Although wearing a medic-alert bracelet, necklace, or tattoo is good for identifying a diabetic in an emergency, many police officers suggest also carrying a card that identifies a person as diabetic (one in a wallet with the driver’s license and one with the car registration in case the other gets misplaced). There are several medic-alert cards that a diabetic, types 1 and 2, and gestational, can use, including those offered by the American Diabetes Association. Not only should the identification include information about the signs of low and high blood glucose (hypo- and hyperglycemia, respectively), but it also should carry a list of suggestions as to how the first responder can help treat both conditions.
Is it better for a person with diabetes to bring his or her own food when traveling?
This is a matter of personal preference. Some conditions do not warrant bringing foods, and there are even certain airlines, especially those from overseas, that do not allow certain foods to be carried on board owing to contamination risks.
What items should a person with diabetes carry on a trip?
Most people don’t leave behind their medicine when they embark on a trip, and a person with diabetes will need to remember not only medicine but also several items that may be vital to keep his or her blood glucose at a safe level. Bringing the proper supplies takes some planning, especially for people on insulin. On an extended trip, most people with diabetes carry snacks and supplies. They also have their blood glucose meter available and often a glucagon kit in case of a hypoglycemic episode.
How can a person with diabetes handle eating on a long trip?
For most diabetics, eating is often a trial when traveling long or short distances, and longer distances are the most challenging.
Thus, most health care professionals suggest that a person with diabetes should stop frequently for meals if possible in order to keep his or her blood sugar levels balanced or should carry enough food to keep levels even.
For insulin-dependent diabetics, knowing how their glucose levels respond to insulin and meals is necessary.
And for those on oral medication, how much and what can be consumed in terms of food is necessary to know.
This does not mean people with diabetes cannot celebrate on a trip, but it is important that they know how certain foods affect them. (For more about eating out, see the chapter “Shopping for Food and Eating Out.”)
Will the temperature in various places visited during a trip affect a diabetic’s insulin and/or diabetic medications?
Y es, temperature can affect some of the medications taken by a diabetic. In particular, insulin should be kept cool, but not frozen, as freezing destroys the insulin. In fact, if insulin is stored beyond 30 days, it should be refrigerated. (For more about taking care of diabetic medications, see the chapter “Taking Charge of Diabetes.”) There are even special coolers for diabetics who are traveling.
What are some conversion tables for blood glucose monitoring during travel outside the United States?
Not all glucose monitors are created equal.
Therefore, it is necessary when traveling outside the United States (or for people coming into the United States) for diabetics to understand the differences in glucose monitoring.
In the United States, monitors use milligrams per deciliter; in other countries, it is thousandths of a mole (mmol; a mole is the amount of any chemical substance that equals the number of atoms in 12 grams of carbon, 2) per liter.
The following chart gives some of those conversions
Converting Moles per Liter to Milligrams per Deciliter
Mmol/l
mg/dl
0.06
0.07
0.28
0.29
0.55
0.56
2.2
2.3
2.8
2.9
3.3
3.4
3.9
3.10
1.4
1.5
5.5
5.6
6.1
6.2
7.2
7.3
8.3
8.4
9.4
9.5
11.1
11.2
13.9
13.10
16.6
16.7
20.0
21.0
22.2
22.3
27.7
27.8
40.0
41.0
50.0
Is there a cruise line that caters to people who need dialysis?
Yes, as of this writing, there is a cruise line that offers dialysis (link to http://www.dialysisatsea.com ). But it does take planning. In addition, the services are usually not covered by insurance, and the times of travel vary widely. Another option for people who need dialysis may be to arrange for dialysis ahead of time at the cruise ship’s ports of call, something that a person’s home dialysis center may be able to help set up.
Do cruise lines cater to people with diabetes?
For many people, going on a cruise is a lifetime dream.
But for a person with diabetes, it’s vital to understand what the cruise line of choice has to offer in terms of accommodations, foods and beverages, and medical facilities.
For example, some cruise lines provide nutritional information, especially carbohydrate counts, that is important to a person with diabetes to maintain blood glucose levels.
Thus, according to many diabetes organizations, the best way for a person with diabetes to approach a cruise is to ask questions and be prepared.
Cruise ships will make arrangements for the dietary needs of vacationers.
PREPARING FOR DISASTERS AND EMERGENCIES
Why should a person with diabetes prepare for possible disasters?
Disasters force people to leave their homes or offices quickly.
Such emergencies can include train derailments or gas explosions or natural disasters, such as hurricanes, earthquakes, or tornadoes.
Because a person with diabetes needs certain foods and medicine, diabetes organizations recommend that a diabetic have an emergency package to grab in times of emergency or disasters.
Also, in temporary shelters, people with diabetes should identify themselves as such so they can get proper care if it’s available.
What are some tips to help people with diabetes plan for emergencies?
According to the Centers for Disease Control and Prevention, there are ways for a person with diabetes to prepare for a possible emergency or disaster. This is particularly important if the person lives in an area with the potential for natural emergencies (such as floods, snowstorms, tornadoes, hurricanes, or earthquakes). The following lists some of these suggestions, which can apply not only to an adult with diabetes but also to a family who has a child with diabetes (for more about websites that help a person with diabetes plan for an emergency, see the chapter “Resources, Websites, and Apps”):
• Prepare an emergency supply of food and water, along with an adequate supply of medicine and medical supplies in an emergency kit.
This should be a three-day supply for most areas, but amounts depend on the needs of the person.
For more disaster-prone areas, it is probably best to have at least a week’s supply or more. (The person with diabetes should ask a pharmacist or health care provider, if the medications come from them, how to properly store the prescription medicines during an emergency.)
• Keep a list of all the medicines (and any other medical information that may be important) handy. Most people keep such information on the refrigerator or on a kitchen or bathroom cabinet door. In case the person with diabetes cannot communicate during an emergency, a list is especially helpful to emergency personnel or others assisting the person with diabetes.
• Keep a copy of all prescriptions and other important medical information in the emergency kit, along with the name and phone number of the health care provider(s) of the person with diabetes.
• Keep a list of the types, model numbers, and number of medical devices used by the person who has diabetes.
• Before an emergency happens, the person with diabetes, especially if he or she needs insulin, should plan how to handle medicine that normally requires refrigeration.
• Periodically check the expiration dates on the medicines and supplies in the emergency kit, so there is not a problem if there is an emergency.
• The person with diabetes, or a person who is providing him or her health care, should keep the emergency kit in easy reach in case of an emergency. The last thing a person wants in an emergency is to be unable to find necessary medications and equipment.
• If a person with diabetes needs certain medical treatments, for example, kidney dialysis, it is best to ask the health care provider (or the person who administers the treatment) about emergency plans to care for the patient.
• A person with diabetes should always wear identification that says he or she has diabetes. In addition, a person with diabetes should carry an emergency identification card at all times, especially when traveling, whether close to or far away from home.
• A person with diabetes who takes insulin should find out from the health care provider what to do if the insulin (or any other necessary medication) runs out during an emergency.
How can parents protect their child with diabetes at school before an emergency happens?
If a parent has a child with diabetes at school, there are additional preparations that can be made in case of an emergency. According to the Centers for Disease Control and Prevention, parents can add several items to the adult emergency preparedness list (above) in order to help their child:
• If a child has diabetes, and is in school or day care, understand the school’s emergency plans, so there will be no added confusion in an already-confusing emergency situation.
• Make sure the school or day care has the supplies needed for the child with diabetes before an emergency happens.
• Ask the school or day care whether anyone there could help the child with diabetes in case medications or injections are needed during an emergency.
What is geoenvironmental diabetology?
Geoenvironmental diabetology is the name for studies of how environmental stressors have negative effects on people with diabetes.
It also includes studies of the interaction between the environment and people with diabetes.
An even more specific definition of the research in this field is the study of how geophysical phenomena affect people with diabetes, including effects on metabolism; equipment, medications, supplies, access to care, and how people with diabetes cope with extreme natural circumstances.
Researchers in this field examine such events as natural disasters (for example, earthquakes) and extreme weather (hurricanes, extreme cold, and heat waves).
The study does not include how events in the physical world might trigger the disease but how environmental factors affect people with the disease.
For example, geoenvironmental diabetology studies of the Kobe and Mid-Niigata earthquakes in Japan (January 17, 1995, and October 2004, respectively) indicated a significant worsening of HbA1c levels in people with diabetes for up to six months following the disasters.
In these cases, people with diabetes could not get to their medications and supplies, and medical care was disrupted.
Most people lost insulin vials, needles, and other diabetes equipment because of the destruction.
Such studies help officials and nongovernmental organizations determine and anticipate the best way to provide people with diabetes relief after natural disasters.
These studies do not apply only to one area of the world but to many places that experience natural disasters.
This field is in its infancy; many researchers believe it has a place in the modern world, especially with an expanding population exposed to extreme geologic and weather events.
In addition, in many places, there is the threat of global climate change that many people, and many with diabetes, face.