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Guest Post: It’s All Happening.

Most of the time, I make sure I know two phrases whenever I’m traveling abroad – “I have type 1 diabetes,” and “Where is the bathroom?” – because … because.  Diabetes might require more planning ahead when it comes to travel, but it can be done, and Sarah from Coffee & Insulin is proving that with every stamp in her passport.  Thanks for guest posting about diabetes and international travel today, Sarah!

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Leaving for my 10-month study abroad trip in Europe, I lugged my carry-on through the airport, stuffed to the gills with test strips, insulin, pen needles, syringes, glucose tablets, batteries, glucagon, and an extra glucose meter. I handed the flight attendant my one-way ticket to Marseille, France and boarded the plane, cradling a year’s worth of diabetes supplies in my arms.

The day before, I’d put 3 small slips of paper in my wallet. They read J’ai le diabète, Tengo diabetes, and Ich habe Diabetes. “I have diabetes” in French, Spanish, and German. (I actually have diabetes in every language, but my wallet is only so big, you know?) I had copies of every prescription folded in my bag. I had travel notes from my endocrinologist. At 21 years old, this would be my third time traveling to Europe. I was beginning to get the hang of the whole “international travel with diabetes” thing, which is certainly an adventure of its own.

I made it to France without a hitch, but my travels abroad didn’t stop there. Over the course of the next 10 months, I visited 11 countries. I went by train, plane, bus, bike, and foot. With each trip, I became a stronger traveler. I became more knowledgeable and more confident. My packing list was an art form. I kept a smaller, pre-packed bag of all the diabetes supplies I would need for a trip, so I could just grab it and stuff it into my backpack. I learned how my blood sugars reacted to hiking hills and winding through narrow cobblestone streets for hours. I learned how much I needed to bolus for a French pain au chocolat… but more importantly, I learned how incredibly delicious a freshly baked French pain au chocolat tastes. I learned and learned and learned about the workings of the world and the workings of myself simultaneously.

While in the Netherlands for a few days, I met a fellow type 1. We were staying at the same hostel, and after spotting her insulin pump, I introduced myself.

Her name was Anna, and she was an American backpacking through Europe for a few weeks with three friends. We became instant friends because of that great, invisible diabetic bond, and we swapped stories on the role diabetes plays in our travels.

Smiling, we acknowledged that any concern, fear, and doubt didn’t manage to stop either of us. Now being on the other side of the pond, being the travelers, knowing the risks and rewards, we thought, how could it?

Just as we made room for diabetes in our daily lives, we made room for diabetes in our travels and more literally, in our suitcases. Once, I wore the same pair of pants for a week so I could fit another jar of glucose tablets and my extra glucose meter into my backpack. And you know what? It was great. Who needs two pairs of pants when you’re busy paddle boating in Prague with an eased mind, knowing you have all the supplies you need?

We laughed (as that is all we can really do) at the awkward moments: when the language barrier was too strong to explain why I had a syringe in my pocket, or trying to find the translation for the word carbohydrates on foreign food packaging. (FYI: In Greek, it is υδατάνθρακες. You can remember that, right?)

We agreed that we’d both hit some bumps in the road. Traveling can be rough. It can be unpredictable. Even if we show up at the airport 3 hours early, the plane might be delayed. Even if we write clearly and legibly and have all the necessary tags on our luggage, it might get lost. And as we know, diabetes can also be unpredictable. Even if we count every carb, bolus precisely, go to the endocrinologist every three months, check our blood sugar 18 times a day- high blood sugar will happen. Low blood sugar will happen. And beautiful, rainbow skied 100mg/dl will happen. It’s all happening.


It’s super cheesy and super true to say that bumps in the road are part of the best adventures, and as long as we are aware and prepared for our needs as diabetics, everything will be okay. I’m not saying everything will be seamless. Our luggage might still get lost (which is why I never put diabetes supplies/medicine in a checked bag!) and our blood sugar might go high because of French baguettes and Italian pizza, but when it boils down to it, we’re stronger than the ups and downs and highs and lows. We’re brave and cool and we’re not going to let diabetes-related fear limit our adventures.

We’ve totally got this.

“If anyone can handle a bump in the road,” Anna laughed when I showed her my backpack full of glucose tablets, “it’s definitely us.”

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Sarah is a recent college graduate, writer and literature nerd, expert coffee drinker, and type 1 diabetic of 9 years. She currently lives in Virginia, but is moving to Europe in the fall! New to the diabetes online community (and amazed by its support and kindness), she hopes to become further involved and continue to connect with other inspiring individuals living with diabetes.  You can read more of her adventures with type one diabetes and world travel on her blog, Coffee & Insulin.

Flight Risk.

I’m not a fan of traveling by air (major understatement) and my flight-related anxiety has ebbed and flowed over the last few years.  Actually, it’s been way more flow than ebb, because traveling by plane has a direct and predictable influence on my blood sugars, in that the anxiety of air travel causes my blood sugar to rise with the plane.

What amazes me is that even with a 200% basal increase and a conservative correction while I watched the double-up arrows on my Dexcom graph, my blood sugars still went berserk.  (Thankfully, the Dexcom showed me up in the 300’s, while my meter only had me in the 230’s.  But still.  And yes, I know I need to calibrate.  You can also see where my connection flight took off, riiiiiight there at the 3.30 am-ish mark.)

Even though I know emotions are on the long list of variables, it still amazes me how something as intangible as stress can be as powerful as food or insulin when it comes to tangling up my blood sugars.

The Friendly Skies.

“Hi there.  Are you the guy who is responsible for this section of the plane?”

He was holding a tray of drinks and paused to contemplate my question.  “I suppose I am.  I am responsible!  Now I feel powerful!”  He flexed, as much as he could in the limited corridor.

“Awesome.  I don’t mean to trouble you, but I am traveling alone and wanted to let the closest flight attendant know that I have type 1 diabetes.  Not a big deal, but just something to have on the radar if I were to have an issue of some kind.”

I don’t mind traveling alone – sometimes, when it comes to the chaos of TSA and luggage and all the rest of it, I prefer alone – but when I am literally flying solo, I feel a little vulnerable.  I always wear my medical alert bracelet when I’m away from home, but sometimes that doesn’t feel like enough.  And for this particular trip, where I’d be in the same plane seat for upwards of seven hours on an overnight flight, I wanted to make sure someone had diabetes in the back of their mind, just in case.

“Not a problem at all.  Type 1 or type 2?”

(What?)

“Type 1, diagnosed when I was a little kid.  Do you have diabetes in your family?”

“My brother was diagnosed when he was eleven.  Lots of shots, lots of all of that growing up.  But he’s doing just fine now.  Two young kids, one more on the way.”

“Aw,good for him.  So you know it better than most, right?”

“I’d hope so, after sharing a house with him and our parents for so long.  Do you mind if I ask what your symptoms are, for your reactions?”

“Honestly, you’ll know something’s up if I start crying without just cause, or if I go pale and shaky, and have a hard time communicating.

“Does the light go out of your eyes, too?”

It’s funny how only those who know, who have seen hypoglycemia in their personal lives, understand what that means.  How low blood sugars make the light go out of your eyes, makes them empty for that brief moment.

“That’s it.  That’s it exactly.”

“Well,” he said, resuming his semi-flex and throwing out a reassuring grin, “as the one in charge of this part of the plane, I can assure you that you are in good hands.  No trouble at all – we’ll keep a quick eye on you.”

“Thank you so much.  I really appreciate it.”

We continued on to our final destination without diabetes incident, and I was again reminded of how small the diabetes community is, and how understanding it can be, down to the smallest detail.

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