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Question:

From Johannesburg, South Africa:

I am a 23 year old female who has had diabetes (Type 1) for 19 years. I am well controlled. I am planning a world tour with a friend, backpacking around the world for an indefinite period of time. What tips do you have about my insulin? Is it wise to purchase insulin in foreign countries, and would a prescription from my doctor allow this?

Answer:

A rather old fashioned friend was a little shaken the other day to get a postcard from a granddaughter something like 'Dear Grandpa, Having a great time and tomorrow we get the bus from Rangoon to Bangkok, Love.'

It sounds as though you have your diabetes under very good control and are also planning a great adventure. A number of thoughts occur to me which I have set down for you to think about and not in any sort of priority. Supplies may be an issue depending on where you plan to go; but the main problem is that in this sort of travel you are vulnerable to unexpected illnesses like gastroenteritis and as a diabetic you need to be specially prepared for sick days.

  1. Itinerary
    Without detracting from the spontaneity of this trip I would suggest that you make a rough itinerary in advance. This way you could start listing local resources that you might need like consulates. Also you could find out about any immunisation and visa requirements and ask the Eli Lilly or the Boot's representative (and global diabetes organizations) to find out about the availability of insulin and other supplies in the areas you plan to visit.

  2. Medical
    Consider medical insurance for the trip if you do not already have it, the chances are you wont need it; but it will be reassuring for everyone else. Apart from immunisations make sure that you and your companion are comfortable with testing, giving glucagon and dealing both with hypoglycemia and ketoacidosis, etc. Ask your doctor about salt tablets and about a minimal First-Aid and Medical Kit. Insulin and syringes should not be a problem except in the out of the way parts of some of the poorest countries (in e.g., RaraTonga or Bolivia) or if you attempt to follow the silk road back to China. I would take your doctor's prescription and a letter not so much to enable you to get supplies; because it would be accepted outside of your own country, but as an affidavit that you are a diabetic who needs syringes.

    Insulin is OTC (Over The Counter) around the world so that you can purchase it if it is available. Prescriptions are required though in countries that have National Health Services, that is in Western Europe, Australasia, and Canada in order to get insulin free; but as a visitor you would not be eligible nowadays and would have to pay market value. Testing supplies may be more of a problem and you may have to write to the maker of the instrument you use to find out about overseas availability and perhaps you should have a small supply of strips that don't need a meter. Finally you need to have some idea of how to get medical help if you should need it.

  3. Communcation
    It would be a good idea if possible to have some friends or relations scattered along you route who can help out if anything goes wrong and who know that you may be coming. You should also arrange to be able to get funds from home if the need arises and you should talk to one of the Bank officers about this.

  4. Security
    Theft is a problem for travellers all over the world. For this reason it is wise always to have in duplicate enough insulin and testing supplies to get you to the next replenishment point, this might mean one lot in your backpack and another in something like a DiaPak that you carry separately.

I'm sorry that this is such a jumbled set of ideas; but I'm sure all will be clearer as your plans mature.

DO'B

[Editor's comment: I assume you'll check the State Department's Travel site). Also, see Traveling with Diabetes and Your Traveling Medical Record for more hints on traveling with diabetes. Another webpage, Traveling with Diabetes, has links to more websites discussing travel. WWQ]

Original posting 28 Mar 1998
Posted to Traveling

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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