Remote traveling with T1D

I have a 10 year old son who was recently diagnosed. Before all of this happened, our family was planning to take a road trip to see some of the national parks out west. We are definitely not giving up on the idea, but wondering how to deal with potentially being in very rural areas during our drive. We will try to go in the spring so we don’t have to deal with as many extreme temperatures or weather issues. But I’m a bit worried about being in the middle of nowhere and having issues. Has anyone else braved this sort of trip? How did you prepare for the unexpected?

I have never been out west, even though I want to really badly, but I have been quiet aways from home and in no places to stop to get anything for a low bloodsugar. When I was younger, my grandparents always brought a cooler with milk and juice in it if I went low. They sometimes brought nuts (I’m not allergic. If your son or anyone is in your family try sunflower seeds) because they have protein and helped stabilized it. Other goodd things to bring, I found, were sweetened applesauce and fruits. Also, glucose tabs or gel can really help. Hope this helps!! :grinning:

@marialauren1981 hi Maria,

please learn all you can about diabetes - I am sure you know by now that the game is to balance insulin, activity, and carbs the best you can. You can get high blood sugar and low blood sugar “protocols” (instruction sets giving you strategy), and I would also suggest a “sick day” protocol.

You will soon learn that a doctor is not going to be 100% available when you need a decision “now”. In a low blood sugar, you are the primary care doctor and need to be comfortable with what to do. It might be possible to get a mobile number from a willing CDE, but even with - you will still need to make the medical decisions.

This is a lot easier with practice. I have hiked and mountain biked into very remote areas and travel the world for work.

dry carbs that won’t spoil are your best bet. examples are skittles and glucose tabs. fats and proteins are not recommended because mixing a fast carb with fat, protein, or even fiber, will delay blood sugar rise and if you need a fast carb - you don’t want a delay if you are low.

IMO, a severe low leading to loss of consciousness is the most likely emergency. If you test often, and are familiar with what to do, a severe low blood sugar is avoidable. In the unlikely event your son passes out, you will need a glucagon kit and you will need to be ready and able to make that injection.

The other potential emergency is diabetic ketoacidosis (DKA). This is the big risk in a remote area because you need access to a hospital if this happens. if you have insulin in your system, DKA is unlikely, but an idea of how you are gong to get to a hospital is necessary. keto strips, water, and proper use of insulin will typically help you avoid DKA but you need to know the signs and have an emergency plan. Please do not rely on google searches for this, please talk to a CDE and a endo and others with real experience.

the fortunate thing is that - even if you are in the woods, this is US and help is typically not that far away. It could be much worse.

bring enough supplies to last, obviously for longer than your trip, and don’t forget to have fun

Hi Maria @marialauren1981, I echo the advice provided by @Joe, especially his first paragraph about learning now how activities, foods and insulin affect him - and he must learn this too and also learn to recognize when he feels his BG dropping. If he can recognize when he is going low, he could avoid hypoglycemic events.

You don’t mention his diabetes therapy protocol si I’ll suggest that if he is using a pump that he learn now how to manage with vials & syringe or with pens. Also, that in addition to him packing and carrying his medical supplies and equipment, that another family member carry back-up supplies in a separate pack - I’ve seen a backpack slide off and disappear in a ravine. My boy scout days, “Be Prepared”.

Have a great time on your adventure, and let him be a boy and not a patient. At ten or eleven years old he will want to be an adventurer and maybe go off on his own exploring - let him be like his siblings and companions.

Ive had T1 x 46 yrs and Ive never let it stop me from traveling, one of my favorite things. With planning, this can be a very good time and teach your son that T1 can’t stop him from doing whatever he wants. Planning and anticipation is the key.
I start by making lists of what I will need and what I might need. If I’m driving I check my routes and places along the way to stop. I always have glucose tabs, hard candy, and cola along with snacks and sugar free drinks. I wear a Dexcom G5 which is invaluable because I have hypo-glycemia unawareness… I can’t feel my lows. When I’m packing supplies, I always double up; two of everything including insulin pens, batteries for my meter, pen needles, ect. This is in anticipation of being delayed or stuck and having enough supplies. And also in anticipation, just in case, I find out where the nearest medical facility is. Once at the beach, I came down with a brutal urinary tract infection which I needed immediate treatment for.
This past summer, I drove myself and daughter to both Ohio and Virginia. With planning and frequent rest stops, we did great and made it to and back home safely. I’ve also been to Europe which was fantastic. Please don’t let T1 stop you and your family from traveling. Your kids are that age when they still want to go see and try new things out. Your son will do fine.

I’ve had type 1 for 42 years and never let it stop me from traveling or doing anything else. As others have said learn as much as you can and prepare for the worse. Bring duplicates and keep them in different places, such as different suitcases or bags. When I was relying on pens and syringes. I kept 1 set to use and one set in the room safe as a reserve just in case. Most times you never need it but that one time it can be a life saver. My wife and I went on a trip to Maui for our honeymoon, and while on a tour around the island I lost my insulin case. Had a light snack instead of lunch and got my sugar under control with my spare kit when I got back the room,

Hi. Our 10yo daughter was dx in March. We just did a road trip last month up California and into Oregon. She is not on cgm or anything. I made sure that I had plenty of needles for her insulin, a disposal container, I bought this cool pack thing from Amazon that doesn’t make the insulin cold, but it doesn’t let it get hot either. Took all her supplies, keytone strips, antinausea pills, glucagon, etc. all in a big back pack. I also ordered her go to snacks (protein bars, beef jerkey, tuna packets, smart popcorn, jiff to go) and had those in the car. We tried to eat a places where we could look up the food in the Calorie King book, but of course there were places we could not look up. She did okay. She ate Clam Chowder in Monterrey, Calamari in San Francisco, Salmon in Oregon, Pizza, etc. We dosed up her novalog/Humalog (I can never remember which one it is) for the extra carbs her endo said 1ml/12carbs. We had an awesome time, a few highs some times, but at the end of the trip, she looked at me with big tears in her eyes and said “thank you, that was the first time since I was diagnosed, where I actually felt normal again.” It broke my heart, but I understood what she meant. We made it work. Hope this inspires you. Also keep in mind you can go to grocery store and get tv dinner, has carbs on it so you know and cook in hotel microwave if necessary. At least you will be certain how many carbs are there. Good luck, go and have fun!

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Maria, there is very good advice in all of the comments above. I have been a T1D for 18 years and have traveled extensively during that time all around the world, including India and China. There are some very common sense steps to take, all of which were mentioned above. Personally I make sure that I plenty of supplies and snacks in my carryon and extra backups in my checked luggage while flying. You did not mention whether your son was on a CGM, but if he is, one thing to keep in mind is the warm up periods for new sensors, which is like 2 hours with the Dexcom G5 and like 12 hours with the Freestyle Libre. So if he is on a CGM, take along a regular monitor everywhere you go, just to be safe. In addition, a CGM or a pump can be affected by high altitude, so if he is using either check the manufacturers user guide for high altitude situations you may encounter. I hike Rocky Mountain National Park regularly each summer and have even hiked a 14er here in Colorado. Throughout all of these hikes, I have only once experienced a high-altitude issue with my pump.

The best advice I can give you though is to let your kid be a kid, and do not shy away from any travel adventure in the slightest. He may develop resentment if he senses that his parents are short changing the trip out of an abundance of caution. Having said that, try simply to be prepared for any imagined situation that might arise. And most of all embrace the experience and enjoy the trip.

I have had Type 1 for 52 years now and have lived all my life on a sailboat with no engine blowing around the islands. Have had a good number of low blood events and am very familiar with being in remote places that have no help available. During that time I have never had refrigeration and have used insulin that was 2 years out of date at the time and had never been refrigerated since it was purchased. It worked just fine. Please do remember to take glucagon with you in case of any real low problems. Have had to start getting mine from Europe as the prices and availability in the US have become extreme problems. The profit being taken from anyone with a chronic condition in the US is a very shameful thing. I guess it will only get worse as long as we have a monetary system dragging us all down. It will of coarse be necessary for him to train himself to carry double or triple glucose supply ESPECIALLY when off by himself. And always plan for the unexpected. Good luck and I do hope for all of us that they will release the correction for this problem soon.

I’ve been T1d for about 45 years, and have travelled as much as I possibly can. All the suggestions you’ve received are amazing! The only other thing I can suggest you bring with you are phone numbers: for your son’s endo/CDE, your pharmacy, the tech support of any manufacturer of electronics he uses (like cgm, pump), and if your insurance has it, the nurse direct and/or on-line medical options. (My husband and I were in Mexico when I developed a crack in my waterproof pump. Thank goodness I had my CDE’s phone number with me to figure out what I needed!) Hopefully you won’t need to use any of them, but when you’re in a stressful situation, it’s easier to grab the number out of a file than to go online and find it! Enjoy your trip, and keep in your mind your son is a 10 year old with diabetes, not a diabetic who is 10!!

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