Niamh Byrne was one of the key speakers at our recent Diabetes Ireland awareness Exhibition.

In this article she shares her top tips for managing your diabetes on your travels.

Ever since I was diagnosed with diabetes when I was nine, I was always of the mind-set that it was never going to stop me from achieving the things I wanted in life. Not even travelling around Europe, without access to a fridge, my usual supply of medication, a local pharmacist, nor a particularly big bag could get in my way!

When I first considered the idea of inter-railing across Europe I was immediately concerned about my diabetes control. However, having successfully completed such a trip, I am now filled with confidence that having diabetes does not hinder the experience in any way! As long as you make the right preparations and take appropriate precautions, anything is achievable. After making it to six countries and 12 destinations, I would unquestionably recommend inter-railing to everyone and hope that this piece of writing will encourage some of you, who were considering such a trip, to go for it!

Preparation
I cannot stress enough how much Niamh Byrne (left) and her friend on their inter-railing trip around Europe the planning I put into the trip paid off during it. My experience is mainly in relation to using the insulin pump. However, with some slightly altered preparations, I believe it is just as achievable if you are taking regular injections.

My biggest issue was figuring out how I would keep all my insulin cold. FRIO Cases were my solution. They essentially work like a mini fridge, stay cool through water evaporation and are incredibly portable. All that is required is access to cold water every 48 hours. This was very reassuring even when temperatures reached over 30 degrees. As I wasn’t sure if I would always have access to a sink to submerge the cases in, I brought along a large Ziploc bag and it worked a treat.

The next step was figuring out the amount of supplies I would need. For the month, I brought almost enough for two in case of breakages. I was advised to bring a spare pump along with me and so I made contact with my pump’s company and there was no problem getting one. The only concern that did remain with me was the amount of expensive medical equipment I was carrying around. Never-theless, once I was a few days into the trip I just made sure I had my handbag close to me at all times and my big bag in a locked locker in the hostels we stayed in. One final preparation I made was for the airport security. As the pump cannot go through the x-ray on the conveyor belt, I had to take it through the walk-through metal detector with me. I was also carrying a spare pump in my hand which can look rather suspicious, but once you have letters signed by your doctors it is fine.

In case of emergency
At all times on the trip I made sure I was wearing my medical ID bracelet.I’ll admit it is badly tarnished and worn from the heat, water and dust now, but it gave me peace of mind while I was away. A wallet card with emergency contacts is also important to have and this can be downloaded easily from the internet. Again it offered me and those I was travelling with reassurance.

Lists and photocopies
They’re worth it! I made a photocopy of my prescription book and also got another prescription made out with all the generic
insulin names. As we had a general idea of the route we were taking, I brought details of nearby hospitals and diabetes clinics. I made photocopies of my health and travel insurance documents. In a notebook I brought with me I noted any important numbers relating to medical care, health insurance and of course stolen cards, money etc. Finally one very important list to come with me was a list of all my pump settings. This would have come in handy in case I had to use the spare pump, which thankfully I didn’t!

Keep your companions well-informed One very important piece of advice I would give, if travelling with others, is to make sure they are well informed:
• Of what diabetes is
• How your pump works
• The sort of equipment they will see you using throughout the trip
• That it is important to stop if you are low
• Most importantly, what to do in the case of an extreme hypo. I felt very reassured knowing that they were familiar with all the equipment I was using and knew what to do if something happened.

Packing
The internet is amazing for planning what to bring. Packing for inter-railing is the very same as any trip, the only difference is you only want to pack only what is absolutely necessary. I brought a 70-litre backpack with me and about a quarter of it was taken up with medical supplies. In order to try and make the load as compact as I could, I removed some of the supplies from their boxes and kept them inside slightly more convenient airtight plastic containers.

I brought a spare set-change around with me in my hand luggage at all times and kept the FRIO cases containing all my insulin here also. Although all of this added extra weight to my bag, it was far less than I had imagined and I found my backpack ended up easy enough to carry. You could also ask your travelling companions to share the load if you found it was unmanageable. Change the time on equipment.The first thing I made sure to do once we started the trip was change the time on my blood glucose monitor and pump. Although I had been told I may need to set different basal patterns while away, I found for me this was not the best option. Every day was different and so I just took one day at a time. I decreased my basal rate when I knew we were walking a lot, tested my blood glucose levels more often and always carried glucose tablets and biscuits in my bag in case of a hypo. There really wasn’t as much to it as I had anticipated.

Consider pump insertion point
One piece of advice I would give is to consider your set location. As I had quite a large bag on my back, I found the best area to insert the set when travelling from place to place was my tummy, as it wasn’t rubbing off the bag and there wasn’t a chance it could come off. One day that did prove challenging for my diabetes was in Budapest when we spent a day at the famous Thermal Baths. I was concerned before going about leaving my pump off for extended lengths of time, as I had been advised not to have it off for more than an hour. Keeping this in mind and yet not wanting to miss out on the experience, I decided to take the pump off for an hour at a time.

Once I put it back on, I would test my levels and give a correction and sometimes more if I knew I was taking it off again. After each hour I would sit on the deck with the pump back on for an hour or two. There was plenty to do outside of the pools anyway. That evening it took several corrections to get my numbers back to normal. However, I was aware this would be the case and felt I handled it as best I could in order to get an authentic Budapest Bath experience! Preparation made for reassuring trip I was surprised how well I was able to handle my diabetes on the trip and most of it is thanks to the preparations made at the start. I was lucky in that I didn’t have any major incidents, however I was very reassured throughout the entire trip that I was well equipped if something did happen. Though I was adamant I wasn’t going to let my diabetes hinder my experience, when challenging situations occurred I remained rational in what I could push to do. It is an unforgettable experience nevertheless and one I would highly recommend to anyone!

You can see more about Niamh Byrne’s travel experience at https://prezi.com/1lwjacut5ymo/inter-railing-with-type-1-diabetes/