help needed....travelling abroad for first time with insulin

[eggyg]

Hi all, I am going to Greece in less than 3 weeks and for the first time I will be travelling with insulin. My DSN suggested looking on Diabetes UK Shop regarding travel wallets etc. I just got confused. So I would like some hints and tips please from your goodselves. I will give you some background to help. I use Humulin I KwikPen, already filled, I will need to take 4. The one in use is ok to be unrefrigerated for up to 30 days, I am going away for 12. but the ones not in use need to be refrigerated. I am travelling to Athens (4 hour flight) for 3 days and have a fridge in the hotel room, then I am travelling by ferry (5 hour journey) to Naxos where once again I have a fridge in my hotel room. My worry is keeping my insulin cool on the ferry, not too concerned about the plane as it's usually freezing. Will the insulin "spoil" if it's too hot? What travel equipment would you recommend, any handy tips at all would be very helpful. I know not to put any of my diabetes kit in the hold and have been advised to take double of everything by my DSN. Hope someone can help. Thanks in advance. Elaine

 

[Redkite]

Hi Elaine, what you need is a Frio pouch:

http://www.friouk.com/shop.aspx

These pouches contain dry crystals - you soak the pouch in water, and the process of evaporation over several days keeps the contents cool. Perfect for hot climates. I don't necessarily trust hotel room fridges - just me being paranoid, but I'd rather keep the insulin in a Frio pouch than risk it being frozen by a dodgy fridge!

Hope you have a lovely holiday 🙂

 

[Redkite]

P.S. Make sure you take insulin in your hand luggage (in fact I take all diabetes supplies in hand luggage in case hold luggage goes missing), because insulin would freeze in the hold.

Ask your DSN for a letter to show at airport security to prove you need to carry insulin, needles, testing equipment and snacks (hypo remedies).

 

[delb t]

Hi - copy of prescription- E111.Also bring a small Tupperware box to keep the stuff in hotel fridge as on one holiday our insulin stuck to the back!! { lesson learnt!] happy hols

 

[Robin]

Don't forget, your insulin pens and spares need to go in the clear re sealable plastic bag that you have to present separately at airport security, along with other liquids and gels. I've never had a problem getting through security with my insulin stuff. the only time there's ever been a query was in fact at Athens last year, when I got the sickening moment of seeing my stuff coming through the X-ray, and the guy stopping it and reversing it, zooming in etc. I think he was a trainee, because he referred to a colleague, who waved the bag of pens and said to me,'this is medicine, Madame? ' and I said yes, and she said fine, and handed it to me, and then proceeded to berate her colleague in rapid Greek!

I use a Frio wallet, which I find keeps it cool enough. Don't put it right next to your tickets and passport though, because even in its cover, I find it exudes a faint air of dampness, and can make paperwork feel a bit limp.

 

[eggyg]

Thanks all for those tips, some of those I would never have thought of, eg. Tuppaware box, brilliant idea. Also thanks re tip about clear plastic bag with all my stuff. I might have been scrabbling about at the last minute trying to find a bag! I have seen the frio wallets on line but didn't understand how you kept them cool, sounds ideal, I will be onto it straight away. One more question if you don't mind, what about disposable of needles, lancets, strips etc? Thanks, Elaine.

 

[Robin]

Used test strips can just go in the ordinary rubbish bin, as can lancet drums. Needles, and lancets that have sharp bits sticking out, should go in a sharps bin. It's worth asking the hotel if they can provide one,but my experience is that it's more hassle than it's worth, and I Put mine in a small Tupperware box and bring them home in my hold luggage. There is a device called a Be safe clipping device, which I got from my GP on prescription, which chops the sharp point off and keeps it safe within the device, and some people then throw the remaining plastic bit in the ordinary rubbish,but I never like doing that because I Have scratched myself on the other end of the sharp bit, ( the bit that screws into the pen) which isn't buried as deep inside the plastic bit as you might think.

 

[DeusXM]

The E111 doesn't exist anymore. What you actually need is an EHIC - you do NOT have to pay for this. The official ordering page is at https://www.ehic.org.uk/

As others have said, keep ALL your diabetes stuff in your hand luggage.

Insulin does spoil at high temperatures but it's fine for it to be in your pocket in warm weather for a bit. However, one thing to watch out for is hot cars and beaches. If you are going to the beach, definitely take a Frio pack for your 'in-use' insulin and then make sure when you are on the beach it is in somewhere with air flow and shade - I generally put mine in an unzipped backpack under a sunlounger/umbrella. NEVER leave your insulin in a car, they turn into ovens.

The not-in-use pens don't necessarily need to be refrigerated but bear in mind that means they will not last as long - insulin can be kept at room temp for 28 days so if you leave them unrefrigerated for 12, that gives you 16 days of life left for them. You can put them back in the fridge or Frio bag to 'stop the clock' though.

Also, take roughly double of everything - test strips, insulin, needles and definitely glucose tablets.As for dealing with sharps etc., strips can just be thrown in the bin, sharps can be stored in a tupperware box for disposal when you get home. Or get a SafeClip so you can just clip your needles.

 

[Copepod]

E111 was replaced by EHIC several years ago - see http://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx

If you ever change to cartridges in reusable pens, then there's a cheaper option of keeping cartridges in a stainless steel vacuum flask, which needs to be empty of water for air travel, but can be filled with cool water from tap or fridge for rest of time. It offers much better physical protection against knocks, vibration etc than Frio pouches.

You'll need to think about what to do with used needles. Personally, as I only use on average 1 needle per week for 2 pens on holiday, I carry a 35mm film pot to contain used sharps, plus a needle clipper eg B-D Safe-Clip - see https://www.bd.com/us/diabetes/page.aspx?cat=7002&id=7416 which I got on prescription. Then empty 35mm film pot into sharps bin if you see one in airport, or bring it home to empty.

Have a good holiday. It's always worth learning how to ask "is there any sugar in this drink?" etc - and learn to read sugar in local language for looking at drinks container, as it's very important to be able to distinguish normal and diet soft drinks. Obviously all fruit juices are high sugar / high carbohydrate. Plus be aware of carbohydrate contents of local dishes eg specific bread, rice etc, plus research lower carbohydrate dishes.

 

[delb t]

Hi Elaine- we just put ours in an empty water bottle and bring home-we have never had any problems at airports- more trouble with the OH metal hips!! OOps meant EHIC

 

[robert@fm]

Used test strips can go in ordinary waste; after all, as has been said on here many times, they have less blood on them than a used sticking plaster, and what there is is also sealed away from contact.

For times when I don't have a proper sharps bin, I use a temporary sharps bin made from a sturdy plastic screw-top container (which once held drinking chocolate) with a biohazard sticker on it, although the last detail is probably not essential. 🙂

 

[trophywench]

Yup - what they said - plus with pen needles, if you stick the thin plastic bit on the actual needle itself before unscrewing it from the pen, then throw the whole thing into your temporary Sharps bin - but throw the outer larger plastic cover into a normal waste bin, most of them should stay on, for when you 'decant' them into your proper one at home on your return.

This is obviously the first time you've travelled to such a place with insulin whereas I've been doing it regularly since 1976 (couldn't afford forrin parts for the first 5 years we were married!) and using one heck of a lot more needles (well - whole syringes for years!) for a good part of that time.

You may well find that your BG dips down once that lovely heat gets to your innards so Test Test Test - and if necessary reduce your dose - I would get away with almost NO bolus insulin for the best part of the first week, unless I absolutely pigged out of course - so on basal only I'm not sure, you'll have to see. But by the end of the first week usually I'd be back on pre-holiday doses. So if you do get that effect - enjoy it while you can! - it doesn't last !

I should say of course I am a lot more active whilst away - walking to & from the beach (at Plakias a lot of the time) - a 15 - 20 minute walk for starters, then in the sea to cool off etc, carrying beach bags and parasols, lunch, some drinks and all the beach paraphernalia and the diabetes ditto. Quite an exercise in expedition planning till you get used to it!

Give my love to Greece - haven't been for over 5 years as we have a motorhome now and it's bit far - and ENJOY !

 

[Austin Mini]

Have a great time. I have never been asked to show my plastic bag with the insulin in (keep it in the box it came in). Security people know all about diabetics. Never soak the Frio pouch for more than ten mins otherwise it gets HUGE. Take a small coke bottle to put your old needles in, they are very tough.
This is the best time of the year to go to Greece around the longest day time. The food is fab very healthy and expertly cooked. Just eat like a native. Hope you like Lamb they cook it to perfection.

 

[eggyg]

Thanks everyone for all the fantastic tips! We tend to go to a Greek island most years. Love the people, the food, the weather. Luckily I have never liked the very sweet and sticky desserts the Greek so love. As for lamb, my favourite meat. I'm hoping as we are going to an island that shouldn't be overrun by Brits I won't get chips with every meal! Once went to Kefalonia ( which we loved) and got chips with every meal, even the starters! Lol! I am really looking forward to it and feel my confident now after all your helpful and handy tips. Once again, thank you all very much. Elaine.

 

[trophywench]

Is it too late in the year for battered courgette flowers? delish. We also love Saganaki and many many other dishes. We usually both have different thinks for both courses, and share them with each other.

However - Pete hates lamb when it tastes like lamb* but he doesn't ban me, and I loathe moussaka, probably the aubergines as I really don't like them full stop. Can't be any of the other ingredients really, I like all of them, so it must be,

* so he'll happily eat a shish kebab for instance - because it's so spicy and the meat is only a carrier for them, isn't it?

 

[KookyCat]

Have a lovely time, enjoy the food and hopefully the absence of chips 🙂. I haven't yet managed to do my first trip abroad yet so I've written all the tips down for next year 🙂

 

[pippaandben]

If using a frio bag do not put it in a plastic bag as it needs access to air to condensate and produce the cooling effect.

I keep all my diabetic stuff and pills in a small flight bag and declare it as diabetic bag including medicines and sharps at security. Copy prescriptions plus Drs letter in it as well. On plane I keep it by my feet - under seat in front so it can be grabbed easily and not have to root around in an overhead locker in turbulence!!!

Never been asked to show contents but have received lots of stories here and abroad about family members of security and check-in staff who have been "cured" by various homeopathic drugs!!!!