Cocktails/all inclusive and diabetes type 1

[Kwilkins]

My son is a newly diagnosed type 1 diabetic aged 20. He’s due to go on an all inclusive holiday and I wondered if anyone had any experience of this? Can you still have cocktails with fruit juices in? If you have been drinking it seems to recommend that you have a snack before bedtime, do you have to inject for this? Thank you

 

[trophywench]

The reason for that is because a goodly amount of alcohol for the person will reduce their BG and because the liver will be busy trying to get rid of the alcohol, that is likely to then inhibit its capacity to set the process of getting some of the body's 'emergency' stored glucose into the bloodstream - so therefore best have something to eat before bed, so as not to suffer a horrible hypo overnight.

But nobody here can tell him how much of what alcohol for what person or at what time any of this is likely to happen! With Type 1, we are all our very own science experiment. I'm boring and have usually chosen to err on the side of caution, rather than chance making myself ill where there is no health service let alone 999!

 

[Kwilkins]

The reason for that is because a goodly amount of alcohol for the person will reduce their BG and because the liver will be busy trying to get rid of the alcohol, that is likely to then inhibit its capacity to set the process of getting some of the body's 'emergency' stored glucose into the bloodstream - so therefore best have something to eat before bed, so as not to suffer a horrible hypo overnight.

But nobody here can tell him how much of what alcohol for what person or at what time any of this is likely to happen! With Type 1, we are all our very own science experiment. I'm boring and have usually chosen to err on the side of caution, rather than chance making myself ill where there is no health service let alone 999!

Thank you, does this mean you don’t take insulin before you have a snack at bedtime after drinking.
He’s just trying to work out what he can drink whilst being careful, but still enjoying himself

 

[Lucyr]

He’s just trying to work out what he can drink whilst being careful, but still enjoying himself

The best way to find out what works for him is to practice really.

 

[rebrascora]

Unfortunately it is all very individual as to how each of us will respond to such situations.
As @Lucyr suggests, have a not so "dry run" in the safety of your/his own home. Have a cocktail evening, have some nibbles to go with the drinks and test/scan lots and see how he gets on. Assume he has Libre or other CGM?

If it was me, i would probably bolus for the first fruit juice cocktail because the fruit juice will hit his blood stream very quickly and cause his levels to rise long before the liver scales down it's activity to work on removing the alcohol. To be honest, in that situation, I am not sure I would find fruit juice cocktails worth the BG aggravation and I would just stick with spirits and diet mixers or at least do that after the first fruit cocktail.

Generally you would not bolus for the small carby snack with/after alcohol but if it was a full meal afterwards he may need a partial bolus. If he is going dancing as well as drinking, he will likely need more unbolused carbs for the exercise of dancing as well as the alcohol. Always err on the safe side and have more carbs rather than not enough.

It is really important to keep himself safe when in such situations and particularly abroad where he may not be able to make his medical situation clear to someone whose native tongue is not English and unfortunately a hypo can often be mistaken for being drunk, which means that people can be treated with distain rather than sympathy or recognized to be having a medical emergency, so make sure his friends know to look out for him if you are not going as a family and probably worth having a medical bracelet or pendant to ensure that his diabetes is easily identified if an emergency situation should arise.

Hope he has a great time.

 

[Callista]

I would get him a letter written in the language of the country he's going to, which states he is diabetic, and what effects it may have, and what treatment will be needed.

Ideally, also get him a letter from his GP stating 'officially' that he is diabetic (you will probably have to pay for this.)

Ensure his travel insurance is fit for cover (eg All Clear, StaySure or other travel insurance companies that offer pre-existing medical conditions cover)

If he is going to a country where there may be issues over what he can take into the country, then check the country's foreign travel (or our own UK's guidance) as to whether he needs, say, a doctor's certificate to say he can bring in insulin, sharps/needles, etc, and they won't be confiscated at the border.

Hopefully this is all pretty standard, as there are loads of diabetic holidaymakers, and whatever country he goes to will have their own diabetics as well - sadly it's not rare.

I did all of the above in the case of my son, who has a potentially life-threatening nut-allergy, and in some countries (eg, Dubai IIRC) I needed a doctor's letter saying he had this condition, to give him permission to bring in his Epipen (sharp needle plus adrenaline) through their customs.

Also, and this, I know is 'Mother Hen' (!) tell him you DO WANT to get a brief text from him every 24 hour saying he's still OK. You dont' have to make a big deal out of it, but tell him if he loves you he'll do it !!!!! Better still, and, indeed, 'as well' identify one of his most reliable mates to 'watch out for him' as well, and give the mate your contact details etc.

Also, and I know this is probably 'Extreme MH' (!!), check your own passport is in order, and that you can book an instant Easy-jet flight out there just in 'case' (!) you get the text 'Mum, I'm fine, but I'm in hospital....' (or the mate texting you!)

If he 's going with a GF then brief her accordingly. (My DIL is now my 'in pro persona' MH!!!!!!!) (Yes, she carries an Epipen in her handbag - or so she tells me at any rate!)

All the above apart (!), I hope he has a really great time, and learns (safely!) how to combine having fun, having as near-like-everyone-else's youth as possible, and is sensible and safe for the duration, without too much anxiety (yours as well as his!)

All the best with it.

 

[Leadinglights]

Yes I had to do that when my daughter was hospitalised in Germany with appendicitis, luckily it was covered by the insurance of the scout group she was with and I did have a passport but I speak no German so was very stressful.
Not easy to keep in touch as it was before the days of mobile phones.

 

[Callista]

Emergencies can happen, so best to be prepared - and then hopefully the won't!

Other 'injectors' here will know, but is there ever an issue with taking a monitor (sharps!) and injection kit into the cabin these days?

 

[Kwilkins]

Unfortunately it is all very individual as to how each of us will respond to such situations.
As @Lucyr suggests, have a not so "dry run" in the safety of your/his own home. Have a cocktail evening, have some nibbles to go with the drinks and test/scan lots and see how he gets on. Assume he has Libre or other CGM?

If it was me, i would probably bolus for the first fruit juice cocktail because the fruit juice will hit his blood stream very quickly and cause his levels to rise long before the liver scales down it's activity to work on removing the alcohol. To be honest, in that situation, I am not sure I would find fruit juice cocktails worth the BG aggravation and I would just stick with spirits and diet mixers or at least do that after the first fruit cocktail.

Generally you would not bolus for the small carby snack with/after alcohol but if it was a full meal afterwards he may need a partial bolus. If he is going dancing as well as drinking, he will likely need more unbolused carbs for the exercise of dancing as well as the alcohol. Always err on the safe side and have more carbs rather than not enough.

It is really important to keep himself safe when in such situations and particularly abroad where he may not be able to make his medical situation clear to someone whose native tongue is not English and unfortunately a hypo can often be mistaken for being drunk, which means that people can be treated with distain rather than sympathy or recognized to be having a medical emergency, so make sure his friends know to look out for him if you are not going as a family and probably worth having a medical bracelet or pendant to ensure that his diabetes is easily identified if an emergency situation should arise.

Hope he has a great time.

Thank you so much that’s all really helpful when we’re so new to this

 

[Kwilkins]

I would get him a letter written in the language of the country he's going to, which states he is diabetic, and what effects it may have, and what treatment will be needed.

Ideally, also get him a letter from his GP stating 'officially' that he is diabetic (you will probably have to pay for this.)

Ensure his travel insurance is fit for cover (eg All Clear, StaySure or other travel insurance companies that offer pre-existing medical conditions cover)

If he is going to a country where there may be issues over what he can take into the country, then check the country's foreign travel (or our own UK's guidance) as to whether he needs, say, a doctor's certificate to say he can bring in insulin, sharps/needles, etc, and they won't be confiscated at the border.

Hopefully this is all pretty standard, as there are loads of diabetic holidaymakers, and whatever country he goes to will have their own diabetics as well - sadly it's not rare.

I did all of the above in the case of my son, who has a potentially life-threatening nut-allergy, and in some countries (eg, Dubai IIRC) I needed a doctor's letter saying he had this condition, to give him permission to bring in his Epipen (sharp needle plus adrenaline) through their customs.

Also, and this, I know is 'Mother Hen' (!) tell him you DO WANT to get a brief text from him every 24 hour saying he's still OK. You dont' have to make a big deal out of it, but tell him if he loves you he'll do it !!!!! Better still, and, indeed, 'as well' identify one of his most reliable mates to 'watch out for him' as well, and give the mate your contact details etc.

Also, and I know this is probably 'Extreme MH' (!!), check your own passport is in order, and that you can book an instant Easy-jet flight out there just in 'case' (!) you get the text 'Mum, I'm fine, but I'm in hospital....' (or the mate texting you!)

If he 's going with a GF then brief her accordingly. (My DIL is now my 'in pro persona' MH!!!!!!!) (Yes, she carries an Epipen in her handbag - or so she tells me at any rate!)

All the above apart (!), I hope he has a really great time, and learns (safely!) how to combine having fun, having as near-like-everyone-else's youth as possible, and is sensible and safe for the duration, without too much anxiety (yours as well as his!)

All the best with it.

Thank you that’s so helpful especially regarding the letters for different countries as I hadn’t though of that and we’re going to uae as a family and he’s doing the all Inclusive with his girlfriend

 

[Carlos]

Emergencies can happen, so best to be prepared - and then hopefully the won't!

Other 'injectors' here will know, but is there ever an issue with taking a monitor (sharps!) and injection kit into the cabin these days?

I don't think there ever was an issue. A doctors letter helps in case anyone asks questions, but in 30 years I've never had to show it.

 

[helli]

Other 'injectors' here will know, but is there ever an issue with taking a monitor (sharps!) and injection kit into the cabin these days?

None whatsoever.
I have been carrying sharps on board planes for nearly 20 years without trouble and without telling anyone unless asked.

Ideally, also get him a letter from his GP stating 'officially' that he is diabetic (you will probably have to pay for this.)

Diabetes consultants (or DSNs at diabetes clinics) do not charge for these letters. Ideally, get one for all travel rather than for a specific trip.