Travelling

[Jam100]

Hello,

I hope you're all well.

My name is Jamie and I have been a type 1 Diabetic for 10 years. I am using the Novomix 30 Flexpen and take 2 injections a day.

I am travelling round the world in August and wondered if anyone else has done the same and how they coped with storing and purchasing their insulin in other countries such as Australia and Thailand.

Any information or advice would be grateful.

Thank you and have a fantastic day

Jamie 🙂

 

[Monica]

hi Jamie, welcome

We have never travelled that extensively, only 2 weeks max.
I have bought a FRIO bag to keep the insulin cool during travelling and put the insulin straight into the fridge on arrival.

But I do know that someone on here will be able to help you more. (copepod?)

 

[Robster65]

Hi Jamie. Welcome 🙂

Is there a reason why you're on novomix rather than MDI (basal/bolus) ?

I would have thought it would give you a lot more flexibility when travelling but I'm no globetrotter so can only speculate!

Rob

 

[Kwaka1]

Hi Jamie,
The only advice that I can offer is the FRIO pouch/bag, as the only commodity required is cold water (you soak the pouch in water for 15 minutes). The crystals in the pouch soak up the water and remain cool for quite a long time afterwards, but how they'd perform in the heat of the Aussie outback is anyones guess.
As regards the purchase of Insulin, I've got absolutely no idea. Would you not take a huge supply with you?

 

[Julia]

Hi Jamie,
Welcome to the forum.
11 years ago I went backpacking in South America for four months. Since then I have travelled for shorter periods to various countries.
I took all my supplies with me (plus lots of spares). My friend carried some of my supplies, just in case my bag got lost/stolen.
I was really worried about keeping insulin out of the fridge for 4 months (although where possible it went in a fridge, which wasn't very much). As Monica and Kwaka have suggested, I am a fan of frio bags. We travelled to the jungle, the desert and above the snow line in the Andes, so I was really aware of where my insulin was and the temperature. I think I was lucky that it seemed fine and I didn't have any major dramas, but as you might imagine, my HbA1c wasn't great after coming home. I've never tried to buy insulin abroad, but you would have to make sure you had the same CONCENTRATION as well as a similar insulin type.

I used to be on twice daily mixed injections as you are, but switched to MDI 15(ish) years ago. As Robster mentions, a basal/bolus approach is much more flexible and would be much easier to manage changing time zones / strange foods etc.

I'm sure you'll get loads more advice on here and there's been a few posts previously on flying/airports etc. Good luck with planning your trip!

 

[Jam100]

Thank you for all your kind responses and warm welcomes to the group.

Yes, I've heard much about the FRIO wallets and seem they will be a great storage for the insulin I'm using.

I'm very hopeful that there will be fridges where I'm going so I will to bring a lot of insulin with me and store it there. I have contacted someone to do with Diabetes in Australia to possibly purchase some there as this would be my half way point (5 months). Yes, I would make absolutely sure that any insulin I did purchase would be the same as I use here.

You're probably right in that taking more injections would be more flexible but my results are good at the moment (7.5%), I may consider more injections later in my life.

I appreciate all your advice and help, I am most grateful.

Have a peaceful evening

Jamie 🙂

 

[Copepod]

Welcome Jamie.

A few quick topics to consider:

Insurance - make sure you have an appropriate policy and that your insurer knows about your diabetes. Most policies don't cover costs of lost insulin. You should also carry a EHIC for any part of your trip in European Economic Area, and check what documentation you need to access reciprocal healthcare schemes in other countries eg Medicare in Australia http://www.nhs.uk/NHSEngland/Health...e/NonEEAcountries/Pages/Non-EEAcountries.aspx

Temperature of insulin - you're right, there are fridges most places, and owners of hostels, hotels, cafes, restaurants etc are usually pretty helpful, provided you can explain - make sure you know the appropriate words, and label insulin packs clearly. I've never used a Frio pouch, preferring a stainless steel vacuum flask, as it offers far more physical protection against knocks than a pouch. Obviously, it has to be empty of water for flights.

Insulin and other supplies - not all GPs will give prescriptions for long trips overseas. Worth contacting the manufacturer of the insulin you use to get details of availability in the countries you intend to visit. Remember to carry adequate supplies of blood glucose test strips, lancets, needles etc, plus container/s to carry used sharps until you find somewhere safe and legal to dispose of them.

Letters / documents - carry a letter explaining why you need to carry sharp items on planes and why your insulin muct not go in the hold. Many GPs charge for such a letter, but DSNs at diabetes clinics don't.

Lonely Planet Thorn Tree forum is a good source of information from travellers about destinations etc.

 

[Jam100]

Thank you very much for your advice Copepod. This will all come in very handy for me!

I have had a quick look at the Lonely Planet forum you suggested and it looks very useful so I appreciate that very much.

Enjoy the rest of your weekend.

Jamie 🙂

 

[DeusXM]

I used to be on twice daily mixed injections as you are, but switched to MDI 15(ish) years ago. As Robster mentions, a basal/bolus approach is much more flexible and would be much easier to manage changing time zones / strange foods etc.

This would be my major concern as well. Your A1C suggests your diabetes runs on the high side anyway so you might not be too worried about hypos, but you're going to be putting some major demands on your flexibility.

If you're on a mix insulin, you'll need to eat at certain times and eat certain amounts of carbs. My experience of backpacking is this won't work well at all. If you are genuinely roughing it and living off minimal cash, the option of three specific meals each day isn't going to be available for you. When I last 'did' Thailand, I was on MDI but found I was hypoing out a lot for the first week because I was doing so much walking round and cash meant I was limited to how much I could eat a day - language barrier didn't help either given that the most economical way to eat is from street stands and 90% of the time I didn't even know what to ask for. I ended up carrying a lot of Thai Red Bull with me - it's sweeter than the stuff here and fixes hypos up good and quick.

Also, watch out for Thai beer - it packs a stronger punch than what you'd find here, and this will screw around with your insulin requirements. As for insulin, many pharmacies will let you buy insulin over the counter and I think most of the brands you get here will be available. Insulin isn't cheap though, I think it works out at ?25 a cartridge if memory serves correctly, so bringing what you need makes more sense.

Frio pouches work very well on a temporary basis, it's what I used. However, don't always expect there to be a fridge around. If you're properly backpacking, you'll find that cheap rooms and huts generally won't have fridges, sometimes not even electricity!

 

[Julio247]

Hi Jamie, I hope this reply finds you well. 🙂

I travel a fair bit for work, especially to SE Asia. I have had Type 1 for nearly 20 years and give my self 4 injections a day - 4 rapid for meals and 1 basal, meaning that I carry my rapid around every day.

Healthcare in SE Asia is very good, especially in Malaysia and Singapore. You should not have a problem getting suplies if you need to, though they are pricey. I had to buy some test strips in KL and they were a good price from a Wotson's chemist.

As for insulin, my pointers would be, keep them cool I find that they become less efficient if they are kept out of the fridge for days. Think about getting a cool-pack if you are hosteling it. I keep my spares in hotel fridges. If you are backpacking then remember this, insulin can be a commodity, so make sure you trust the hostel before you put it in their fridge.

Most countries have a Diabetes UK equivalent organisation.

My top tip is this, translate the words 'Diabetes' and 'No Sugar' into the languages of the countries that you plan to visit. They come in handy if people ask. I've never been asked when in Malaysia and Indonesia, but it would clear the air if somebody did.

Food wise, as and DeusXM says, food tends to be sweet in SE Asia so bear that in mind. While I carbo-count I always ask/say 'No sugar'. Fruit drinks tend to have syrup. Plenty of waters and sugar-free drinks though.

Oh, a non-diabetes tip, carry an unlocked cheap smartphone and get cheap data only sim cards (very cheap in Thailand and elsewhere!!) in the countries you visit. I always do this and it gives me access to Google Translate, etc!

Enjoy!!

 

[Jam100]

Thank you very much, Julio247 and DeusXM.

The advice and information you have given me will help me tremendously on my travels so I am truly grateful.

It's great to hear from lot's of different people and what worked for them, all of which I will take into consideration.

Have a fantastic day

Jamie 🙂