Travelling in Thailand in Hot Climate as a Type 1

[sflynn96]

Hi,
I am hoping to book a 3 week holiday to Thailand in March with my fiance. I have been delaying booking this as I am feeling increasingly anxious about going due to my Diabetes. The temperatures will be in excess of 30 degrees Celsius, most places around 34. I have been on many holidays before to warm climates but never as hot as this and normally only for around a week at most. I am concerned how my body and blood sugar levels will react to the intense heat and I am worried of suffering from many hypos throughout my time there and I will not have a readily available pack of Lucozade bottles with me as I do at home and I will start to panic about not being able to get my blood sugars up. I will be taking Glucose tablets with me and will stock up on sugary drinks/snacks over there in the supermarkets, obviously as well as bottled water. I have also been told to reduce my insulin slightly to see how this affects my blood sugars, I am on Novorapid; I give 2 units of this for every 10 grams of carbs that I eat and I am also on Levemir, I give 12 units at 10am in the morning and 12 units at 6pm in the evening. I will consult with my DSN about what times to change these to. I also worry about running high blood sugar levels, I guess it's just the fear of going so far away from home and the worry of something happening with my diabetes. Will the high temperature even make much of a difference to my blood sugars or could they just stay the same? I have been telling myself there is so many people in countries like Thailand, even Australia or even America when the weather is warm in summer and they all seem to cope ok. I just don't want this to affect the holiday of a life time with my constant worry! Has anyone had any experience with this? Thank you

 

[everydayupsanddowns]

Welcome to the forum @sflynn96

What an exciting trip to have coming up!

We have certainly had members in the past who did the whole backpacking-around-Southeast-Asia adventure, and some current members who travel to very hot parts of Europe all while taking their diabetes along for the ride.

You will need to bear in mind that your body is quite likely to become more sensitive to insulin in hotter temperatures.

I spent 5 days in Singapore about 10 years ago, while still on MDI and my diabetes behaved very well, with just one slightly nasty (but self treatable) hypo where I misjudged the carbs in the food and how active we had been.

If you are worried about your insulin’s exposure to heat (especially the extra supplies rather than your ‘in use’ pen, you could use a Frio bag. There is also some fancy gadget that tracks temperature of medications - but I can’t remember what that’s called!

I wonder if you might switch to reusable pens with cartridges if you are currently using disposable pens, as the insulin cartridges would be smaller and easier to transport and keep cool I would imagine.

If you are using accommodation which has a fridge, this could be very handy to store your insulin supplies, but do be cautious because if it is too cold and your insulin freezes it will be unusable.

When it comes to your basal insulin, I have seen some people putting together very complex sequences to gently time-shift their basal over a number of days at either end of the trip. But my suggestion would be much simpler... I would simply switch insulin timings destination time zone when you board the plane, even if this means a longer or shorter gap between basal doses. I always find travel, flights and airport food quite chaotic BG-wise with a fair amount of firefighting and guesswork, so slightly out of kilter basal doses just get lost in that mix

Most of all... enjoy your trip!

 

[trophywench]

I've never back-packed anywhere but I've certainly been to very hot and humid places and a Frio is essential in my book. I agree with Mike about the timing which has certainly worked OK everywhere I've been, including when we went to Australia via KL.

I seem to need a lot less insulin when it's hot but that usually wears off around Day 10 for me, in the places I've been to. No idea how it will affect you of course and you won't either until you do it! Just need to test LOTS so make absolutely sure you have at least double the strips you think you might need - and the same goes for insulin. You can get a double or treble prescription if you explain you are going on holiday for X amount of time - but get it ordered early in plenty of time to get all the boxes of strips packed in your 'hold' luggage.

 

[Thebearcametoo]

Talk to your DSN soon. They will be able to give you the letter you’ll need for taking all your meds through the airport etc as well as give you advice about doses. Dextrose tablets are fairly cheap and small to carry and do the same as lucozade if you have some water with them. Your DSN should be able to advise you on taking spare pens, meters etc too.

 

[trophywench]

Oh yeah - DSN for letter - most GPs charge silly money to provide stuff like that, these days. (Like mine wanted £135 last time I asked, c 15 years ago!)

 

[everydayupsanddowns]

but get it ordered early in plenty of time to get all the boxes of strips packed in your 'hold' luggage.

For clarity... Not the insulin though. Insulin needs to go in hand luggage ONLY as there’s a risk it might freeze in the hold and become unusable

 

[missclb]

I've just moved back to the UK after 10 years in Dubai where the temp in summer was often in the high 40s. I used frio pouches to keep insulin cool if i was going to be out and about for any length of time – they're really, really useful. You are likely to have different insulin needs when on holiday as you'll be hotter and perhaps moving around much more than a normal day at home (depending on what you do for a living) plus eating foods that you wouldn't normally eat. All the worries you have are completely normal. The very fact that you're thinking about it means that you'll be well prepared. Once you're there, you'll just need to check, check, check, check your blood as often as you can. You might start to see patterns forming in the first few days, which will make things easier for you as your holiday progresses. It's all totally do-able. I trekked the Inca Trail to Machu Picchu a couple of years ago and had all the same concerns. Maybe start using glucose tablets rather than lucozade now so that you are familiar with their effect on your BGs, then when you're away, that's one less unfamiliar element. And most importantly, try not to let this ruin the excitement of such an amazing trip!