Travel to Australia

[George donnelly]

Hi, I travel to Australia in February for one month. i am type 1 diabetic and take Nova-rapid throughout the day and at night I take Lantus.
I travel to from Manchester to Abu Dhabi >Brisbane> Sydney arriving at mid night.
what would be the best way for me to regulate/alter my insulin due to the multi time zone changes?

 

[grovesy]

Welcome.

 

[trophywench]

When we went I was on MDI same as you but used Novorapid and Levemir - and since that's injected twice a day, it's a little easier to swap about. Obviously the Novorapid isn't a concern since you simply use it whenever and whatever you happen to eat, immaterial of what time it is where you happen to be at that time.

We didn't have a stopover going out (via KL) and stayed awake apart from catnaps in the air, and having taken off from HR first thing one morning arrived at our final destination (Brissie) at 10.30pm at night the next day their time - having had to change planes in Sydney a few hours earlier. I had my evening Levemir during the leg between Syd and Bris. I simply 'firefought' with extra little bits of Novo occasionally during the extended 'day' we had travelling - since we were largely just sitting on our bums in plane seats, testing and jabbing weren't exactly a prob. And in any case, the Malaysian lady sitting next to me was also on Novo and Lev anyway - we were comparing carb counts for the meals we were served en route, to do our boluses! You couldn't have invented that scenario could you? LOL Where Lev is available - Lantus was well before that (eg Lantus was available in Oz for years, then they added Lev - but Lev didn't become available in NZ for years after that!) And Novorapid appears to be cosmopolitan anyway - all available in Oz anyway cos I had cause to find that out LOL (Just not free even on scrip, since there's co-pay for all drugs unless you specifically register with Medicare and that just wastes your holiday time cos streamlined, they ain't))

What is the timetable for the travelling and arrival? - cos you will be 'winging' it for around 24 hours whatever way you do it - but it's definitely worth it and you won't die!

 

[Northerner]

Hi, I travel to Australia in February for one month. i am type 1 diabetic and take Nova-rapid throughout the day and at night I take Lantus.
I travel to from Manchester to Abu Dhabi >Brisbane> Sydney arriving at mid night.
what would be the best way for me to regulate/alter my insulin due to the multi time zone changes?

Hi George, welcome to the forum 🙂 You might find the Diabetes UK Travel page helpful when planning the trip: https://www.diabetes.org.uk/travel

Hope you have a fantastic time - please come back and let us know how it went, or if you have any more questions 🙂

 

[George donnelly]

When we went I was on MDI same as you but used Novorapid and Levemir - and since that's injected twice a day, it's a little easier to swap about. Obviously the Novorapid isn't a concern since you simply use it whenever and whatever you happen to eat, immaterial of what time it is where you happen to be at that time.

We didn't have a stopover going out (via KL) and stayed awake apart from catnaps in the air, and having taken off from HR first thing one morning arrived at our final destination (Brissie) at 10.30pm at night the next day their time - having had to change planes in Sydney a few hours earlier. I had my evening Levemir during the leg between Syd and Bris. I simply 'firefought' with extra little bits of Novo occasionally during the extended 'day' we had travelling - since we were largely just sitting on our bums in plane seats, testing and jabbing weren't exactly a prob. And in any case, the Malaysian lady sitting next to me was also on Novo and Lev anyway - we were comparing carb counts for the meals we were served en route, to do our boluses! You couldn't have invented that scenario could you? LOL Where Lev is available - Lantus was well before that (eg Lantus was available in Oz for years, then they added Lev - but Lev didn't become available in NZ for years after that!) And Novorapid appears to be cosmopolitan anyway - all available in Oz anyway cos I had cause to find that out LOL (Just not free even on scrip, since there's co-pay for all drugs unless you specifically register with Medicare and that just wastes your holiday time cos streamlined, they ain't))

What is the timetable for the travelling and arrival? - cos you will be 'winging' it for around 24 hours whatever way you do it - but it's definitely worth it and you won't die!

The time table is as follows;
Travel from Manchester 08:10 arrive in Abu Dhabi at 19:20 their time - a 7 hour minute flight - that would be 15:20 UK time
Depart Au Dhabi @ 21:40 their time arriving in Brisbane 17:30 Brisbane time - a 13 hour flight
Depart Brisbane 20:05 arriving in Sydney 22:40 - a 1 hour flight

 

[trophywench]

Right. So your last UK Lantus was late-ish pm the night before departure. Let's say 11pm. You arrive in AbuD as you say, 16 hours after the Lantus. You take off again 2 hours later = 18 hours. However 'on the plane' they will be working to Abu D clocks so will expect the passengers to go to sleep, say 2hrs 30 +/- after take off - which will only be 20/21 hours after your last Lantus jab and it will be another 3 or 4 hours before the last UK Lantus expires. So - have a proportion of the Lantus you would normally have in a few hours - unless you can nap for a couple of hours and jab it when you wake up. You need it to last the rest of this flight - another 10.5 hrs or 7.5hrs depending on what time you actually have the Lantus mid flight, plus another 3hrs at Bris, plus 1 hr flight, plus say another 2 hrs to get luggage at Sydney and then get wherever you're going (if this works the same as it did with us - we cleared immigration customs when we deplaned in Sydney - so the next bit only classed as an internal flight, therefore the only thing we had to do at Bris airport was find a trolley, wait around bored for the bags and sally forth and find my big sis, who'd come to pick us up. Then just the journey to where you're going - so allow a couple of hours to get wherever for the night, and have your next Lantus when you get there. So on the AbuD - Bris leg, you need to jab enough Lantus to last either 16.5 hours or 13.5 hours.

These are all guesstimates, you are simply firefighting and playing it by ear - but on the AbuD leg I would either stay awake or set an alarm to have that Lantus as near as poss to the actual 24 hours after my last, and then I would jab HALF what I normally have. It most likely won't be quite enough, so just do little Novorapid corrections each time you bolus for food during the journey. If it's too much - well - just eat more! LOL

Then once you are ready for bed - just have your normal Lantus - go to bed and wake up next day and just act normal again!

 

[SB2015]

The advice I was given, was to change clocks to the destination time, firefight on route using correction doses of Novorapid and set an alarm on my phone to do 'night time' injections based on destination time on route, and on arrival.
That worked for me on my way to NZ. Well worth a day of confusion.

 

[Northerner]

@Austin Mini has just posted his experiences on his trip to New Zealand:

https://forum.diabetes.org.uk/boards/threads/long-long-haul-flights-and-insulin.63624/

🙂

 

[DeusXM]

As I write this I am currently in Tahiti (having flown via Dubai and a couple of days in New Zealand) and will actually be flying to Australia on Wednesday...so it's fair to say I'm currently going through a lot of time zones (and indeed, mucking about with the international date line).

The trick is to remember that you can take your Lantus at 22-26 hour intervals.

What I would do is first work out what time your Lantus dose in the UK is in Australian time. Brisbane is 10 hours ahead and Sydney is 11.

So say you take your Lantus at 1900 UK, that's 0500 Brisbane and 0600 Sydney.

That may be too early for you, so you need to plan to start moving your Lantus a week or so before.

So when you're in the UK, one take your Lantus at 1700 (0300 Brisbane, 0400 Sydney).

The next day, 1500 (0100/0200).
The next day, 1300 (2300/0000).
The next day, 1100 (2100/2200).

Do you see what happens? You adjust Lantus time while maintaining a safe 22 hour interval, which means you eventually end up taking it at a convenient time when you arrive in your new time zone. You guarantee basal insulin coverage without risk of hypos. And similarly, you repeat the procedure as you look to return home - you will need to work out whether it makes sense to keep going backwards through the clock or go forwards (in which case, go with 26 hour intervals).

You may also find it helpful to set a timer on your phone/watch to run the requisite number of hours - that way, you don't get the issue of alarms altering as you change timezone. The important thing is to maintain a 22-26 hour gap between your Lantus doses. Zero confusion, zero need to firefight, minimal risk of DKA or hypos.