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Time Travel.

I know there are a dozen different strategies for dealing with diabetes while traveling in different time zones, but I've never found one that goes off without a hitch.  If you're pumping insulin and rocking different basal rates throughout the course of the day, adjusting to a new time zone can be a total pain in the hey, look, something shiny!

Throughout our vacation, my blood sugars actually behaved themselves.  And I can't figure out how, since we were five hours off on our natural schedule, our meals were carb-filled traditional Irish breakfasts and chicken and champ, and we were in the land of Guinness.  It makes NO sense that my numbers were in range, better than they were the week before, when I was home and cruising around in my regularly scheduled chaos.  But I think part of it came down to dumb luck with the timing of my basal rate changes.  And the alignment of some planets. 

The flight from Boston to Ireland was just over five hours long, which also accounted for the time difference.  With Irish time five hours ahead of Rhode Island, I had to decide how to best manage the change.  Did I want to spend the first day adjusting the clock on my pump every few hours until it was synched up with the new timezone?  Did I want to change it right away when I landed?  Or did I want to keep it as is and hope that a week wasn't enough to muck with things?

I decided to change the time on my pump as soon as we took off, because I knew it was going to be a very tricky travel day.  Here's why: After boarding the plane in Boston at 6 pm and flying some awkward version of "overnight" (where we landed at midnight our time, but 5:30 am Ireland time), and by the time we arrived at our hotel in downtown Dublin, Chris and I were giddy from the lack of sleep.  Thanks to the luck of the Irish, we were able to get into our room well before check-in time, and we collapsed and slept for almost six and a half hours. 

This is precisely why I changed my pump right away.  My basal rate is 0.45u from 11 am - 11 pm, drops to 0.25u at 11 pm until 3 am, and then it goes all apeshit from 3 - 11 am.  At 3 am, it jumps up to 0.60u.  At 9 am, it jumps again to 0.9u, where it hangs out until the 11 am rate kicks in.  In those wee morning hours, that 0.6u is a lot of insulin for me.  Without it, my blood sugars creep up into the 180 - 240 mg/dl range.  With it, I'm solid.  But if it's delivered at the wrong time, I could end up with a really nasty low blood sugar.  So there's a lot to juggle when considering just that one thing.  (Never mind the addition of driving, new foods, BEER, and sheep.  And sheep drinking beer whilst playing paintball.)

Pretty pictures from Ireland never fail to make a post seem a little more ... I don't know ... friendly?

Too many variables, too much guesstimating, and too few hard and fast rules of diabetes make traveling through time zones tricky. But we've all done it, and we're all continuing to do it. What tips would you have for a PWD traveling through time zones?  Do you make one fast move, or are you a slow transitioner? 

Comments

My endocrinologist tells all of his pump patients that traveling with the pump is the easist thing for time zones. His suggestion is exactly what you did-change it before you get there. Of course, I mostly heard him talking about traveling to Israel, which is a 12-hour flight and a 7 hour time difference, but all of his pump patients told him it worked for them!

I read on the CWD listserv before FFL one year about a technique that has worked for me since.

I change my pump one hour each day until I get to the actual time where I am. Good for long trips, not so much for short getaways :)

You were in Ireland. Dumb luck had nothing to do with it!

Ive tried changing the clock in the pump once, usually in the plane on the way to my destination, or when I arrive. That has not worked for me, and I think it is bc my body is still on my "home time," so it's metabolism or whatever didtates different basal rates for different times - is "hard wired" for home time. So, I keep the pump on home time if the trip is less than a week. That seems to work for me. Except then I can't easily use my pump as my watch, as I usually do... but that is another story.

I have no useful advice to add and am not very good at "time travel" in general. I just wanted to say that I love that you used the word "whilst." For some reason that word makes me sooo happy, and I think it should be used more often!

I generally fly to Ireland once or twice a year. As you say that's a 5-hour time difference. Normally the flights leave Boston around 6:30 PM. What I do is to get on the plane and reset the time on my pump/cgm/watch immediately. Then I take some melatonin, cover myself with a blanket and try desperately to sleep as much as I can on the flight. 1st day I'm there I stay up as late as I can, usually 8 PM. Then I go to sleep and the rest of the trip is fine. I've used this approach many times for a 4-day trip to Ireland and it works for me.

I just change it when I get there,but my basal rates are pretty close to each other(0.1 or less)so there's no possible way I could get too screwed up.(thankful for that,because I'm bad at "adjusting" things!)

I change the time once, sometime between when I get on the plane and when I arrive. This seems to work reasonably well for me. Traveling always involves enough of an element of being out of my normal routine that any differences based on what basal rate I'm getting when don't seem to matter.

When I travel between California to Boston, I change my pump to local time of my destination sometime during the flight. So far my blood sugars haven't gone nuts as a result of that.

On Saturday we're flying to Japan, however, which is 16 hours ahead--yikes. I guess I'm going to have to try this incremental shifting thing.

Thank you, this has been helpful while i have not traveled yet with d this summer I am going to south africa, 13hr flight and 7hr difference. I have no idea what i'm going to do, bbut you got me thinking about it

On a trip to France last year, I tried changing the pump time by 1.5 hrs each day, until I was on France time by the 4th day (6 hrs difference). Didn't work very well, as my basal rate in the afternoon is 0.025 and goes up to 0.225 at 5 p.m. By the 3rd day, I was seeing serious ketones after 5 p.m. as my pump was still delivering 0.025 units, as it was still 1.5 hrs behind France time. On the trip home, I changed the time to U.S. time as soon as I arrived in the U.S. and my BS's were normal. Am going to Italy in a few weeks, and will change clock to Rome time as soon as I arrive. We'll see what happens!

apeshit... should be a medical term!

I don't pump (MDIs for me) and I don't travel... so I'm no help!

I live in the Middle East for nine months out of the year, which is a nine or ten hour difference(depending on daylight savings)from my home state so it is a tricky thing having a 25 hour flight with multiple stops. My favorite diabetes expert (Mesha, my diabestes educator) told me to change my pump time when I land in the new time zone. That has worked pretty well for me, even when I fall into bed and wake up at crazy hours as I suffer with jet lag. Now adjusting basal rates for 118 degree weather is a whole other problem!

When I cross a time zone, or an ocean, I just switch the pump to the new location as soon as I'm on plane #1. I just make sure I'm packing tons of sugar in case of lows - or if I'm high, I just rage bolus obsessively and keep an eye on things until they've cooled down a bit, or I crash (enter the packed sugar). By day 2 of the vacation, everything is back to normal. I've just come to expect the chaos of the first day and deal with it. It sucks, but that's just the nature of this beast.

I just change it on the plane, all at once, and try to get on a normal sleep schedule asap. If I'm only changing time zone by an hour, I just leave it.

Firstly - hello! I've never posted here before; although have been a follower for some time.

I live in Australia - an incredible distance from pretty much anywhere! I've travelled to the US and Europe a number of in my 10 years of pumping and I've always changed the time on my pump as soon as we touch down in our final destination (often after as much as 30 hours in transit - fun!). This has always, always worked for me without any hitches at all.
One reason that I don't change the time to my destination's when we take off is that there will always be at least one stop over (sometimes only a couple of hours, other times hours and hours and hours and hours etc), and the possibility of delays is very real.

Ireland is stunning, isn't it - and you're right about photos not capturing its amazing verdant landscape!

I have found that as a hybrid (1.5?) my blood does better when I am relaxed and enjoying myself. When I'm out motorcycling for a day or three, I have constantly better levels. That could be part of it.

In my experience, everything with D is a total crapshoot. You can do the same thing each time and some weird variable will sneak in and give you completely different results each time. With regard to time travel, the closest I've come to getting it right has been when I've changed my settings/schedule as soon as I touch down in my destination, and then I try to just follow a schedule based on the local time. It's not perfect, possibly because I'm usually really tired, but it comes close to getting it right.

thanks for this post! I am planning a trip from middle America to Australia (home for my husband) and I have been thinking of this quite a bit. I think I will take the Aussie's advice and change to the correct time (and DAY!) when I arrive. Did you leave your pump on through airport security? What about the dexcom? Thanks!

10 years ago, my sister and I (both diabetics, both using injections and not the pump) had CRAZY low blood sugars from changing time zones when we visited Paris and Ireland, and that wasn't even when we used pumps with basal rates (good old Lantus was our friend). Now, every time I travel more than two time zones, I set my pump to the time zone I'm traveling as the plane is about to leave, but I also give a little bit of insulin if I know I'm missing a basal rate that should be higher than it's being set to. I also try to avoid eating many carbs, because for some reason when I bolus after changing my basal rates, it reacts much much differently (in both ways - causes highs and lows when it shouldn't) than it normally does.

Sounds like Ireland was beautiful!!! I just got back from Belgium. I had no idea as to what to do with the time change so I when we landed there, I set my pump to Belgian time. Unfortunately, I kept going low for 2 days. So after eating 1/2 a bottle of glucose tabs, I ended up reducing my basal rate by 20% for the whole trip. I did end up high in the middle of the night 2 nights (I think that was the Belgian chocolates and waffles!) but otherwise it worked great! Coming home was no problem. I think my body just stayed on East Coast time...

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