Crossing time zones with multiple injections
If you are on insulin injections, it can often feel quite daunting when it comes to crossing time zones. But don’t worry, it’s not as bad as you’re thinking and with a little practice it becomes quite easy to manage.
Below is a typical scenario when flying from the US (East) to Europe (West).
- The day of your travels east from the U.S. to Europe, inject your basal (long-lasting Lantus or Levemir) insulin 2-3 hours earlier than normal.
- On your first day in West Europe, take your background insulin (Lantus/Levemir) 2-3 hours earlier than normal, local time.
- The next day, give yourself a basal insulin dose at what would be the “normal” time of day for you back home, but at local time.
Europe (West) to US (East)
- On the day you are to traveling west from Europe to the U.S., take your basal insulin (Lantus/Levemir) injection 2-3 hours later than usual.
- On your first “full day” back in the US, take your long-lasting insulin 2-3 hours later than usual, on local time.
- Then on the next day, so back to your normal timing for basal injections
Basically, you need to try and switch your insulin to the routine timing of the new country. It’s important to test frequently in between as you may need to either give yourself a little more insulin to help lower your blood sugars (if necessary) or eat a little more to help avoid hypos. This will depend entirely on the individual and their bodies reaction.
When it comes to your fast-acting insulin, ie the insulin you take to cover food, you simply take it when you eat as normal.
If you are travelling on “SET” insulin doses (Which is a very old school way of doing things), I don’t recommend you cross a time zone without speaking with your doctor, or learning how to carbohydrate count.
It’s important to note that if the time difference is LESS than 4 hours, then you won’t need to make MAJOR changes to your insulin. Just simply monitor closely and adjust as necessary.
This formal often helps people calculate their long-lasting dose when travelling West to East (where the day is shortened)
Reduced travel dose = Normal dose x (0.9 – [#of time zones you cross ÷ 24])
My personal approach: When I travelled with insulin pens I would take my Lantus at the same time I would back home then adjust as necessary.
So, basically, if my flight was at 8 o’clock in the evening, and my background insulin was typically given around 9 pm, then I would take it on the plane.
Then, when I arrived at my new destination with my new time zone, I would wait until the full 24 hours of the background insulin was up (or however long your background insulin lasts) and then I would take my next dose of background insulin at 8 pm LOCAL TIME.
So in between, there would be a period that there was no background insulin, and for that, I would monitor closely and use fast-acting insulin to keep my blood sugars down.
For me, this is the quickest and easiest way to adapt to a new time zone with injections.
Crossing time zones with an insulin pump
I travel with an insulin pump all the time now. I have pens as a backup, but it’s the insulin pump life for me. I actually find switching time zones with an insulin pump an absolute breeze, and recently (August 2018), within a 36 hour period I switched through four time zones from California to the UK, to the UK to MUSCAT to SRI LANKA and I had no issues!
For travelling with an insulin pump you need to change the time and date of your pump settings to your new time zone.
Some people do this when they’re on the plane, some people do it when they land. I do it when I land because it’s easier.
As soon as I land I switch my insulin pump to local time, and I monitor closely for any changes needed. I usually find I will need to alter my basal rate for different parts of the day, but these changes are quick and easy and usually, within 3-4 days I’ve got it adjusted.
Always expect some sort of adjustment period.
If you are sitting on a flight for a LONG time, (i.e journey above), then you may find your blood sugars run a little higher, basically because your body isn’t doing anything. So, you may find increasing your basal rate by 10-15% will help.
Remember flying makes us dehydrated, and dehydration can push our blood sugars up, so stay hydrated and monitor closely. I find my FreeStyle Libre is really useful on plane journeys and crossing time zones.
Dealing with Jet Lag
Don’t underestimate the power of jet lag and its effect on blood sugars! I often combat jet lag by this motto: sleep when your destination country is sleeping and stay awake when they are.
This can be a challenge, especially if you’re shattered, but I swear by it. I have never experienced severe jet lag because when I fly I always follow the routine of the country I am going too.
For example, on my recent flight from the UK (8 pm) to Sri Lanka (lunchtime local time). The journey was 14 hours, and I slept on my UK flight, then when I arrived at my connection, it was morning time in Sri Lanka, so I stayed awake for the rest of the flight.
I haven’t done a flight to Australia yet, and I am sure that my little system will be thrown into orbit when I do, BUT I’ll deal with that when it happens.
I would also suggest drinking lots of water and going easy on the alcohol as it dehydrates us further and just generally makes us feel crap (diabetes or not). I do drink on the plane, but I tend to have a 2-3 drink maximum over a 14 hour period!
If you want more tips and tricks and even moreeee information on crossing time zones and dealing with various aspects of jet lag (plus everything you’ll ever need to know about travelling with diabetes), you can purchase an ebook here.
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I hope you’ve enjoyed this post, and as always, Dream Big and Travel Far!
As you all know, I LOVE to travel far distances, but with that comes many challenges with type 1 diabetes. One of those is crossing time zones with type 1 diabetes and managing insulin doses and insulin pumps. So, to help advise you, I’ve put together everything I know and do to manage my diabetes when I am crossing various time zones around the world.