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Long haul travel and 6yo with type 1

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Mummy2type1

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Hi, I’m new here. Recent type 1 diagnosis for my 6yo daughter. Massively overwhelming but starting to get our heads around carb counting etc.
We have a ‘once in a lifetime’ holiday planned to Thailand. It’s been a year in the planning and is fast approaching. Things have obviously become complicated by the diagnosis but the children are so looking forward to going and we would like to still go. We’ve heard lots of people saying that it shouldn’t prevent my daughter from doing anything she wants to but I just wondered if anyone has experienced long haul flights and time zone changes with a child with type 1? Just looking for some advice/tips which may be useful. Thank you in advance
 
Welcome @Mummy2type1 🙂 I definitely agree you should go! I have Type 1 myself and have travelled long haul. There are a few basic things:

- appropriate travel insurance
- take a doctor’s letter to help at Security, along with a copy of her prescription
- take at least twice as much of everything as you think she’ll need
- keep all insulin with you in the cabin

What insulins does she take? Does she have a Libre?
 
Thank you so much for your reply.
Great advice too.
She has levemir once in the evening and her bolts is Novorapid
 
Inka said:
Welcome @Mummy2type1 🙂 I definitely agree you should go! I have Type 1 myself and have travelled long haul. There are a few basic things:

- appropriate travel insurance
- take a doctor’s letter to help at Security, along with a copy of her prescription
- take at least twice as much of everything as you think she’ll need
- keep all insulin with you in the cabin

What insulins does she take? Does she have a Libre?
Click to expand...
Thank you so much for your reply. Great advice.
I’m feeling very daunted by the whole thing
She’s taking levemir (once in the evening) and her bolus is Novorapid.
 
Inka said:
take a doctor’s letter to help at Security, along with a copy of her prescription
Click to expand...
I have seen you mention the need to take a copy of your prescription when travelling. Have you ever been asked for this? Thankfully, it is not something I have been asked for because my prescription is no longer provided in paper format. I guess I could bring up my NHS app on my phone which has my prescription items but I a, not sure sure if that would be recognised outside the UK.
To be honest, in twenty years and hundreds of flights, I have only needed to show my letter once but will always carry it as “insurance”.
 
@Mummy2type1 as I mentioned, I have flown many times, including long haul and sometimes to some pretty out of the way places and never experienced any issues. I have never done it as a child with Type 1 but agree with @Inka that we shouldn’t let diabetes dictate our lives.

I would discuss with her DSN the best way to handle the time difference. I now have an insulin pump which handles it well. But used to travel with Lantus that was taken once a day and had a bit of flexibility when to take it. I have not travelled across multiple time zones with Levemir but it should be easier as it is taken twice a day.
I always tried to take my long acting insulin around the same time of day (rather than the middle of the day or night). Some people handle this by taking less on the travel day and others handle it by moving the time by a couple of hours each day depending.

As well as taking all insulin in hand luggage, I would also recommend keeping hypo treatment with you in your seat. I once had a hypo whilst taking off and my hypo treatment was in the overhead lockers. I have never made that mistake again.

If you are concerned about airport security, some airports (e.g. Heathrow) have a “secret” security area for people and families who may have additional issues or concerns. I only used this once but it was far quieter.
 
No, I’ve never been asked for my prescription specifically @helli but I did show it once as part of my proof, along with my doctor letter as I was having an unusually slow time at security in that country and they seemed to be peering at my sharps and insulin and staring at me. That was very unusual so I got out everything I had and showed it to them, including the prescription. They definitely looked at the prescription. On that same trip, I needed non-diabetic meds while in the country which I’d need to take home on the plane with me and the doctor wrote me something to show Security.

I just take the green sheets they give you back when you collect a prescription, not anything special. It all goes in a special wallet with my passport, tickets, etc, so easy to take.
 
May I suggest that in addition you get a Sunflower Lanyard for your daughter for the journey. It signifies a "hidden disability" and usually you will be ushered through the fast track security (or be ushered to the front of the normal queue) at the airport swiftly and with minumum fuss if she is wearing it. You can get it by post ahead of travelling. See this website. https://www.heathrowexpress.com/sunflower#/
 
@Mummy2type1 Re the injections, I just took my bolus as needed and calculated when to take my basal. It depends on whether you’re flying East or West, the time difference and your flight times. Sometimes you need to ‘stretch’ the insulin over a longer day, other times you need to reduce the amount as you’ll be having a shorter day.
 
Our DSN is super helpful with travel plans. They should come up with a plan for you. We’re told to take twice as much of everything as we think we’ll need and we split it between our cabin bags. We use frio pouces for insulin to keep it cool and take a copy of the prescription and a letter from the DSN. You can keep the basal on UK time (or close to) or move it back by an hour a day. Have lots of hypo treatments with you and we take our scales and copy of carbs and cals. My kid has been diabetic for 5 years now so I can guesstimate a plate of food pretty well but you won’t have had that practice yet. The carbs and cals book is handy because you can see portion sizes so you don’t have to weight everything.

At the airport if you buy drinks from the shops airside you can take them on the plane (boots is often the cheapest place for food and drink funnily enough).

Don’t forget to take your ketone strips and meter. And take a small sharps bin and check with the hotel what the local options are for sharps. We use an empty strips canister for carrying around with us but have a proper sharps bin for the hotel room and empty into it.
 
As others have said there is no reason not to go, but I recognise that there are a ‘few extra things’ to take account of. However they are doable.

You mention that your daughter is on Levemir. This basal insulin is often split into two doses, one for the morning and another for the evening, but I don’t know whether that is the same with children. It might be worth asking about this with your PDSN as I wonder whether that would make shifting the injections in the time zone easier. Your PDSN will have helped loads of other families with holiday plans such as yours and they will come up with a plan.

The sunshine lanyard can be very helpful at some airports where you may well be ushered through a much shorter channel where the staff are more used to things that are unusual. Having said that our pens and pumps are now something they don’t get bothered by.

It sounds like you are going to have a trip of a lifetime.
 
@SB2015 The OP mentions her daughter has the Levemir once a day and, in a way, that might make it easier because there’s the option of splitting or reducing to fit the required amount into the travel ‘day’, with a split being very common when travelling. Keeping/manipulating two basal injections would probably be more confusing.
 
Inka said:
@SB2015 The OP mentions her daughter has the Levemir once a day and, in a way, that might make it easier because there’s the option of splitting or reducing to fit the required amount into the travel ‘day’, with a split being very common when travelling.
Click to expand...
Thanks Inka. I spotted that but wondered whether, with time differences (and I didn’t check their destination) the split dose could then mean no change needed once there.
I am sure their PDSN will have a plan.
 
I tried to do the Maths and that was ok, but without knowing the departure/arrival time, it’s not really possible. There are percentages relating to how many time zones you cross, but I mainly use the home and local times plus flight departure/arrivals. Although some of the websites have ridiculously complicated calculations, it’s actually not too hard with a bit of common sense. An important thing is to avoid hypos when travelling so if in doubt I always err on the side of caution.
 
Take sufficient snacks to cover her needs, be careful to not let her get dehydrated - I was diagnosed at 7 and recall (though in very little detail - it was a long time ago) going on holiday to Spain. I got dehydrated which then made my blood sugars very erratic, so much so that we ended up coming home pretty swiftly.

I've travelled a lot since then without any problems, but I would still always ensure I have enough fast acting carbs to get me out of trouble - especially if you don't really fancy eating (general travel exhaustion, heat exhaustion, food poisoning, don't like the food, etc.) with that said life is easier now that one is not committed at breakfast time (one injection a day of mixed insulins when I started out many years ago).

In more recent years I used to "migrate" the basal dose to a suitable time (doing this on mixed insulins was an interesting experiment though it usually worked quite effectively), usually by splitting dose while in the air and filling any obvious highs with bolus corrections (on e.g. a flight to Australia - though I tend to run low when travelling so not a major issue). I now split my basal anyway which makes life easier - even at home I don't worry too much about a 4h difference in dose timing from day to day (e.g. very early start for a meeting vs lie in at the weekend, or early night vs night out).

It'll all be fine, have fun and enjoy it 🙂
 
Mummy2type1 said:
Hi, I’m new here. Recent type 1 diagnosis for my 6yo daughter. Massively overwhelming but starting to get our heads around carb counting etc.
We have a ‘once in a lifetime’ holiday planned to Thailand. It’s been a year in the planning and is fast approaching. Things have obviously become complicated by the diagnosis but the children are so looking forward to going and we would like to still go. We’ve heard lots of people saying that it shouldn’t prevent my daughter from doing anything she wants to but I just wondered if anyone has experienced long haul flights and time zone changes with a child with type 1? Just looking for some advice/tips which may be useful. Thank you in advance
Click to expand...
Are you flying direct UK to Thailand, or transmitting in Qatar or Dubai? How long are you going for?

The reason I ask is a stopover is a mixed blessing, but sort of punctuates the time changes about half way, and also gives a better chance to stretch your legs than strolling around the plane.

I’m not T1, but maybe ask your daughters clinic for guidance on how to handle insulins whilst travelling.

Thailand is a wonderful country. It’s currently 18:30 and still 28c, so drinking plenty is really important.
 
Thank you all so much, some fabulous, practical advice and tips. Really appreciate it. It’s my first time using a forum. Thanks for your kindness. We have a meeting with the consultant tomorrow and they are going to help with a plan for the time zone adjustments We are due to fly 12th feb so will let you know how we get on. Thanks again
 
Hello all, sorry to have taken so long, but I promised I would update you. We had the most wonderful time in Thailand!!! The flight, (great advice about the sunflower lanyard!) was seamless. Glad, as advised that we took plants of snacks onboard as my little one did have a hypo just as we were taking off and didn’t really like the plane food so we had plenty of alternatives which meant it was actually an exciting experience.
We were basically guessing carb content and very much ‘winging it’ in Thailand but the warm weather and constant swimming seemed to mean her glucose control was the best it had been! Thank you for all your useful advice. It really helped reassure me.
We are already starting to look into planning our next holiday.
 
helli said:
I have only needed to show my letter once
Click to expand...
I must have a dodgy face, because I’ve always had to show my letter to Mr or Mrs Officious.

So glad to hear the holiday was brilliant and your daughter’s diabetes wasn’t a problem @Mummy2type1. :D
 
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