need assistance so that everyone in your group can preboard.
If someone is traveling with their own wheelchair, Holtz says to remove and take everything from the wheelchair that could fall off and get lost during storage, including the foot rest, head rest, and any cushions. On board, every U.S. airline that seats more than 60 and is equipped with an accessible bathroom is required to have an aisle wheelchair. Holtz suggests always requesting an aisle seat close to the bathroom. Finally, he notes that those in wheelchairs are last off the plane, so factor in that time and allow help through customs, if applicable. 960 1280
Decide Whether to Bring or Borrow a WheelchairThis depends on the nature of the trip and the needs of the user. The pros of bringing one include the known comfort level of the person using it, and not having to worry about arranging one for every step of the journey. On the other hand, if it’s electric, for example, you will have to factor in power outlet access for charging it. If you're flying, review the U.S. Department of Transportation and the Air Carrier Access Act for rights on U.S. airlines. It’s also important to understand the laws for where you’re going. 960 1280
Take Advantage of DiscountsFor example, Amtrak offers discounts (from 15%-50%) to wheelchair users and a travel companion. You must show proof of your disability, such as a doctor’s note or transit ID card; visit the site for a full list of approved documents. Reduced fares for those with physical limitations are also available on buses (such as Greyhound) and trains both here and abroad, including Japan, London, Singapore and more.
The National Park Service Access Pass is free for U.S. citizens with permanent disabilities and grants access to any of the national parks, monuments, historic sites, and more. Museums, zoos, and theme parks are some other attractions that typically offer discounts. 960 1280
Don’t Forget the Needs of the CaregiverIf a wheelchair user is in a manual (as opposed to an electric) wheelchair, Holtz says the needs of the caregiver pushing that person are often forgotten. He advises against seeing too much in one day to account for the stamina of both people. Holtz also advises considering the amount of care someone needs, which affects how much energy the caregiver has to expend. For example, if the caregiver has to get up early to help the person in a wheelchair get ready, then both people might need a nap in the afternoon.
Flying Wheels Travel offers travel companions on both independent and group tours, which gives the caretaker or spouse a vacation as well. 960 1280
Know Before You Go: LodgingThe Americans with Disabilities Act (ADA) site is a good place to start for those with vision or hearing issues. While U.S. hotels, transportation, and cruise ships sailing in U.S. waters are required to be ADA-compliant, don’t assume that the foreign equivalent will be. For example, for those who are vision impaired, ADA-compliant lodging is required to allow service animals; provide large-print, Braille, or audio options for relevant hotel information; and comply with requests for adjoining rooms. Other services such as conducting a room orientation tour should also be provided.
For hard-of-hearing guests, ADA-compliant lodging is required to provide, upon request, a compliancy kit that includes visual alarms and visual notification devices. Teletypewriters (TTY or TDD) or amplified phones should also be available. If transportation, a cruise, hotel, or other lodging (such as Airbnb) isn’t ADA-compliant, call ahead to discuss what accommodations can be made. However, bring whatever aide is necessary in your carry-on, in case loaner equipment isn’t working or available. Multiple kits aren’t always available, so it’s a good idea to travel with devices such as SafeAwake, a travel-size alarm that shakes the bed and flashes a light if the smoke detector is triggered.
Joel Barish, founder of DeafNation.com, a comprehensive source for the deaf and hard of hearing, also advises performing a Google search to find similar communities at your destination. For example, Signs Restaurant & Bar in Toronto employs a deaf waitstaff that only communicates in sign language. Dans le Noir is a restaurant chain where you eat in complete darkness, with locations in London, Paris, Barcelona, and more. 960 1280
Know Your RightsIf you’re traveling within the U.S. or staying at a U.S. chain abroad, familiarize yourself with ADA laws, since you can’t assume that every staff member, regardless of whether it’s a hotel, cruise ship, theme park, etc. will know your rights and options. Review the Air Carrier Access Act for rights on U.S. airlines.
It’s also key to understand the laws for where you’re going. “They may differ significantly from the U.S. for protecting individuals who are disabled and for service animals that might need additional vaccinations,” says Dr. Margaret Wilson, chief medical officer for UnitedHealthcare Global. 960 1280
Use a Specialized Travel Agent or CompanyTravel agencies that specialize in trips for the blind or deaf can help facilitate a stress-free trip. Mind’s Eye Travel provides group trips that range from cruises to an African safari. Traveleyes is a UK-based company (although it attracts an international crowd) with a unique concept: trips are a blend of blind and sighted travelers. Upcoming trips encompass a broad range from Burma to Peru.
Deaf Globetrotters also offers group trips, (and provides a sign language interpreter) such as an upcoming one to Cuba, along with the opportunity to connect with the local deaf community. Group tours with translators can be especially helpful for those who are deaf, since sign language is not a universal language. Deaf Globetrotters can also arrange customized family trips. An organization like the Society for Accessible Travel & Hospitality is another resource for finding agents and companies. 960 1280
Visit a MuseumMany museums offer special programs for the deaf and blind. For example, MoMA in NYC offers touch and visually descriptive tours, as well as Braille maps. It also allows service animals. Sign language interpretation, captioning, and FM assistive-listening devices are available to the deaf and hard of hearing. The Louvre, the Smithsonian Museums, and the Vatican Museums also offer accessibility options. 960 1280
Get Reduced Fares on TransportationFor example, Amtrak offers discounts (from 15%-50%) to both the deaf and blind, plus a travel companion. You must show proof of your disability, such as a doctor’s note or ID card; visit the site for a full list of approved documents.
Reduced fares are also available on buses (such as Greyhound) and other trains both here and abroad, including Japan, London, and Singapore. 960 1280
Ask for AssistanceWhether at airports, hotels, train, or bus stations, alert the staff in advance so they can help with your needs. For example, airline staff can assist with getting through security faster. At the very least, familiarize yourself with TSA guidelines to learn about security procedures, such as traveling with a service animal. Amtrak also provides services upon request, including Red Cap agents who will carry luggage onto the train. Amtrak also allows service animals, but review its guidelines beforehand.
Even when assistance isn’t needed, it’s important to make staff aware of any issues, since a family member might not be present all the time. Nancy Nadler, deputy executive director at the Center for Hearing and Communication, recommends alerting staff of a disability in the event of an emergency or important announcement. 960 1280
Apply for a Free Access Pass from the National Park ServiceAny U.S. citizen with a permanent disability, including hearing and vision loss, is eligible to receive a free, lifetime access pass to any of the national parks, monuments, historic sites, and more. 960 1280
Consider a CruiseBy law, all cruise lines sailing in U.S. waters are supposed to be ADA-compliant, making them an ideal option. However, ADA guidelines for cruise ships aren’t standardized, so the level of service and resources vary—be sure to research each line. However, for those who are blind or have low vision, Royal Caribbean provides orientation tours, large-print menus and daily activity lists, and qualified readers. Braille signs are available in elevators and public areas, and service animals are also allowed. For those who are deaf or hard of hearing, Royal Caribbean will provide a TTY phone in the room, along with a visual alert system for the phone, door, smoke detector, and alarm clock. With advance notice (at least 60 days ahead) the ship will even provide sign language interpreters on cruises between the U.S. and Canada. 960 1280
Head to a Disney Theme ParkA Disney vacation is another great option for families, since the parks are sensitive to a wide range of needs. Those with vision issues can take advantage of handheld audio description devices, which provide visual details for various attractions and shows. Braille guidebooks and digital audio tours are available, and Braille maps are located throughout the parks. Service animals are allowed too.
Hard-of-hearing services include handheld, reflective, and video captioning, assistive-listening devices, and sign language interpretation at some of the live shows. However, sign language interpretation is available at other performances, such as Disney’s Spirit of Aloha, if it’s requested 14 days in advance. In-room options include TTY phones, strobe-light smoke detectors, and a bed shaker notification device. 960 1280