uk to australia time lag - how to inject?

[FaithElliott]

Hi there all, you have been amazing at helping me in the past thank you!!!

My husband (Serbian Romany type 1 diabetic) and I are planning to go to Australia for 3 months. However...he is now refusing as the Serbian doctors ho ho ho.... have said that on his current insulin regime he could end up in a coma if he does that.
I know this is of course not so if managed properly. Could anyone tell me how he should change his injections. He injects Actrapid (fast acting) and Insulatard (long basal dose) in the morning at about 9am, and at night at about 7pm. These times can vary by about 2 hours. I know (and English doctors have told him) that he should change to rapid acting insulin and inject to cover his meals - especially as he is a musician and doesn't have a stable lifestyle. At the moment he is force feeding himself food every 2 hours, or eating when he is not hungry simply to cover his insulin - and this is stressful for him and for me to be constantly thinking about his food. Could you tell me a) with his current regime how would he change to the new time zone b) if he changes to rapid acting insulins is this a fairly smooth transition - are there possible downsides to this that we should be aware of - he is scared of changing a familiar routine which at the present is keeping his sugar levels fairly stable.
THANKYOU!!

 

[Lauras87]

I went to Oz for my 21st & from memory due to all the different time zones we went through. I kept to UK time until I got there, then injected UK time but was actually Oz time (UK when I was on once a day was 9pm)
Then slowly moved it to Oz 9pm

It messed with my bloods a bit but this was the advice my gp gave me (as I didn't have a consultant at the time)

Hope you have a nice time 🙂

 

[Cleo]

Hi faith Elliot
My husband is Australian so we've been out there 3 times and its not a major problem at all. I was given the same advice as Laura - stick to the regular UK times and then when you get out there change to Aus time. There will obviously be a short time when your body needs to adjust but that's it. Obviously he should make sure he has plenty of extra insulin, testing strips and hypo treatment on him In case he feels funny on the plane. I also got a letter from my GP saying that I am a type 1 and that I need to take needles onto the plane. The only minor glitch I had a few years at ago which was totally down to my own STUPIDITY was that I wasn't drinking enough water and we went out there in their summer so I ended up in hospital with dehydration - but that as I said is totally preventable.
Have a great trip 🙂

 

[trophywench]

Hi Faith

As an old timer, I'm afraid I HATE Insulatard - it's one of the older insulins and brilliant in its day, but we've all moved on now - or we should have done.

On modern regimes you don't have to feed the insulin at all - you just feed yourself when you want to eat. If you go hypo between meals, either your basal (long acting) insulin is up the swanee, or you took too much bolus (fast acting) insulin for what you just ate.

Australia - fortunately for me, I was using Levemir as my basal when we went to Oz. I say fortunate because unlike Lantus (the other one of 'first choice' these days) which is usually taken once a day, Levemir is taken usually twice a day. Sounds like a PITA but it isn't, because if it lets you have marvellous BGs, then it's worth it - and it's very very flexible in comparison to others. Injecting twice a day means you are never that far in front or behind yourself when crossing time zones, and you can just use your own instinct and let your logic (combined with your meter, of course!) tell you how to play it.

Then you inject fast-acting (Novorapid, Humalog or Apidra) before each meal - which you eat when YOU are ready to eat, not because the insulin INSISTS that you do! You calculate what to inject, according to how much carbohydrate is in the meal. If it doesn't contain any carb, then you shouldn't need any insulin with it!

Full English breakfast? - well as long as you don't have baked beans, toast, fried bread or hash browns, then no insulin. Sunday dinner? - nothing for the meat and green veg, a bit for root veggies (hardly any) so it's basically just the carb in the spuds, Yorkshire Pudding and gravy, or stuffing and gravy when it's appropriate. Cheese sandwich? - just the bread.

You just err on the side of caution and give your BG a decent margin for emergencies.

Have a little read of this article about basal insulins generally.

http://www.diabetes-support.org.uk/info/?page_id=120

And finally I can tell you that both Levemir and Novorapid are available in Australia - but don't ask who left her spares at Gatwick airport when she went to Oz? 😱

 

[DeusXM]

You'll need to do a time zone shift, which is really easy to do.

Generally, with a basal you can get away with injecting either 2 hours earlier or later than normal. So what your husband needs to do is adjust his insulatard doses by two hours each day in the lead up to the flight and arrival until he is injecting at a sensible time in Australia. So say he injects at 7pm, he then moves to either 5pm or 9pm and then the next day at either 3pm or 11pm. You'll need to do a comparison with the Australian time zone that's relevant to know which way to go and when to stop or start moving.

None of this changes, unfortunately, the fact he is on an inappropriate regime for managing his diabetes.

 

[PattiEvans]

I've been to both Australia and California whilst on Levemir. It does depend where in Australia you are going as they have several different time zones. I just kept to British time until I got there. Brisbane is 10 hours different to UK, so I just slipped the injections by 2 hours and took them before bed and when I got up as I do at home. Levemir is quite forgiving as to when you take it so no problem but I wouldn't have a clue how to titrate Insulatard.

As others have said, your husband would be much more comfortable and not having to think about food 24 hours a day if he switched to the modern insulins cos you only inject rapid acting when you intend to eat. Does he go to a diabetes clinic in UK?