Managing Diabetes During International Travel: Complete Guide 2025

Traveling internationally with diabetes requires careful planning and preparation, but it shouldn't prevent you from exploring the world. Whether you manage Type 1 or Type 2 diabetes with insulin pumps, CGMs, injections, or oral medications, this comprehensive guide covers everything you need to know for safe international diabetes travel.

Pre-Travel Medical Consultation

6-8 Weeks Before Departure

Schedule Comprehensive Diabetes Checkup

Visit your endocrinologist or diabetes care team to ensure you're medically cleared for international travel.

Essential Checkup Components:

• A1C test (ensure diabetes well-controlled before travel)
• Blood pressure check
• Foot examination (critical for long flights and walking)
• Eye examination if due
• Kidney function tests if appropriate
• Review of current medication regimen

Travel-Specific Discussions:

• Destination medical facilities and diabetes care availability
• Time zone adjustment strategies for insulin/medication timing
• Altitude considerations (if traveling to high-elevation destinations)
• Climate impacts on blood sugar and insulin storage
• Activity level changes and blood sugar management
• Emergency action plan for hypoglycemia and hyperglycemia

Obtain Essential Documentation:

1. Doctor's letter (on official letterhead) stating:

   • Diagnosis of diabetes (Type 1 or Type 2)
   • List of all medications and devices with dosages
   • Medical necessity for carrying syringes, needles, insulin, devices
   • Emergency treatment instructions
   • Doctor's contact information

2. Prescriptions for all diabetes supplies:

   • Generic medication names (not just brand names)
   • Dosages clearly stated
   • "For foreign travel" notation
   • Multiple copies (keep separately)

3. Medical ID card with:

   • Diabetes type
   • Emergency contact information
   • Medication list
   • Language translations for destination country

4. Travel immunization records (if applicable)

Medication Adjustments:

• Discuss time zone insulin adjustment strategy
• Consider backup medication options if primary unavailable abroad
• Adjust basal insulin for international flights
• Review hypoglycemia and hyperglycemia treatment protocols

Getting Extra Prescriptions

Request from Your Doctor:

• Double your expected medication supply (in case of loss, damage, or trip extension)
• Extra insulin prescriptions (3-4 vials/pens beyond expected needs)
• Extra test strips, lancets, pump supplies, CGM sensors
• Prescription for glucagon emergency kit
• Prescription for anti-nausea medication (for diabetes-related illness)

Insurance Considerations:

• Contact insurance to approve early refills for travel
• Verify international coverage for diabetes emergencies
• Consider travel medical insurance with diabetes coverage
• Understand pre-authorization requirements for foreign medical care

Insulin & Medication Management

Insulin Storage During International Travel

Optimal Insulin Storage Temperature: 36-46°F (2-8°C)

Unopened Insulin:

• Must be refrigerated until first use
• Can be stored at room temperature for limited time (see manufacturer guidelines)
• Never freeze (frozen insulin is damaged and ineffective)
• Keep in original packaging until needed

Opened Insulin (In Use):

• Can be stored at room temperature (below 86°F/30°C) for 28 days (most brands)
• Avoid direct sunlight and extreme heat
• Discard after manufacturer-specified time (usually 28 days)
• Mark opening date on vial/pen

Travel Storage Solutions:

1. Insulated Medication Cases (Recommended for Most Travelers)

• FRIO cooling pouches (evaporative cooling, no ice needed)
• MedAngel temperature monitoring cases
• Medicool diabetic supply cases
• Benefits: No ice required, TSA-friendly, lightweight

2. Portable Medication Refrigerators (For Extended Travel)

• 4AllFamily insulin coolers (battery-powered)
• Dison diabetic insulin cooler (USB rechargeable)
• Benefits: Precise temperature control, larger capacity
• Considerations: Heavier, requires power source

3. Ice Packs & Cooler Bags (Budget Option)

• Reusable gel ice packs
• Insulated lunch bags
• Benefits: Inexpensive, widely available
• Considerations: Must avoid freezing insulin, ice packs need refreezing

Airport & Flight Storage:

• ✅ ALWAYS carry insulin in cabin (NEVER check in cargo hold - freezes)
• ✅ Use insulated case even in cabin (temperature fluctuations)
• ✅ Keep insulin separate from ice packs (don't freeze)
• ✅ Store under seat (easier temperature control than overhead bin)

Hotel Storage:

• Most hotels provide mini-fridges (request when booking)
• Keep insulin away from freezer compartment
• Use hotel safe for backup supplies
• Bring thermometer to monitor fridge temperature

Hot Climate Travel:

• Use FRIO or powered cooling case
• Avoid leaving insulin in car (can reach 120°F+)
• Carry insulin close to body (cooler than ambient temperature)
• Plan indoor activities during peak heat hours
• Replace insulin if exposed to heat >86°F for extended time

Cold Climate Travel:

• Keep insulin close to body (inner jacket pocket)
• Don't leave in unheated cars or outdoor areas
• Warm insulin to room temperature before injecting (cold insulin hurts!)
• Check for ice crystals (if frozen, discard)

Time Zone Adjustments for Insulin

Challenge: International travel crosses multiple time zones, disrupting normal insulin timing.

Strategies for Long-Acting (Basal) Insulin:

Traveling East (Shorter Day)

• Day becomes shorter (example: 8-hour time difference = 16-hour day)
• Take usual morning long-acting dose before flight
• Reduce basal insulin dose by 20-30% for shorter day
• Resume normal schedule on arrival (morning dose at new local time)
• Monitor blood sugar frequently during transition (every 2-3 hours)

Traveling West (Longer Day)

• Day becomes longer (example: 8-hour time difference = 32-hour day)
• Take usual morning long-acting dose before flight
• May need small additional basal dose (30-50% of usual) 12 hours later
• Resume normal schedule on arrival (morning dose at new local time)
• Monitor blood sugar frequently

For Insulin Pump Users:

• Adjust pump time to destination time zone immediately or gradually
• Consider gradual adjustment (1-2 hours per day) for large time differences
• Monitor blood sugar closely during transition
• Basal rates may need temporary adjustments during flight

For Rapid-Acting (Bolus) Insulin:

• Easier to adjust (dose with meals regardless of time)
• Continue dosing based on carb counting and correction factors
• Monitor blood sugar before/after meals during adjustment period
• Consider reducing bolus doses if less active during travel

General Time Zone Tips:

• Start adjusting sleep schedule 2-3 days before departure
• Use continuous glucose monitor (CGM) for real-time tracking during transition
• Set phone alarms for blood sugar checks during adjustment period
• Keep detailed log during first 48 hours in new time zone
• Consult with endocrinologist for personalized plan (especially for complex regimens)

Oral Diabetes Medications

Common Medications:

• Metformin (Glucophage)
• Sulfonylureas (Glipizide, Glyburide)
• DPP-4 inhibitors (Januvia, Tradjenta)
• SGLT2 inhibitors (Jardiance, Farxiga)
• GLP-1 agonists (Ozempic, Trulicity)

Travel Considerations:

• Keep in original pharmacy bottles (labeled with your name)
• Bring extra supply (double expected needs)
• Bring written prescriptions (generic names)
• Adjust timing gradually for time zone changes
• Some medications require refrigeration (check manufacturer guidelines)

Time Zone Adjustments (Oral Meds):

• Shift medication times gradually (1-2 hours per day)
• OR take at usual time relative to destination time zone
• Monitor blood sugar closely during adjustment
• Consult pharmacist/doctor for medication-specific guidance

Diabetes Devices & Technology

Insulin Pumps

Travel Preparation:

Before You Leave:

• ✅ Bring backup insulin pens/syringes (pump may fail)
• ✅ Pack extra infusion sets, reservoirs, batteries
• ✅ Bring pump supplies for 2-3× expected duration
• ✅ Download pump settings to app/write down (in case of replacement needed)
• ✅ Identify pump manufacturer support in destination country
• ✅ Bring pump instruction manual (digital or printed)

TSA/Airport Security:

• Insulin pumps can go through airport X-ray (most manufacturers approve)
• Request physical pat-down if concerned about X-ray exposure
• Inform TSA officer: "I'm wearing an insulin pump for diabetes"
• Keep pump attached during screening (don't disconnect)
• May require explosive residue swab of pump
• Private screening available on request

In-Flight Management:

• Cabin pressure changes can create air bubbles in reservoir (check for bubbles before bolusing)
• Some pumps may alarm due to pressure changes (normal)
• Keep pump supplies in carry-on (never check)
• Consider disconnecting pump during flight and using injections (if long flight and concerned about air bubbles)

International Considerations:

• Voltage compatibility for battery chargers (100-240V typically standard)
• Bring universal power adapter
• Research local pump supply availability (in case of emergency)
• Contact pump manufacturer for international customer support numbers

Continuous Glucose Monitors (CGMs)

Popular CGM Systems:

• Dexcom G6/G7
• FreeStyle Libre 2/3
• Medtronic Guardian Connect

TSA/Airport Security:

• CGM sensors can go through X-ray safely
• Inform TSA officer about CGM sensor on body
• Most manufacturers approve airport screening
• Request hand pat-down if preferred
• Do NOT remove sensor for screening

In-Flight Monitoring:

• CGM works normally during flight
• Altitude may slightly affect readings (usually minimal)
• Keep receiver/smartphone in airplane mode (or turn off cellular)
• Bring backup finger-stick meter (in case CGM fails)

International Travel:

• Bring extra sensors (2-3× expected needs)
• CGM may not be available in all countries
• Check phone data/roaming for CGM apps requiring connectivity
• Download CGM reports before travel (backup data)

Temperature Considerations:

• Store unused sensors at room temperature
• Avoid extreme heat exposure
• Keep sensors in carry-on (cabin temperature controlled)

Blood Glucose Meters

Essential Supplies:

• Blood glucose meter (bring backup meter)
• Test strips (pack 2-3× expected usage)
• Lancet device and lancets
• Control solution (to test meter accuracy)
• Extra batteries for meter

TSA Screening:

• Meters and test strips are allowed in carry-on (unlimited quantity)
• Lancets allowed (medical necessity)
• Keep supplies together in clear bag for easy screening
• Test strips CAN go through X-ray (does not damage them)

International Considerations:

• Test strips may be unavailable or expensive abroad
• Bring ample supply (cannot rely on finding compatible strips)
• Humidity can damage test strips (keep in sealed container)
• Altitude affects some meters (check manufacturer specs)

Backup Options:

• Two meters (in case one fails)
• Different brands if possible (strips for both)
• Keep one meter in separate bag (in case carry-on lost)

Blood Sugar Management During Travel

Managing Blood Sugar on Flights

Pre-Flight Preparation:

• Check blood sugar before security screening
• Eat regular meal before flight (don't fly hungry)
• Pack diabetes-friendly snacks in carry-on
• Bring fast-acting glucose (juice, glucose tablets, candy)

During Flight:

Challenges:

• Irregular meal timing
• Sitting for extended periods (reduces insulin sensitivity)
• Dehydration (affects blood sugar)
• Stress (can elevate blood sugar)
• Airline meals (unknown carb content)

Strategies: ✅ Check blood sugar every 2-3 hours ✅ Stay hydrated (drink water frequently - dehydration raises blood sugar) ✅ Move regularly (walk aisle every hour, ankle/leg exercises) ✅ Bring own food (don't rely on airline meals) ✅ Be conservative with bolus insulin (less activity = less insulin needed) ✅ Set CGM alarms (if using CGM) ✅ Avoid alcohol (can cause delayed hypoglycemia)

Dealing with Airline Meals:

• Request diabetic meal (when booking) - typically lower carb/sugar
• Visually estimate carbohydrates (bread, rice, pasta, fruit)
• Bolus conservatively (can correct later if needed)
• Bring backup food if meal insufficient or delayed

Hypoglycemia on Plane:

• Carry fast-acting glucose in seat pocket (easy access)
• Inform flight attendant if feeling low
• Don't wait to treat - act immediately
• Recheck blood sugar 15 minutes after treatment

Hyperglycemia on Plane:

• Drink water to stay hydrated
• Correct with insulin conservatively
• Walk aisle to help bring blood sugar down
• Avoid overcorrection (risk of low later)

Adjusting for Activity Level Changes

Travel Often Means More Walking

• Sightseeing = increased physical activity
• More walking = lower blood sugar
• May need to reduce basal insulin 10-20%
• May need to reduce bolus insulin or eat more carbs
• Check blood sugar before, during, and after activity

Strategies:

• Start conservatively (slight reductions in insulin)
• Monitor closely and adjust as needed
• Bring fast-acting carbs during sightseeing
• Consider temporary basal reduction (if using pump)
• Eat small snacks during long walking tours

Less Activity Than Usual (Relaxing Beach Vacation):

• Less activity = higher blood sugar
• May need to increase insulin slightly
• Monitor for elevated post-meal blood sugars
• Adjust based on CGM trends

Jet Lag & Blood Sugar

Jet Lag Effects:

• Disrupted sleep affects insulin sensitivity
• Cortisol elevation from stress can raise blood sugar
• Irregular eating times impact blood sugar patterns

Management Tips:

• Prioritize sleep (even if blood sugar slightly higher)
• Be patient with blood sugar fluctuations (normal during adjustment)
• Increase monitoring frequency for first 2-3 days
• Stay hydrated
• Avoid heavy meals late at night
• Gradually adjust to local meal times

International Customs & Security

TSA Screening (U.S. Departure)

What to Declare:

• Inform TSA officer: "I have diabetes and am carrying insulin, syringes, and medical devices"
• Keep diabetes supplies easily accessible in carry-on
• Medications do NOT need to be in quart-size bag (medical exemption)

What's Allowed:

• Unlimited insulin (any quantity)
• Syringes and needles (with insulin or prescription)
• Lancets
• Blood glucose meters and test strips
• Insulin pumps and CGMs (wear during screening)
• Ice packs (frozen or gel - for insulin cooling)
• Juice boxes and glucose gels (medical exemption from liquid limits)

Screening Process:

• Medications and supplies will go through X-ray
• TSA may ask to see medications
• May request physical inspection or explosive residue swab
• Private screening available (request if needed)
• Average time: 5-15 minutes extra (arrive early)

TSA Cares Program:

• Call 72 hours before flight: 855-787-2227
• Coordinator will meet you at checkpoint
• Assistance with medical device screening
• Free service

International Customs (Arrival)

Customs Declaration:

• Most countries allow personal medication imports (30-90 day supply)
• Declare medications if asked on customs form
• Keep prescription and doctor's letter accessible

Country-Specific Considerations:

European Union:

• Generally allows insulin and diabetes supplies without issue
• Doctor's letter recommended (especially for syringes)
• Prescription may be required for customs
• Translation to local language helpful but usually not required

United Kingdom:

• Up to 3 months personal supply allowed
• Doctor's letter recommended
• No prescription required for personal use insulin
• Syringes allowed with diabetes documentation

Australia:

• Strict biosecurity laws
• Declare all medications on Incoming Passenger Card
• Doctor's letter required for quantities over 3 months
• Insulin and supplies generally no issue with declaration

Japan:

• Up to 1 month supply without import permit
• Larger quantities require Yakkan Shoumei (import certificate)
• Apply online before travel if bringing >1 month supply
• Doctor's letter in English accepted

Middle East (UAE, Saudi Arabia, etc.):

• Strict medication import laws
• Doctor's letter mandatory
• Some medications banned (check embassy website)
• Insulin generally allowed with documentation

China:

• Doctor's letter required (with Chinese translation recommended)
• Limited supply (30 days) usually no issue
• Register medications at customs on arrival
• Bring prescription labels in English

Canada:

• 90-day personal supply allowed
• Doctor's note recommended
• Insulin and diabetes supplies typically no issue
• Similar rules to U.S.

Tips for Smooth Customs:

• Keep all diabetes supplies in carry-on (easy to show if asked)
• Have doctor's letter and prescriptions ready
• Be honest and declare medications
• Remain calm and polite with customs officers
• Know a few key phrases in local language ("I have diabetes" / "insulin")

Diabetes Emergency Protocols Abroad

Hypoglycemia (Low Blood Sugar)

Symptoms:

• Shakiness, sweating, rapid heartbeat
• Dizziness, confusion, irritability
• Hunger, weakness
• Blurred vision
• Severe: Loss of consciousness, seizures

Immediate Treatment (Rule of 15):

1. Check blood sugar (if possible)
2. If <70 mg/dL: Consume 15g fast-acting carbs
   • 4 glucose tablets
   • 4 oz fruit juice
   • 5-6 pieces hard candy
   • 1 tablespoon honey or sugar
3. Wait 15 minutes
4. Recheck blood sugar
5. If still <70 mg/dL: Repeat treatment
6. Once >70 mg/dL: Eat small snack with protein

Severe Hypoglycemia (Unconscious/Seizing):

• Companion should administer glucagon injection
• Call local emergency number (see list below)
• Position person on side (prevent choking)
• Do NOT give food/drink if unconscious
• After glucagon: Person usually wakes in 10-15 minutes
• Seek emergency medical care even if person recovers

Glucagon Emergency Kit:

• Bring on all trips
• Teach travel companion how to use before trip
• Check expiration date before travel
• New nasal glucagon (Baqsimi) easier to use than injection

Hyperglycemia (High Blood Sugar)

Symptoms:

• Frequent urination, extreme thirst
• Blurred vision
• Fatigue, weakness
• Headache
• Nausea

Treatment:

• Check blood sugar and ketones
• Drink water (stay hydrated)
• Correct with insulin per usual correction factor
• Avoid exercise if ketones present
• Recheck in 2-3 hours

Diabetic Ketoacidosis (DKA) - Medical Emergency:

• Blood sugar >250 mg/dL with ketones
• Nausea/vomiting, abdominal pain
• Fruity-smelling breath
• Confusion, difficulty breathing

Action:

• Call local emergency services immediately
• Go to emergency room
• Bring diabetes medical ID and medication list
• DKA requires IV fluids and insulin (hospitalization)

Finding Medical Care Abroad

Emergency Numbers (Call for Ambulance):

• European Union: 112
• United Kingdom: 999
• Australia: 000
• Japan: 119
• China: 120
• Mexico: 911
• Canada: 911
• Middle East (UAE): 998 or 999

Locating Hospitals/Clinics:

• Google Maps: Search "hospital" or "emergency room"
• Hotel concierge can direct you to nearest facility
• U.S. Embassy/Consulate can provide medical facility referrals
• International Association for Medical Assistance to Travellers (IAMAT): www.iamat.org

What to Bring to Emergency Room:

• Passport/ID
• Travel insurance card
• Doctor's letter with diabetes information
• Medication list (including dosages)
• Recent blood sugar log (if available)

Communicating Diabetes Emergency:

Key Phrases in Major Languages:

Spanish: "Tengo diabetes. Necesito ayuda médica." (I have diabetes. I need medical help.)

French: "J'ai le diabète. J'ai besoin d'aide médicale."

German: "Ich habe Diabetes. Ich brauche medizinische Hilfe."

Italian: "Ho il diabete. Ho bisogno di assistenza medica."

Mandarin: "我有糖尿病。我需要医疗帮助。" (Wǒ yǒu tángniàobìng. Wǒ xūyào yīliáo bāngzhù.)

Japanese: "私は糖尿病です。医療援助が必要です。" (Watashi wa tōnyōbyōdesu. Iryō enjo ga hitsuyōdesu.)

Arabic: "أنا مصاب بمرض السكري. أحتاج إلى مساعدة طبية." (Ana musab bimarad alsukri. Ahtaj 'iilaa musaeadat tibia.)

Download translation app (Google Translate works offline with pre-downloaded languages)

Destination-Specific Diabetes Considerations

Europe

Insulin Availability:

• Available at pharmacies with prescription
• May have different brand names (e.g., Humalog = Humalin Lispro)
• Prices generally lower than U.S.
• Some countries require local doctor prescription

Blood Glucose Units:

• Europe uses mmol/L (not mg/dL)
• Conversion: mg/dL ÷ 18 = mmol/L
• Example: 100 mg/dL = 5.6 mmol/L

Food Considerations:

• Carb counting challenging (different portion sizes)
• European bread denser (more carbs per slice)
• Restaurant meals may include unexpected starches
• Use MyFitnessPal or Carbs & Cals app for European foods

Medical System:

• Excellent healthcare throughout EU
• Some countries offer free emergency care to tourists
• Travel insurance still recommended
• Pharmacists very knowledgeable (can help with minor issues)

Asia

Insulin Availability:

• Available in major cities (international brands)
• Difficult to find in rural areas
• Bring full supply from home
• Refrigeration widely available

Food Considerations:

• Rice-heavy diet (high carb)
• Soy sauce contains sugar (less than expected though)
• Fresh fruit often very sweet (higher glycemic impact)
• Street food carb content unknown (dose conservatively)
• Learn to count carbs in local staples (rice, noodles, dumplings)

Climate:

• Heat and humidity affect insulin stability
• Use cooling case mandatory
• Increased sweating can lower blood sugar
• Stay very well hydrated

Medical Care:

• Major cities have excellent hospitals (English-speaking)
• Rural areas may have limited diabetes expertise
• Medical tourism destinations (Thailand, Singapore) have world-class care
• Bring comprehensive diabetes documentation

Latin America

Insulin Availability:

• Available in pharmacies (major cities)
• May be different concentrations (U-40 vs U-100)
• Verify insulin concentration matches your syringes
• Bring full supply to be safe

Food Considerations:

• Rice, beans, tortillas (high carb staples)
• Fresh fruit juice very common (high sugar)
• Portion sizes often large
• Street food safety concerns (avoid if experiencing high blood sugars - infections make management difficult)

Water Safety:

• Bottled water only in many countries
• Dehydration risk (affects blood sugar)
• Avoid ice in drinks
• Water purification tablets for emergencies

Medical Care:

• Quality varies significantly by region
• Private hospitals better than public in many countries
• Medical tourism options (Mexico, Costa Rica)
• Travel insurance essential

Africa

Insulin Availability:

• Limited outside major cities
• Bring full supply + extra
• Refrigeration may be unreliable
• FRIO cooling pouches essential

Food Considerations:

• Carb-heavy diets (rice, cassava, plantains)
• Limited diabetes-specific foods
• Fresh produce excellent (low-carb options)
• Food safety important (infections affect blood sugar)

Climate:

• Extreme heat common
• Malaria risk in some areas (affects blood sugar if infected)
• Dehydration risk very high
• Sun exposure affects insulin stability

Medical Care:

• Limited diabetes expertise outside major cities
• Bring comprehensive supplies
• Medical evacuation insurance recommended
• South Africa has excellent medical care

Middle East

Insulin Availability:

• Widely available in cities (modern pharmacies)
• Brands may differ
• Bring documentation for customs

Food Considerations:

• Rice, bread, sweets common
• Dates very high in sugar (popular snack)
• Large meals traditional (Ramadan considerations if traveling during)
• Excellent fresh vegetables and grilled meats (low-carb options)

Climate:

• Extreme heat common
• Indoor spaces heavily air-conditioned
• Cooling case essential for insulin
• Dehydration risk

Cultural Considerations:

• Modest dress may be required
• Insulin pump may be visible (explain medical device if questioned)
• Fasting during Ramadan (not required if medical condition - discuss with doctor if Muslim)

Medical Care:

• Excellent modern hospitals (Dubai, Abu Dhabi, Doha)
• English widely spoken in medical facilities
• Expensive without insurance

Diabetes-Friendly Travel Tips

Food & Dining Strategies

Restaurant Dining:

• Research restaurants in advance (carb-friendly options)
• Apps: HappyCow (plant-based), MyFitnessPal (carb counting)
• Choose protein + vegetable-heavy meals
• Ask about ingredients if uncertain
• Request sauces on side (often contain sugar)
• Don't be afraid to ask for modifications

Snack Packing:

• Nuts (almonds, walnuts) - low carb, filling
• Protein bars (check carb count)
• Cheese sticks (if refrigeration available)
• Beef jerky
• Low-carb crackers
• Nut butter packets

Hypoglycemia Treatment Abroad:

• Learn local terms for juice, candy, sugar
• Coca-Cola available worldwide (fast-acting carbs)
• Honey packets (portable, stable)
• Glucose tablets (bring from home - may not be available)

Dining Out Carb Counting:

• Use Carbs & Cals app (international food database)
• MyFitnessPal has international foods
• Calorie King (restaurant nutrition)
• When in doubt, overestimate carbs slightly

Staying Active Safely

Activity Considerations:

• New activities = unpredictable blood sugar
• Start conservatively (reduce insulin or eat extra)
• Monitor blood sugar before, during, after
• Bring fast-acting carbs on all activities
• Wear medical ID bracelet
• Inform tour guides/companions about diabetes

Water Activities:

• Waterproof CGM with adhesive patches (e.g., Tegaderm)
• Waterproof insulin pump or disconnect and use injections
• Check blood sugar before swimming (aim for 150-180 mg/dL)
• Have juice/glucose gel poolside
• Ocean/lake swimming: have buddy aware of diabetes

High-Altitude Activities:

• Altitude affects blood sugar (usually lowers)
• Monitor more frequently
• CGM may be less accurate at altitude
• Bring backup finger-stick meter
• Adjust insulin conservatively
• Stay very well hydrated

Adventure Travel (Hiking, Trekking):

• Bring 2-3× expected diabetes supplies
• Plan for longer trips than expected (delays)
• Know evacuation options
• Travel with guide familiar with diabetes
• Satellite phone/GPS device if remote

Sleep & Rest

Hotel Accommodations:

• Request mini-fridge (insulin storage)
• Keep room cool (better for insulin and sleep)
• Set multiple alarms (for blood sugar checks if needed)
• Keep glucose tablets on nightstand
• Use CGM low alarms overnight

Managing Sleep Disruption:

• Jet lag affects blood sugar
• Prioritize sleep over perfect blood sugar
• Slightly higher blood sugar acceptable short-term
• Avoid sleeping pills (can mask hypoglycemia symptoms)

Travel Insurance for Diabetes

What to Look For

Essential Coverage:

• Pre-existing condition coverage (diabetes)
• Emergency medical care abroad
• Medical evacuation/repatriation
• Lost/stolen medication replacement
• Trip interruption due to medical emergency
• 24/7 emergency assistance

Recommended Providers (with Diabetes Coverage):

• World Nomads (adventure travel)
• Allianz Travel Insurance
• Travel Guard
• Seven Corners
• IMG Global

Important:

• Read policy carefully (diabetes must be specifically covered)
• Disclose diabetes when applying
• Understand exclusions (DKA may not be covered if deemed preventable)
• Keep policy number and emergency contact in phone and wallet

Using Insurance Abroad

In Case of Emergency:

1. Call insurance emergency hotline (before seeking care if possible)
2. Get pre-authorization for treatment
3. Keep all receipts and medical records
4. File claim promptly (within time limits)
5. Keep copies of all documentation

Claim Documentation:

• Itemized medical bills
• Receipts for medications purchased
• Doctor's notes explaining treatment
• Police report (if supplies stolen)
• Proof of prescriptions

Diabetes Travel Checklist

8 Weeks Before

• Schedule doctor appointment
• Get A1C test
• Obtain doctor's letter
• Get prescriptions for 2× expected supply
• Request early medication refills from insurance
• Purchase travel insurance with diabetes coverage

4 Weeks Before

• Fill all prescriptions
• Purchase extra diabetes supplies
• Buy insulated medication case (FRIO or similar)
• Research medical facilities at destination
• Learn key diabetes phrases in local language
• Download translation app and offline maps

1 Week Before

• Check insulin expiration dates
• Test blood glucose meter accuracy
• Charge all device batteries
• Pack diabetes supplies in carry-on
• Make copies of prescriptions and doctor's letter
• Verify travel insurance coverage

Day Before Travel

• Check blood sugar and adjust insulin for travel day
• Pack fast-acting glucose in multiple locations
• Verify all medications in carry-on
• Print/save emergency contacts
• Set phone alarms for medication times in new time zone

Day of Travel

• Eat regular breakfast
• Bring extra snacks
• Wear medical ID bracelet
• Keep glucose tablets in pocket
• Inform TSA about diabetes supplies

Conclusion

International travel with diabetes is absolutely achievable with proper planning and preparation. Millions of people with diabetes travel safely worldwide every year.

Key Takeaways: ✅ Bring 2× expected diabetes supplies ✅ Always carry insulin and medications in cabin luggage ✅ Use insulated case for insulin in all climates ✅ Bring doctor's letter and prescriptions ✅ Monitor blood sugar more frequently during travel ✅ Adjust insulin for time zones with doctor's guidance ✅ Purchase travel insurance with diabetes coverage ✅ Know emergency numbers and hospital locations at destination ✅ Learn key diabetes phrases in local language ✅ Carry fast-acting glucose at all times

The world is yours to explore - diabetes doesn't have to hold you back!

Safe travels from the MedFly Safe Team!