2 Week Trip to Europe

Hey everyone!

I am going on a two week trip to Spain to visit a friend over my winter break. I was wondering if anyone had any advice on traveling with a time change and in regards to traveling insurance?
I am afraid my blood sugars are going to be completely crazy due to the time change for the first few days. Any advice on how to ease this transition? Also when it comes to traveling insurance- do I need to just got through my current company? This will be my first time traveling outside of a group trip.
I have been to Latin America before with my church (where there was only a 1 hour difference and the church took care of the insurance) So these are new waters for me. Any advice and comments are welcome!
Thank you in advance!! :slight_smile:

HI
I am from Spain and we go three-four weeks each year with my son. He is now 10 years old. We were also wondering about the effect of time change and the truth is that he was just fine. Actually, his readings were amazing, better than ever…
We land around 6am so I change all his routine as soon as we land. We proceed with breakfast around 9am and snack when his BSL tells us so. Lunch around 2pm like the locals and proceed with snacks as needed. Dinner is late, around 9pm.
Then we give him his lantus around 11pm. This routine was in place since the day we landed. And just monitor closely so you have plenty of snacks to balance out until your body gets used to the new scheduled. Surprisingly, he always has great numbers when we are overseas! The food in Spain is great, tons of fish, meats and veggies so carbs are easy to fight. Carbs are complex and the diet is so much well balanced with plenty of ingredients.
Regarding insurance, we do travel with a regular travel insurance that covers emergency room visits. In Spain you can go to a private hospital or a public hospital. Public hospitals are busier but have all the resources for anything serious. Private hospitals are more patient centered and also capable to deal with a regular hypoglycemic or even major things. Travel insurance are not that expensive and that would give you a peace of mind. Keep in mind though that nutrition facts labels are not like here in the USA. And they do not display total carbs “per servings” Many products don’t even have labels.
Good luck and have fun! It is a great place!

I am just back from a 2 week trip to Spain - Barcelona and Madrid. Are you using an insulin pump, or injections?

My first trip to Europe I asked my endocrinologist how to adjust insulin for the flight and then the time change, though I can’t remember exactly what she said. Since I’ve been on the pump it’s much easier.

i also recommend frequently blood testing - I found I was running low a lot due to the walking - we averaged 10 miles a day!

The food is as heavy, or light as you want. Fish, protein (lots of jamon!); but also churros with chocolate (madrid).

Hi!

I travel worldwide for work and I am on Lantus and Humalog and even though I am Type 1 I take Metformin, which is something Type 2 Diabetics typically take. I also wear a CGM, which helps during long flights. In different type zones I adjust my Lantus, so I am still on the same schedule as if I were home. For example I take my Lantus every morning at 10am when I am home, if I am in London I would need to take Lantus at 3pm because of the time change. I take humalog and metformin as I usually do with meals. I notify the airlines and hotels that I am type 1, so they can accommodate meal requests.

Hi there,

If you’re on Lantus and want to take it at the same time of day you normally would, you just have to make some simple adjustments.

This advice is very straightforward:

‘Assume that the patient taking this flight is instead on a regimen of once-daily glargine (24 units at bedtime) with a premeal rapid-acting insulin analog (10 units lispro before each meal). An alternative would be to take the usual dose of glargine at the usual time, say 10:00 p.m. Los Angeles time (this would be on the flight). Twenty-four hours later (i.e., again around 10:00 p.m. Los Angeles time, which would be around 6:00 a.m. London time on the morning of the day after arrival), he can take half his usual glargine dose (12 units). That night at bedtime (London time) he can take the remaining half of his usual glargine dose (12 units), thus keeping the total 24-hour glargine dose the same. Premeal coverage using short-acting insulin would remain the same or be increased if he will be eating more than his usual amount or if there are more meals than usual. The pre-travel regimen of 24 units of glargine at bedtime can be resumed on the third night (second night in London).’

Source of the advice: http://clinical.diabetesjournals.org/content/21/2/82.full

If you’re on a pump, just switch the clock to the new timezone and go about your day as normal. Overseas travel is a piece of cake on the pump!

My only other advice is to always keep your diabetes supplies in your carry-on, take double the supplies you think you need and, if possible, split them with your travel companion. This way, if ANYTHING happens, you have a spare set of supplies.

Have fun! Spain is amazing!

Hi! I spent a year in Switzerland when I was in college and my nurse educator drew me a diagram to help me remember what to do when traveling back and forth. I can’t copy it, but I’ll try to explain it best I can. For context, at the time I was taking 33 units of lantus around 10 pm with humolog before each meal.

Going from Boston to Switzerland: My day was getting 6 hours shorter (leave at 6 pm, spend 6 hours on the plain, arrive at 6 am; losing 25% of my day), so instead of taking my usual 33 units the night I left I took 25 units at 10 pm Boston time (cut it back by ~25%). The night that I arrived I took my usual 33 units at 10 pm Swiss time and continued with my usual routine so long as I was in Europe.

Going from Switzerland to Boston: My day was getting 6 hours longer (leave at 6 am, spend 6 hours on the plane, arrive at 6 pm). Taking extra lantus is tricky; it can peak at weird times. So the night before I left I still took my usual 33 units of insulin at 10 pm Swiss time. This meant there would be a 6-hour period in which I had no basal insulin. Instead of taking extra lantus I took 2 extra doses of humolog during that 6 hour window (or at least checked my blood sugar and corrected as necessary), and then took my usual 33 units of lantus at 10 pm Boston time.

If you have a good doctor or nurse educator you can talk to before you leave, I definitely would. I don’t know if your regiment is anything like mine, so what worked for me might not work well for you.

Oh, and about insurance… I honestly don’t know much about that other than checking the box when I book my tickets saying that I want to pay the extra $8 for travel insurance. [Shrugs] I’m pretty sure that’s more for lost luggage than healthcare. I used to have a Medjet membership, though, so I could be evacuated back to the States in the event of a medical emergency. That was more for when I was traveling to developing countries. Not so much for Switzerland.

If you are on a pump, you may want to disconnect the tubing at the infusion site and leave it disconnected for the 20-30 minutes of descent before landing. (Remember to set an alarm to remind you to reconnect after you land!!!)

As the cabin pressure changes and the insulin in your tubing expands, that may push a little more insulin than you expect. The result: the low blood sugars pumpers frequently report experiencing at the baggage pickup after the flight.