Traveling for Work (Specifically) with Type 1

Hi all. So I am happy to say that I am in line for a new position with a great company and the role requires travel roughly 20% of the time. I have had T1 since 2014 (age 40) and am pretty dialed in after years of trial and error and supportive help from Integrated Diabetes, a T1 concierge endo, JDRF and Beyond Type 1. Im very active - century rides, golf, swimming etc. Current regimen is afrezza for meals on top of tresiba. I like the afrezza as its in and out of your system and i use exercise and a heavier dose of tresiba to level out the protein and low fat diet additions to my veggies and fruits. This said, the afrezza can onboard very quickly and I am wondering whether a pump may better for traveling/entertaining clients due to temp basal functionality. I was on the ominpod years ago and didnt necessarily like it…every 3rd day change, PDM etc. Just looking for specific traveling for work tips and current regimen guidance more importantly. I am going to limit alcohol, keep to known foods and try day trips where possible. thanks for all of the help.

I love my pump - TSlim, running CIQ with Dexcom’s CGM (sensor is changed every 10 days). I am supposed to change pump site every 3 days, as you did with your Omnipod, although sometimes I go 4 with no apparent problems.
As much as I appreciate the convenience of pumping, if a person is doing well on and happy with shots and there’s no compelling need to change, and they’re not excited/highly motivated to use a pump - I suggest they consider staying on injections. It sounds like you’ve found what works for you, and no doubt can make any necessary adaptations to your new job when the time comes (congratulations, by the way!). And while there are formulas doctors use to determine your initial settings, that will probably take some tweaking to find what works best. That might be difficult with a new job.
That said, I wouldn’t want to discourage you if you truly are interested. Just make sure you’re happy with your reasons for changing.

IMO @csnash1 from what you wrote and my several decades living with diabetes and occasional travel for both business and pleasure [less than 20% of life], you will do well with your background insulin schedule and your inhaled insulin. From what an acquaintance has told me about his success using the two insulin formulations that you use, your results will be better than with the “limitations” of a pump. The acquaintance I mentioned is very active and has had irregular meal schedule for the last three years while hiking all mountain ranges in US.

My experience when business travel required time-zone changes and long days with spread out meal times such as breakfast in Boston at 6 AM, a couple of lunches - one in air the second with colleagues in SF - and then cocktail hour snacks with business dinner at 8 PM Calif time. Yes, I had a pump for my later years which proved more difficult than my earlier travels managing diabetes with MDI. Your inhaled would have worked better for me, I think.

Enjoy your new position!

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Thank you both. I feel as T1ers we are always curious if there isnt a better solution out there. Greater relief. To each their own seems especially true with this disease but also good to know Im on the right path. Immensely grateful for the advice.

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Hi @csnash1 I travel for work and find myself on an airplane every month. My current long distance projects are in London and Singapore and I’m based in New Jersey. If your current plan is working there’s no need to change it just because you are traveling. It’s a matter of convenience and performance. I do need to adjust my long acting and I find for me that being able to adjust my pump basal rate is super convenient. You don’t day if you have CGM but I find continuous monitoring very useful.

The real thing about travel is eating at restaurants. If you already have a plan and experience with wildly different sugar and fat then you are all set.

Good luck and safe travels.

Thanks Joe and great to hear. I’d love to visit Singapore one of these days. Yes to CGM not sure how life existed before without it.

And yes restaurants/flights/entertaining pose a challenge albeit all doable but that’s why I thought perhaps having the ability to set a temp increase and eating lower carb may be useful and frankly I may then be able to still bolus with Afrezza. Are you on Tslim or Omnipod?

Just comes down to trade offs between pumps and MDIs I guess. I also have the thought that being able to “float” between regimens is good for management of this disease. Make periodic changes. I’m a different person today then when I was on an omnipod 4 years ago.

Again thanks for all of this advice.

totally agree with “trade-off” no single system is perfect. I do like to be able to set temp basal - and I also like to not have to remember when my long acting shot needs to go in due to +/- UTC it can make me crazy. With a pump I just reset the time and no need to adjust when I do the long acting shot. Full disclosure, I do have strange high BS during flights about 50% of the time. I am using a medtronic pump (an old one, no fancy feedback) and the reservoir could be affected by cabin pressure. My last flight from London I needed 12 units to correct a high bs that should have only needed 2 units. In about 600,000 flight miles I have never had a unexplained low or emergency low BS.

Interesting and I love that last comment regarding no lows…with Gvoke and Baqsimi on the market there is added assurance. And something your comment regarding strange highs speaks to which I think is valuable is how any regimen requires us to learn how to deal with/take in stride the nuances and shortcomings that it presents. No silver bullet how much we all long for one. All good stuff and appreciate the guidance Joe. I like how you seemingly dont slow down cause of T1. I am trying to lean in myself.

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I am a tslimx2 user. I have traveled a couple of times for work always through multiple time zones. I love the adjustability of my pump but when traveling it brings an extra set of worries as how many extra supplies to bring and then getting through airport security. The last time i was in Denver it took me an extra 65min to get through security compared to rest of my family because you can’t go throught the scanner with a pump. I ruined a medtronic 670g going through the scanner at Orlando out of fear of missing my flight. My pump malfunctioned about halfway home and medtronic blamed the scanner so I am as well. So if your current system works well for you i wouldn’t change it.