These are all questions I wondered before my first ever flight with diabetes. Pre diagnosis, I had only flown to Spain couple of times, but not long after diagnosis, I was on a flight to Paris with my best friend! I also flew back to Spain two more times with the family (because who doesn't love Spain?) My mum was so worried, as I can imagine diabetic mothers would be, so to help ease their nerves and yours, here is all the information I learnt about flying with type 1 diabetes and hopefully you find it useful and reassuring to know it’s a breeze!
When I was first diagnosed, I was given a lot misinformed and wrong information, so in true Cazzy style (yes, that's a style) I decided to do my own research and find out for myself what answers are right and what are wrong. The first answer to this question was no, however, the real answer is YES. Of course you can inject on board! Insulin makers did consider us travellers taking 15 hour flights around the world! Your insulin is taken as you normally would, via pen or pump.
I had never done this, but then my DSN mentioned that on my long haul flight to Bangladesh, it's a good idea to disconnect on takeoff & landing. I never really understood why, but a quick google search provided the answer, and the reasoning is logical...pressure! Just like your ears can't handle the pressure, the subtle workings of an insulin pump can't either, so disconnection during ascent and descent is key to a healthy pump.
Also, the air pressure causes the wonderful little air bubbles we love to have in our pump (I am sure you can relate to my sarcasm ) to deliver extra insulin into your body without you or the pump actually knowing. This means you are at a higher risk of taking a low….BUT this is unlikely as it will be 1-2 units (even if that) that can potentially enter your body! (Side- note, it is likely to have an effect on babies and children as they are usually on such low amounts of insulin)
Lesson here? Disconnect when you go up, check & prime, and repeat when you go down and tadaaa, perfect blood sugars (if only, eh), but at least a perfectly working pump!
I used this method on my 12 hour flight to Rio and it worked wonderfully.
Oh airplane food, you either love or hate it. I, however, am a lover. I've never experienced a bad meal yet, or maybe I am just really lucky, or just not that fussy, either way, I love it! (The free alcohol on long haul flights probably helps with the enjoyment)
I will just get this out of the way, I have never and will never order a “diabetic meal”. I understand why they are there...perhaps for the type 2 diabetics of the world? (The description always says they're low in fat) But for us, no need! Order the normal meal (unless you're vegetarian, celiac, or anything else, I reckon it would be a lot tastier.
Now you're wondering, how do I carb count these meals when there is no packaging? Honestly? Practice. It takes practice, and I have practiced, but if you want a guide, then the best book/app in the counting carbs world is ‘Carbs & Cals’.This book gives you a visual representation of a portion size of any food and the estimated carbs in it. It may not be perfect, and your bloods may run a little higher than you're expecting, but nothing extreme, and nothing that can't be fixed! You could also contact the airline beforehand and ask them for nutritional information.
Some meals are more difficult than others to carb count to get the right amount of insulin & this will be more difficult on particular airlines. For example, when flying within asia, everything they offered food wise had rice with it (one had noodles and I did a mini fist pump.) Rice for me is a no go, not only because it VERY annoying to try and get my bloods balanced with it, but it's also hurts my tummy! So in this case, I just ate the meat and left the rice. In other instances if I want to give my blood sugars a rest, or I am anxious I may not be able to get the right insulin balance, I just eat the protein in the meal and a little bit of the carbs that come in packaging (snack packs etc) that have the carbs written on them. Or you can always bring your own food on board with you and just take advantage of the free beverages!
So, if you are confident at carb counting and just need a visual aid, then carbs & cals is for you! Or if you are a little anxious and just want to make it through the flight without a hypo or extreme thirst, then stick to your meats & veg! ( I have actually asked an airline to double the meat in place of a rice pot- and they happily provided me with it)
One of the joys of being diabetic is being told the wonderful scare stories about how our feet are going to fall off if we don't have good blood sugars. So, I always like to try manage my feet the best I can, and that includes my legs- because they link up!
Many flight socks carry the warning that they are not suitable for people with diabetes. If you have any circulatory problems or complications with your feet, such as ulcers, then speak to your GP before using them. If, however, your feet and legs are generally healthy and you are normally active, using flight socks is unlikely to do you any harm.
I have used them on long-haul flights safely and will continue to do so.
When travelling you should bring a mini sharps box with you- you can find these online. But if it's a short trip, you can bring a small medication box that's empty and use that. You just bring it to a pharmacy and they will dispose of it for you.
Side note: If you are on set insulin doses- i.e, An exact amount in the morning, lunch & evening, then firstly, I urge you not to go on an adventurous trip just yet. You need to know how to carb count, otherwise your blood sugars will be out of control and result in sickness and possible hospital admissions! DAFNE (Dose Adjustment For Normal Eating) courses are the UK based go to course- and the one I did, 4 months after diagnosis. Not carb counting restricts your life and the opportunities available to you. Take a course! (You can do them online now too)
If you are on set insulin doses and taking a holiday for a short period of time, then remember you can check with airlines pre-travel for the timing of meals so that insulin doses can be planned.
I would love to hear your thoughts below so get involved!
**Remember to always consult your DSN/GP before taking a trip away**