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Insulin
Dependent
Diabetes
Trust
.
Driving and Diabetes
- Looking after your insulin
- Healthy Travelling
- Travel Insurance
- Increased Security on Flights affects people with Diabetes
- Return to Living with Diabetes
Going on holiday if you have diabetes means that you have to take a few extra precautions, especially if you are travelling overseas. Here are some tips to help you – ones that we have learnt by experience:
· Travelling overseas probably means that your insulin will not be kept in a refrigerator for days for even weeks. Exposing insulin to high temperatures makes the insulin weaker and so it does not act as efficiently.
· If a refrigerator is not available try to store the insulin in a cool dark place.
· Carry your insulin in a polystyrene container or a small wide necked vacuum flask.
· There are also containers available with a cooling system of plastic containers filled with liquid that can be pre-cooled in your refrigerator. Do not pre-cool to the low temperature of a deep freeze because freezing can destroy the insulin. See details of FRIO Wallets at the end of this article.
· If travelling by air make sure that your insulin is in your hand luggage in the cabin with you. The luggage hold of the aeroplane will go below freezing point because of the high altitude and this will destroy or damage your insulin.
· Carry two lots of insulin, testing equipment and syringes/pens and distribute them between two different hand luggage bags. You could give one set to your travelling companion. Luggage does frequently get lost and it could prove difficult to replace your insulin or syringes/pens.
FRIO Wallets - keep your insulin cool
In the UK this device came on the market in 1999 and it is designed to
keep your insulin cool and safe for a minimum of 45 hours, even in
temperatures of 100 degrees Fahrenheit. Depending on what country you
are inm they have stayed activated for about a week. Insulin is safe in
the wallet for up to 28 days.The main advantages are that there are no
bulky ice packs, you do not have to worry about finding a freezer to get
supplies of ice and the wallet is light to carry.
How does the FRIO wallet work?
It is activated by immersing it in cold water for 5-15 minutes. The
panels of the wallet contain crystals and these expand into gel with the
immersion in water. The system relies on the evaporation process for
cooling. Drying the wallet with a towel makes it dry to the touch.
User Experience
One of our members found that while the actual cooler part worked well,
the inner bag stayed moist due to the evaporation process so that the
labels on the insulin vials came off. This dampness was raised with the
manufacturer and they advised that waiting for 20 minutes after soaking
would solve the problem. Vials and pens can be put into plastic bags as
this does not affect the cooling properties of the wallets but Frio also
supply a rip stop water proof liner which can be used to cover pens or
vials before putting them into the inner wallet. These are available on
request at an extra cost. Note: ONLY the vials that should be put in the
plastic bag and NOT the whole pouch.
The FRIO wallet comes in four sizes:
· Individual – for carrying one pen only.
· Duo pen - for carrying 1 pen and two 3ml cartridges or just 2 pens.
· Small – suitable for two 10ml vials of insulin.
· Large – suitable for one pen and two sets of cartridges or 4 10ml vials or 5 disposable pens.
· Extra large – carries 20 x 3ml cartridges, up to 8 pens or a mix of both.
The device has been approved by the British Medical Devices Evaluation Unit.
For further information or to order a wallet contact the manufacturers at:
FRIO UK, PO Box 10, Haverfordwest SA62 5YG
Tel 01437 741700, e-mail
info@friouk.com website:
www.friouk.com
Healthy travelling - deep vein thrombosis
Recent cases of deep vein thrombosis [DVT] on flights longer than 4 hours has caused concern for travellers. There are several misconceptions about DVT that should be corrected:
· It is often thought of as an economy class syndrome – it isn’t as it has also occurred in first and business class passengers.
· DVT can be caused by travelling at 33,000 feet in the air, it can also be caused by sitting for long periods in cars, buses, lorries and trains.
Some people are more at risk of DVT than others. The at risk factors are:
· Certain forms of cardiac disease
· Abnormalities in blood clotting
· Pregnancy
· Recent major surgery or injury
· Recent immobilisation for a day or more.
In addition to these factors, recent research has shown that there may be additional risks from smoking, obesity and varicose veins.
Avoiding the development of DVT
· Drink adequate amounts of fluids, especially water
· Avoid drinks that contain alcohol and caffeine
· Avoid smoking
· Avoid sitting cross legged
· Walk around in the cabin whenever you can
· Stand up and stretch your arms and legs periodically
· Wear loose fitting clothes when travelling.
Jet lag
The main cause of jet lag is crossing time zones and a lot of research
shows that it is worse going from west to east than from east to west
but people vary and are affected differently.
Advice for minimising jet lag
· Try to keep calm before the journey as excitement, stress and nervousness can make it worse
· Have a good night’s sleep before the journey
· Try not to eat too much on the flight
· Avoid alcohol, tea and coffee
· Drink plenty of water because the body is susceptible to de-hydration on long flight
Travel insurance
From 2005 travel
insurance sold by insurers or brokers will be regulated by the Financial
Services Authority [FSA] but insurance bought with a holiday package
will not. This could lead to confusion and lack of protection, often
because travel agents do not know the right questions to ask! A recent
survey by Which? found that only three out of 20 agents
questioned asked about pre-existing medical conditions.
At the moment two out of three people buy their holiday insurance from travel agents rather than shopping around because many agents refuse to accept the booking unless the cover is purchased as well. The lack of regulation for travel insurance through travel agents could mean that people are not receiving the protection they require.
Pre-existing medical conditions such as diabetes, are already a grey area for travel insurance with many people finding that when they make a claim the insurer will not pay up saying that the pre-existing illness or condition excluded them from the scope of the policy. These problems usually occur when the insurance is sold as part of a holiday package.
Each insurance company has its own criteria for judging medical conditions and in many cases the more serious the illness the higher will be the premium. Diabetes is one of the medical conditions that attracts a higher premium.
Best advice!
Always check the small print of a policy to make sure that you are
adequately covered. If you are not asked very detailed questions about
your health then ask whether any of the conditions you have will affect
the cover that is offered.
Increased security on flights affects people with diabetes.
As a result of the New York disaster, there is increased security at airports and on flights. There are to be no sharp objects in hand luggage and this clearly affects people requiring insulin because syringes, pen injection devices and blood testing lancets are all sharp objects and therefore fit into this category. However airports and airlines have recognised the need for people with diabetes to inject on flights and therefore special regulations have been made to enable people requiring insulin to take the necessary equipment on board the aircraft.
The regulations are different in the UK and the US and currently are as follows:
The United Kingdom
People treated with insulin require a letter from their GP to allow
syringes and other equipment to be carried in hand luggage. The letter
must clearly state that you have diabetes and will need to inject during
the flight. The letter will also need to refer to any further supplies
in the baggage in the hold. Without such a letter you may not be allowed
to take your medication on board. It is recommended that the letter be
obtained well ahead of the expected date of your flight.
IDDT recommends that you contact your airline for its exact policy but to be on the safe side it is sensible to obtain a doctor’s letter.
Canada
The increased security on flights in Canada are similar to the UK in
that you must have a doctor’s letter stating that you have diabetes and
that you need to carry insulin and all your other equipment with you. In
Canada there has always been a demand for people with diabetes to carry
a letter from their doctor to this effect when flying although this has
not necessarily been adhered to in the past.
The United States
The following
information applies to airports in all 50 United States and was supplied
to the American Diabetes Association.
1. Because of concerns over forgeries, prescriptions and doctors’ letters are not sufficient to allow people with diabetes to carry syringes and other equipment on board.
2. Passengers may board with syringes and other insulin delivery systems only if they can produce a vial of insulin with a professional, pharmaceutical pre-printed label that clearly identifies the medication. NO EXCEPTIONS WILL BE MADE. Since the prescription label is on the outside of the box, it is recommended that passengers refrain from discarding their insulin box and come prepared with their vial of insulin in its original pharmaceutically labeled box.
3. Passengers who have diabetes not requiring insulin but who need to test their blood glucose may carry their lancets on board as long as the lancets are capped and are brought on with a glucose meter that has the name embossed on the meter eg ‘One Touch’, ‘Accucheck’.
4. Glucagon should be kept in its original pre-printed pharmaceutically labelled container.
General points
· If you are concerned that your syringes may be handled or tampered with at your hotel in your absence, take individually wrapped syringes with you rather than packs of ten. Use a syringe only once and then dispose of it carefully. In this way you will be sure of a sterile syringe each time you have an injection.
· Remember to always take sufficient insulin with you because you may not be able to obtain your type of insulin in the country that you are visiting. This is particularly important for people using beef or pork insulins that have been withdrawn from many countries.
· When you come home it is sensible to throw away any unused insulin that has travelled with you because it has not only been exposed to heat and bright light but also to vibrations, all of which can damage insulin and make it less effective.
· If you are overseas for long periods and cannot obtain your usual insulin in that country John Bell and Croyden, Pharmacists, Wigmore Street, London will courier insulin [and other drugs] to you. All you have to do is to send them a doctor’s prescription, either NHS or private and they will properly pack the insulin and courier it to you. You will have to pay the courier charges. Alternatively if you use Hypurin beef or pork insulins these can be obtained with a doctor’s prescription directly from the manufacturer’s CP Pharmaceuticals and their contact address and telephone numbers will be on your insulin pack.
·
Using a pen
injector means that injections can be done discreetly in public if
necessary. For those who do not a pen [or cannot use a pen because of
lack of availability for their particular type of insulin], travelling
can be difficult if you are stuck in airports. No one wants to inject in
public toilets with all the modern day connotations of syringes. Here is
a tip – use the baby changing rooms, they are bigger, cleaner and can be
used by both men and women. Alternatively most airports have a medical
room than can be used.