Safe Cruising with Diabetes

Safe Cruising with Diabetes – Some Tips for Making Your Trip Less Stressful

What is the first thing that comes to your mind when planning a cruise??? One of the most common answers I always get is the abundance of food. Then there are all the sights to see and fun entertainment on the ship. But, for a person with diabetes, taking a cruise is not as simple as throwing some clothes in a suitcase. It takes a lot of planning to travel with diabetes. This article is designed to share some insight and direction if you plan to take a cruise. 

I recently returned from a cruise and I tried to see the experience through the lens of a person with diabetes. While each traveler will have their own specific needs, here are some tips for making a cruise successful and not stressful.

Travel Tips for People With Diabetes

Start with a plan 

Make sure to have plenty of diabetes supplies on-hand prior to your trip. I remember helping my son pack for a cruise several years ago. He has type 1 diabetes and as he was packing, we realized he was nearly out of pump supplies and would not be receiving more until after he left for his vacation. We were currently ordering his supplies by mail and we had no way to get more in time. It was a little stressful as we tried to come up with adequate for his trip. With this lesson learned, I advise that you always make sure to have plenty of supplies on-hand at all times with a few to spare.

Be sure to pack your supplies in your carry-on in the unfortunate event that your luggage does not make it to your destination. You do not want to be without all your necessities as it is difficult to replace diabetes supplies.

Airports and flying

Next, learn what is required in regards to flying with the specific diabetes equipment you have. Pack your supplies in gallon Ziplock bags so it is clear what you are packing. I recommend protecting your insulin vial in a silicone protective case. This will keep the insulin bottle from being damaged while traveling and prevent it from shattering in the event it is accidentally dropped.

Traveling With Diabetes Devices

The following information was taken from each company’s website.

Always be sure you fully understand how to safely travel with your specific device so it is not damaged. Also, be sure to know your airline’s guidelines and your personal rights as a person with diabetes.

Dexcom G6

• Hand-wanding, pat-downs, and visual inspections can all be used. Because ALL walk-through scanners have not been tested for safety, Dexcom recommends hand-wanding or a full-body pat-down. Let the security officer know that the sensor cannot be removed because it is inserted under the skin. Do NOT put your CGM through the x-ray machines.
• To use your smart device or receiver to get sensor glucose information while on the plane, switch your smart device to airplane mode and turn Bluetooth ON. Keep your receiver on.
• Get a Notice of Medical Device and you can have it filled out by your physician to be presented to airport security to better explain your Dexcom system.
• Get more information on Dexcom G6 and flying.

Freestyle Libre

• When flying, you can put your Freestyle Libre sensors in your carry-on bag. You can go through x-ray machines while wearing a sensor. It is recommended you notify security personnel when going through airport security screening.
• It is also recommended that readers be powered off during a flight and not used for scanning.
• Get more information on Freestyle Libre here.

Tandem Insulin Pump

• Your device is safe for use during air travel and complies with FAA wireless transmission standards. It can safely be carried through metal detectors. Your pump should NOT be put through x-ray machines, luggage scanning machines, and full-body scanners. It is recommended that you disconnect your pump at the infusion site and ask the security agent for an alternative screening method. You can also notify your agent about your pump and request to go through a standard metal detector wearing your pump.
• Get more information about traveling with a Tandem pump. This resource also includes a printout of information about your pump to show the agent during screening.

Medtronic

Going through security

• You can continue to wear your insulin pump or CGM system while going through common security systems such as an airport metal detector as it will not harm the device or trigger an alarm. Do not send the devices through the x-ray machine.
• You need to remove your insulin pump and CGM (sensor and transmitter) while going through an airport body scanner. If you do not wish to remove your devices, you may request an alternative pat-down screening process.
  Notify security screeners that you have diabetes, that you are wearing an insulin pump, and are carrying supplies with you.

On the Plane:

Insulin pumps and blood glucose meters

• When on an airplane, you should go to Utilities > Connect Devices > Meters pump screen, select OFF, and press ACT to unlink your meter from your insulin pump. Manually test your glucose levels using a blood glucose meter.

Personal CGM

• If you wear a CGM device, it is typically safe for use on commercial airlines. Get an airport information card here. If they still request that you turn off your CGM device, you must comply.
• If you are asked to turn off your CGM device, you will have a “data gap” when uploading data into the Care Link personal software.

Learn more about traveling with Medtronic devices.

ALWAYS contact your airline so you will know their policies.

And remember to adjust your settings when needed as you travel to different time zones. Be sure to check your blood glucose frequently or pay attention to your CGM as the hassle of traveling, stress, time changes, altering meal times, activity levels, and type of food can all affect your diabetes control.

Here is some useful travel information from the American Diabetes Association

Smooth Sailing
Learn the lingo of sailing. This may not have an impact on your diabetes management but it will save you lots of stress and wandering about the ship.

Aft: The rear of the ship
Forward: The front of the ship
Port: The left side of the ship when facing forward (I remember this because “port” and “left” both have 4 letters)
Starboard: The right side of the ship when facing forward

How to Navigate the Cruise Food and Buffet

Now you will be able to find the food which is our next topic.

Always have extra snacks on-hand to treat lows just like you would normally do. There is the notion that food is available 24-7 on a cruise ship. The first thing we were told was that the buffet was open 24 hours. However, the buffet closed at 10pm and so did the soft ice cream stand. There was limited food in one area of the ship that could be accessed anytime. This may vary between cruise lines. Be sure to know what is available, where it is located and what the hours of operation are. Do not rely on the fact that there is food handy. There are too many variables such as food choices are more limited when changing from breakfast to lunch and then lunch to dinner or the buffet area may be crowded and many buffets are no longer self-serve.

There were always sugar-free desserts in the buffet. Just remember that sugar-free does not mean “carb-free”. Make sure to have a good assessment of the sugar-free foods so you can have a valid estimation of carbs.

The food staff is always willing to accommodate special food needs. If you have dietary restrictions such as celiac disease or a peanut allergy, always let your food server know ahead of time so they can be sure your food was prepared in a safe manner for you. If you have questions about the method your food was prepared, just ask. Don’t feel you are being an inconvenience.

Medical Assistance on the Ship

I took a jaunt down to the medical center on the ship. It was in a bit of a remote area. I recommend finding this when you first get onboard in the event you need it quickly. Also, find out what hours they are open and how to reach help after hours. I did find that this particular ship carried a variety of insulin and common diabetes medications. They also had glucagon kits, glucose meters, testing supplies, and syringes. They said they have had passengers who needed prescriptions and they were able to help facilitate filling them through a pharmacy while at port. Keep in mind that this would only be a good solution in a dire emergency. You may be outside your native country, you may have excursions scheduled for your day at port, and I don’t imagine it would be a quick process to get off the ship, get to the pharmacy and then get back to the ship. It was nice to know this particular ship had this option but I would try to avoid needing this service. This goes back to planning ahead and packing plenty of extra supplies.

Excursions off the Ship

Make sure to have plenty of fun while you are traveling. Taking excursions can be a great way to see the area and get some time on land. Or maybe you are going to venture out on your own. I was looking for some hiking trails that would get me in the great outdoors and away from the tourist traps. However, my group did not plan well and we found ourselves on a hike that lasted WAY longer than planned. Always expect to be away from the ship for longer than anticipated. Maybe you will decide to shop a little longer, or the excursion transportation is delayed or you do what I did and end up on a trail that is more difficult than planned. I recommend taking a small day pack where you can keep your water bottle, food for the time you are away and your diabetes supplies. Be sure to stay hydrated and have plenty of food to eat.

One last thing, if you are planning a cruise or any vacation, enlist those you are traveling with to be a part of your diabetes team. Let them know more about your diabetes and how you manage it. Explain to them what it means if you are low and how they can help. Then go and enjoy your vacation!

Yes, life with diabetes requires a lot of patience for many reasons. Learning when to act and when to remember to wait can take time to figure out. If you feel like you need some assistance with figuring out where your management needs some patience give Integrated Diabetes Services a call – we have all had to learn to navigate when to wait and when to act in our lives with diabetes.