The Indian Council of Medical Research (ICMR) released a travel guide for children and adolescents with type-1 diabetes in India, on Sunday, 12 June.
According to the International Diabetes Foundation, India is home to the highest number of type-1 diabetes patients.
Studies have linked diabetes to long COVID and more severe symptoms, and this guide could help save many diabetics and children and adolescents with type-1 diabetes.
The 173-page guide, which also covers a list of pre-travel steps and travel precautions, is the first of its kind for patients with type-1 diabetes in India. It covers basic dos and don’t to ensure the safety of type-1 patients during travel.
Here are some of the new travel guidelines for children and adolescents with type-1 diabetes.
Type I diabetes is a chronic illness where the pancreas produce little to no insulin. It typically appears in adolescents and growing children and is also called juvenile diabetes. The symptoms of type-1 diabetes include fatigue, hunger, frequent urination, increased thirst, and blurry vision. While there's no cure for type-1 diabetes, it can be treated through a healthy diet, exercise, and insulin administration.
What should children and adolescents with type-1 diabetes do before travel?
Inform your physician or doctor well in advance about your travel plans. Get their advice on your travel time, your travel safety, the medication you'll need, and any other precautions you need to take.
If your child suffers from type-1 diabetes, make sure you check with their physician on what needs to be done. Especially if they're going on a school trip or a vacation without you.
Ensure your physician gives you the right prescription with clear markings of his seal. Make copies of the prescription and if possible, laminate your prescription for safety. Taking a photo for a digital copy is also advisable.
The ICMR's guide adds that you should ensure you stock up on medication, injections, and blood sugar testing kits for the duration of the whole journey and carry enough for an extra few weeks at least, in case any contingencies force your travel plans to extend.
Your doctor will advise you further on what to do as far as medications go.
Ensure you also have portable cold storage to keep your insulin at 2-25°C.
Also check that your portable cold storage has adequate electricity and that your insulin is appropriately stored at the medical shop from where you bought it.
What does the ICMR guide say about things to do while you travel to and from your destination?
Make sure you know whether the flight/train/bus provides food and carry snacks with you to keep your blood sugar from falling too low.
Always carry your insulin, insulin pen, and your blood testing kit in your personal luggage. A pen is advisable since it's easier to use. Carry extras with you and syringes as well, in case of an emergency.
During a flight, insulin should not be placed in the check-in luggage since it may be exposed to extremes of temperature. Inform the airline about your diabetes status as well.
While travelling, it is convenient to use ready-made “cool packs” which are previously frozen in the ice compartment of the refrigerator. Alternatively, the vials should be kept in a plastic wrapper and placed in a cold thermos.
Avoid wearing brand new shoes, since they might put pressure on your feet. This is to make sure you don't suffer any blisters or cuts in your foot.
If your journey is particularly long, make sure you eat well before, during, and after.
If your journey is long and has multiple stops, try and test your blood sugar at a travel stop or overlay.
What does the guide say about dos and don'ts once you arrive at your destination?
Always check your blood sugar as soon as you arrive at your destination. Jet lag can make it hard to tell whether you have low blood sugar (hypoglycaemia).
Your insulin should be administered on a 24-hour basis, since days and nights are of different lengths in different parts of the world.
Additionally, monitor your blood glucose in the night between 1 to 3 am for nocturnal hypoglycemia.
During your travel make sure you carry comfortable shoes which have been worn for at least 1-2 weeks, and broken in properly, before the journey.
When you travel, you tend to walk and move around a lot, so check your blood sugar before and during exercise and before performing critical tasks like driving, hiking, or adventure sports.
It's also important to frequently monitor your blood sugar since people tend to eat at irregular times and in irregular patterns while they travel. A blood sugar check every four hours is advised.
If you're driving, make sure your blood sugar is in a healthy range. If you suffer from blurry vision while you're driving, pull up to a safe spot, stop driving and test your blood sugar.
On that note, it's essential that you carry sweet, high-calorie foods with you at all times, like chocolate bars, dry fruits, and other quick sources of energy. This will help if you experience hypoglycaemia.
What other safety and precautions should you keep in mind?
Always adjust your insulin and diet for travel time, different time zones, and other factors like jet lag. Adjustments are usually required when you travel West to East or vice versa, not when you travel North to South or vice versa. Make sure you speak to your doctor first before you do so.
Learn the conversion units for insulin at the place you're visiting. Some parts of the world stock insulin labelled with 'ml' measurements while others use 'iu' measurements.
Your doctor will let you know exactly what you need to do and how to prepare for contingencies.
You can read the full guide from the ICMR here.