Packing with T1D

Packing with T1D

Packing for vacation with Type 1 Diabetes takes a good amount of planning and organization. Our first vacation as a T1D family was 3 months almost to the day after B was diagnosed. We were on a family trip to Orlando that was planned well before dx and it had its highs and lows, both literally and figuratively. We’ve learned a lot since then! And packing doesn’t cause me near the stress that it used to…so I thought I would write a post on the diabetes supplies I pack for B when we go on vacation. I will soon have another post on flying with T1D as well as a post on our favorite travel items.

Even though B is only 5 now, I think this list should work well as a starting point for any T1D. To reiterate this is a starting point, your T1D’s requirements will each be different and so my intent with this post is to act as a base for those that might seem overwhelmed or a checkpoint for those who are already in the swing of things. If anyone has any thoughts on something I haven’t accounted for, or some interesting tips please post in the comments! Also, important to note, B is on both Dexcom and Omnipod. I’ve attempted to account for non-pumpers and non-dex wearers as well, but would love any feedback from those of you on injections and finger pokes. Finally, I apologize to those using the cloud coverage method, I am completely unfamiliar with this regiment and I’m not sure how well I have captured your needs. Hopefully if I don’t nail it on the insulin and syringes you are able to find something in the rest of the post that is helpful.

When I start packing I really I pack 3 “kits”; our small go to kit that follows her almost everywhere, her emergency kit, and the extra supplies needed for travel. I’ve debated how to list all of the supplies from these different packing locations. What I landed on was a master list with notes in brackets for the items I pack in her “go to” and “emergency” kits. NOTE – if we are flying, with exception of the aerosol adhesive remover and lithium batteries, I carry everything on with us!

Master Packing List

  • Loaner Pump – B used to wear an Animas pump and they were great with sending a loaner pump to us in the event that something happened to hers while we were away (this significantly reduced my back up supplies). It is my understanding that Medtronic offers the same type of service for their pumps (and perhaps Animas ones they support). If you are planning on getting a loaner pump try to allow at least two weeks prior to departure to ensure enough time for the paperwork to be processed and the loaner to be shipped. Omnipod to my understanding does not offer a travel PDM service, so as you will see below my back up supplies are significant.
  • Insets – 1.5x – 2x the number of days gone (this seems like a lot especially if you are changing out every 3 days, but we’ve found we go through an incredible amount on vacation especially if there is a pool).
  • Syringe/Pen Tips – For those of you Omnipod wearers, I accommodate for 10/day of vacation. The reason this number is so high, is if something happens to your PDM while on vacation, worst case scenario you will need to switch back to your long and fast acting insulin for the duration of the trip. You may be able to get a PDM shipped to you, but it’s better to be safe than sorry. This is also the number I used to account for when Brooklyn was on injections, 10/day, but you may have a number that works better for you. For pumpers that have a travel pump this number will be lower, roughly 10-15 (enough to get you through a failed pump plus a few back ups for emergencies and mini-dose glucagon if needed) If you are unfamiliar with mini-dose glucagon I highly recommend you read this document from diabetesincontrol.com
  • Fast Acting Insulin – For those of you pumpers my general rule of thumb is to bring enough fast acting (B is on Humalog) insulin to fill each of the insets you bring (I’m a bit paranoid about running out so bring 1.5x this amount). In actuality this number doesn’t need to be quite as high for those using Animas or Medtronic as you aren’t required to refill the cartridge with every inset change – with Omnipod you do (I have heard of people drawing out insulin from the Pods but I haven’t had any success with it).
  • Long Acting Insulin – For Omnipod wearers, I pack 1.5x the long acting insulin (B is on Lantus) I would need if her PDM was not functional for the duration of the trip. For other pumpers travelling with a loaner pump I used to bring 1 cartridge as an emergency back up. For those on injections I used to bring 2x the amount I would need at home for that same period, so that i was prepared if a vial was dropped on the floor or spoiled in the heat.
  • Dose Conversion Sheet -In the unlikely event that we have to switch back to injections, I like to have a note packed in our supplies that has the calculation B would need for her long acting insulin as well as a list of IC ratios throughout her day. The IC ratios can be found in your pump settings. The long acting insulin (B is on Lantus) is roughly 1/2 of the average total daily dose. This can also be found in you pump settings. The Alberta Children’s Hospital has a good document that outlines this calculation as we as tips for timing the dose – it can be found here.
  • Dexcom Sensors – B wears her sensors for an average of 10 days and I try time it so that she has a reasonably new one on when we leave. That being said, I pack 2x the number of scheduled changes she will have while we are gone or a minimum of 2 sensors. We’ve had too many failed sensors and tear offs to chance it with just one back up. Also just a note to double check when your transmitter is due to expire. We have had transmitters last 3 weeks after the low battery warning but we’ve also had ones die on the same day as the first notice. If you think it might go while away bring along an extra.
  • Dexcom Receiver – We are using the G5 now and her data primarily sends to my phone but as a backup we always travel with a spare phone or receiver and charger.
  • Test Strips – Thanks to the Dexcom this number is lower for us now, although on vacation we experience more highs, lows, and ??? periods that usual so we bring a lot of test strips with us! We bring 3x the number of test strips we would normally use for that period of time.
  • Lancets – B uses the Accu-Check Multi Click – which we LOVE! The lancing device looks similar to a pen with similar depth options as other lancets, however there are no exposed lancets to load and dispose of. You insert a cartridge that contains 6 individual lancets that are completely contained. Because each cartridge contains 6 lancets the number we end up packing and carrying around is less. I generally pack equivalent of 3 lancets per day…we’re pretty bad at remembering to change them so this is often overkill, but gives us some room if something happens to our lancing device. I also always pack an extra lancing device just in case we lose our main one (which has happened a lot!).
  • Extra Meter – In the off chance something happens to our PDM we pack a back up meter. Thankfully our back up meter uses the same strips as our PDM so we don’t have to double up on strips.
  • Ketone Strips/Meter – The worst stomach bugs B has gotten was while we were on vacation, so I tend to go a little crazy with the Ketone strips. She always carries a ketone blood meter in her kit along with about 10 strips. For vacation I usually pack an extra 15 per week we are away – this is a lot but running around at 2am to find more in a foreign city is not something I want to try.
  • Skin Prep – We use SkinTac skin prep for both our Dexcom and Pods, therefore I pack these roughly 1:1 with the pods and sensors we are bringing plus a couple extra incase we need to re-secure the sensor if the dressing is starting to lift.
  • Alcohol Swabs – We us these with each Pod and Sensor change as well, plus we keep a few in her kit in case we need to do a test and there isn’t the option to wash her hands first. I generally pack 2x the number of pods and sensors we are bringing.
  • Wipes – For BG checks we often use baby wipes. They are also super handy to have around so I pack a small one in my purse and a refill pack in the suitcase.
  • Adhesive Remover – I cannot express how much we love Niltac Adhesive Remover. I pack 10 wipes (more for emergency changes when were out) and 1 can of the aerosol spray.
  • Low Treatments – Finding a candy store on our first or second day of vacation has become a much loved tradition for us. B gets to pick out a variety of low treatments that are new and fun! Because of this I usually bring enough low treatments to get us through 3 or 4 days (worst case scenario amounts). For us this is 15 – 20 low treatments (for B a low treatment is 15CHO).
  • Glucagon – We always carry this in her emergency kit along with 2 syringes. The syringes are way less scary looking and are a huge help if you need to do an emergency min-dose treatment. Here is another link to a great document on the mini-dose from diabetesincontrol.com
  • Batteries – I’m sure most batteries can be found wherever you are travelling, but its one less thing to worry about. Our PDM goes through batteries fast! So I pack and extra set per week we are away, as well as an extra set of batteries for our Ketone Meter and out backup BG Meter.
  • Friopac – At first I had mixed feelings about the Friopac but it has become a must bring when we are in hot locations. It keeps your insulin at room temperature while out so it doesn’t denature. It will not keep it at fridge temperature though so your insulin will activate the 28-30 day expiry when you use it.
  • Icepac and small cooler – If you want to make sure that your extra insulin is kept cool on route to your vacation and don’t want to bring it to room temperature, make sure you pack it in a small cooler. I usually wrap the insulin in a dishcloth to make sure it doesn’t get too cool either. NOTE – I haven’t tried this flying yet. I’m sure along with our Dr. note we would be able to carry on the icepac but I have never tried.
  • Travel Letter from Dr. – If you are flying make sure you get a note from your Dr. and your pump company if the pump cannot go through the xray. We have only ever need each of these once (on separate occasions) but I was very happy we had them with us!
  • Logbook or Software – We no longer use a written logbook, between the pump and our dexcom we get a very good digital record. On vacation B’s sugars generally go crazy, we’re either battling highs because of excitement and heat or lows because of the exercise. Either way, especially on trips longer than a week, it’s been really helpful to review the data and make adjustments.
  • Fun Covers – On vacation, particularly those in warmer locations, her pod and dex are on more display than usual so we use fun custom decals to decorate them. This year for our trip to Disney World we took along a lot of custom Disney Character pod covers. You can order them from our shop!
  • Foreign Language Emergency Card – When travelling to a country where you are not fluent in the language, if may be helpful to do up an emergency card that has been translated. Last year when we went to Mexico, I printed a card with a translation of Type 1 Diabetes and her medications on one side. On the other side I listed the possible reasons why we would visit an emergency room with a check box along side.

 

Here is our packing list for our 10 Day Trip to Disney World:

Diabetes supplies for our 10 Day trip to Florida
  • 20 Pods (2 are in her emergency kit)
  • 50 Syringes and 50 Pen Tips (2 of each are kept in her emergency kit)
  • 1 vial and 5 cartridges of Humalog (1 cartridge is in her pen in the emergency kit)
  • 2 cartridges of Lantus
  • Dose conversion sheet
  • 2 Dexcom sensors (1 in the emergency kit)
  • Backup Dexcom receiver and charger (for us this is the iphone B brings to school)
  • 350 test strips (1 vial of 50 is in her go to kit and another vial of 50 is in her emergency kit)
  • 5 lancet cartridges and extra lancing device (1 cartridge is in her go to kit, another 2 are in her emergency kit along with the extra lancing device)
  • extra BG meter (in her emergency kit)
  • 30 ketone test strips and ketone meter (10 strips and meter are in her go to kit)
  • 30 skintac (4 are in her emergency kit)
  • 40 alcohol wipes (10 in her go to kit and 10 in the emergency kit)
  • 1 pack baby wipes (in my purse I have a small pack, the big one is put in the checked luggage if flying)
  • 10 adhesive remover wipes and 1 spray can (4 wipes in her emergency kit, if flying the can goes in our checked luggage)
  • 20 low treatments (5 in her emergency kit, 5 in my purse)
  • Glucagon (in the emergency kit)
  • 4 AAA batteries and 2 CR2032 batteries (2 AAA and 1 CR2032 in her emergency kit)
  • Friopac
  • Travel Letter
  • Omnipod PDM upload cord
  • Dexcom transmitter and pod covers!

If you are flying anything that contains a liquid will need to be put into a clear ziploc bag (ie. insulin and glucagon) to go through security. I usually pack all liquids at home into ziplocs and after security put them back in to the appropriate places so we know where to find them in an emergency.