diabetes in young persons in elgin
HOLIDAYS
Just a day to the beach or a long stay across the ocean should not be a problem for
someone with diabetes. With trips and travels you have to allow for unexpected
events. ‘The bus/train/plane may be late, the restaurant closed, no proper food
available, breakdown of the car, flat tire, etc.’ All this helps to make your holiday to
an experience. With a few things in mind and common sense diabetes will not spoil
the fun.
Keep your insulin with you in your handbag (not in luggage compartment or on
hold):
Take twice as much supplies as you need
Split it in two and keep each in a separate bag
Keep insulin cool (not too hot, not frozen)
Have food available
Carry hypo remedies
Glucogel
Dextro tablets, biscuits
Drinks (e.g. concentrated lemonade mix)
Have your meter with you
Check more often
Carry a letter for customs
Take less insulin when it is expected to be:
a warmer climate
an event of more activities
Check your travel insurance
A DAY OUT
It is best to keep the normal routine as much as possible Outings are usually
exciting and require more food. Having food with you is easier than having to shop
around for it.
If the day starts early than take a snack at getting up and inject the insulin at the
usual breakfast time. If the child gets up early and falls asleep again in the car or so,
then don’t give extra snack.
Take lunch at the usual time when on a twice daily injection regime.
Often supper/tea is a bit later on such a day. If it will be substantially later an option
than is to have a small snack or the evening snack at teatime. The meal can than be
taken later with the usual insulin.
LONGER HOLIDAYS
The days of travel to and from the holiday destination are the important ones to
consider because this involves travelling, and thus doing nothing. The same applies
for these days as for a day out. For the other days of the holiday the same advice is
to follow as much as possible the normal routine.
Think about the change in temperature (warmer=less insulin) and the activities to
undertake (more active=less insulin). A reduction of 20-25% may be necessary.
Don’t worry too much about a higher blood glucose if you know that the insulin has
been given and there is plenty to drink.
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diabetes in young persons in elgin
Keep in mind that some want to sunbathe and others want to swim when it is warm.
This of course needs a different amount of carbohydrates and insulin.
TIME TRAVEL
Travelling through time zones makes a day longer (to the west) or shorter (to the
east). The usual total daily dose is meant for 24 hours and therefore needs
adjustment. There is no need top change the total daily dose if the time difference is
3 hours or less.
A handy solution is to for instance the TRAVEL DOSE or the HOUR DOSE:
Travel Dose:
Take the total daily dose and divide by 4. This is the Travel Dose in clear insulin
(Actrapid, Humulin, NovoRapid, Velosulin). Take this dose every 6 hours before a
meal.
The next day back to normal doses again of the regular types of insulin.
Example:
* twice daily regime
Breakfast 20 units Mix TRAVEL DOSE =
Teatime 12 units Mix (20 + 12) / 4 = 8 units
* three times daily regime
Breakfast 20 units Mix TRAVEL DOSE =
Teatime 4 units Fast (20 + 4 + 8) / 4 = 8 units
Teatime 8 units Slow
Basal Bolus Regime
For people on basal bolus regime (4 times a day), the time travel is not too
complicated:
Continue with long-acting insulin (glargine or detemir) every 24 hours. This
means that if you travel westward over 6 hours, than to take the insulin 6 hours
earlier at destination time. Also is possible to keep a British watch going and to
take the insulin at the usual home time.
Take the usual amount of fast acting insulin before meals.
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diabetes in young persons in elgin
Example:
Someone who takes the glargine or detemir at 21.00 hours in Aberdeen
travels to Los Angeles, where it is 8 hours earlier. This person should
take the same dosis in Los Angeles at (20 – 8 =) 13.00 hours.
Similarly if that person travels from Aberdeen to Sydney (9 hours later),
then the glargine/detemir should be taken at 21.00 hours in the
aeroplane (where British time is kept) and after arrival in Australia to
continu taking the glargine/detemir at (21 + 8 =) 05.00 hours.
Keep British time in the aeroplane on the return flight.
Take note that the day may shift as well.
TRAVEL SICKNESS
General advice:
Take carbohydrate food in smaller portions, more frequent
Don’t have too much of fizzy diet drinks
Take travel sickness medication if you expect to be sick
Have a plastic bag at hand
Don’t forget your insulin
YOUTH CAMPS
Camping out with other young people is great fun. These events are usually full of
activities and excitement. That is a great experience and there is no reason why
someone with diabetes should not also take part. Think about your safety by:
Telling your friends about diabetes
Informing the responsible adults
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diabetes in young persons in elgin
Example of letter for customs and others who may ask for it
NHS GRAMPIAN Clinic for Young Persons
with Diabetes in Moray
DrGray’s Hospital
Elgin (Moray)
IV30 1SN
01343 543131
To whom it may concern
re: Calum MacFarlane, d.o.b. 21/09/1999,
Alt-na-Green, Lossie Road, Elgin IV30 1AB
This to confirm that the above person is known to this clinic with a diagnosis of
diabetes mellitus type 1.
For this he needs to carry on his person:
Insulin in vials and/or cartridges,
Injection pens, needles and syringes,
Blood glucose monitoring equipment (meter, finger prickers, test strips),
Glucose tablets, food and drink.
Please contact this clinic in case of emergencies.
Regards,
Dr Willem J van IJperen, MSc MD, MA, DCH, FRCPCH
Consultant Paediatrician
Elgin, date
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