Travel and Adventure with Diabetes: Planning for a Life of Exploration

In this article, I’ll share some of the adventures my partner and family have experienced while managing type 1 diabetes. Anything is achievable with enough planning!

Adventure is Our Way of Life

My partner Simon, who has type 1 diabetes, and I are passionate about adventure activities, particularly those involving overseas travel. We love rock climbing, caving, scuba diving, and multi-day hiking expeditions, carrying everything on our backs. Before having kids, we spent most weekends outdoors.

Since then, our adventures are less frequent, but we still cherish every chance to explore and embrace the outdoors.

Adventure sports require extra planning when diabetes is involved, but they are entirely manageable. Choosing the right hypo foods is an essential part of our preparation. Simon has taken hypo snacks into caves with 50-meter abseils, carried jellybeans up multi-pitch rock climbs, and stashed glucose gel tubes in wetsuits and rafts.

Adapting Insulin Doses for Activity

Adjusting insulin doses for physical activities is critical and, admittedly, this hasn’t always been easy, and we certainly didn’t get it right the first time. Over time, we’ve learned how different activities affect Simon’s glucose levels, allowing him to refine dosing strategies.

Some activities cause blood glucose to drop rapidly, some cause a slow lowering of glucose levels over hours, while other activities result in blood glucose drops one to two hours later. This learning curve has involved starting with lower-risk adventures and gradually building up to more challenging ones.

A 14-Month Backpacking Adventure

One of our most ambitious trips was a 14-month backpacking journey through Egypt, Jordan, Syria, Turkey, Greece, China, Laos, Vietnam, Thailand and Cambodia. Highlights included visiting Everest Base Camp from Tibet and staying overnight in below-freezing monasteries, scuba diving in Egypt’s Red Sea, hiking the Annapurna Sanctuary in Nepal, and the scorching (43 degrees) Roman ruins at Palmyra, Syria.

Managing type 1 diabetes on a trip like this required significant planning, and further down the page are some tips for embarking on this type of travel.

Traveling with Kids

Even after having kids, we continued to explore. One memorable trip was a six-week European adventure with everything packed into two large backpacks—leaving our hands free to keep track of our four children in busy areas. This required careful packing, as Simon’s diabetes supplies were joined by our daughter Lucy’s type 1 diabetes and coeliac disease essentials, including gluten-free foods.

Our packing approach has become a fine art.

Sometimes, our backpacks feel like they are bigger on the inside than what they appear! Our tip is to pack light as you will probably only use half of what you initially plan to take, and you can always buy items on the road if you miss anything.

These days our kids are older (16-21 years old) and travel is in some ways a little easier, but we still need to manage all the diabetes supplies which have drastically increased in volume with continuous glucose monitors (CGMs) and pump supplies. And of course, we still manage blood glucose levels and insulin dosing to keep Simon and Lucy safe.

Challenges of Traveling with Diabetes Supplies

Traveling with diabetes supplies requires detailed preparation. For our extended 14-month trip, we set up base countries. For travelling to the Middle East, we used the UK as a base as there are reciprocal healthcare agreements with Australia. This was useful in restocking on insulin and for vaccinations. We were also lucky enough to have a friend living in England who could store some of our diabetes supplies, so we didn’t have to carry everything around with us.

These days there are locker facilities around most major cities which can be useful for storage.

For the Asian part of this extended trip, we didn’t have friends who we could leave supplies with. Instead, we made Bangkok our base. We stayed at a middle range hotel and always made a booking for our return after each extended leg and asked the hotel to store some luggage for us. This meant the luggage was stored in a secure room for free. We also used this address to post items we bought along the way, so we didn’t have to carry our souvenirs with us. Again, the hotel took delivery of these items for us and stored them securely until our return.

Stockpiling pump and CGM and pump consumables can be hard, however the NDSS allows for a 6-month supply of consumables, and the PBS allows 1 script + 5 repeats to be filled which can be done prior to leaving Australia.

Australia also has reciprocal healthcare arrangements with many countries around the world (not just the UK). This may enable you to access subsidised medications and diabetes consumables in these countries. It’s a good idea to contact the local diabetes organisation in the countries you are planning to visit prior to leaving Australia – they should be able to answer any questions you have.

It is also worth investigating whether you can purchase medications and consumables as you travel, bearing in mind that you will need to cover the full cost of these items.Alternatively, if you are going to travel for an extended period, going back to finger prick checks is an option. It’s not ideal but it does provide an alternative for longer travel.

Airport Travel with Diabetes Devices

Navigating airports with diabetes devices is usually straightforward if you allow for extra time to pass through the security checks. Always carry a detailed doctor’s letter listing your medications and diabetes supplies. If using CGMs and pumps, ensure the letter covers these items - they cannot pass through X-ray machines or body scanners, and require manual checks.

Metal detectors can be used for people wearing insulin pumps and CGMs.

We always keep our carry-on items within our line of sight. Occasionally a security officer will try and put items through the X-ray machine despite our doctor’s letter, and our request for a manual check. In these instances, a polite but assertive manner may be needed. Ask to speak with the person’s manager as they are usually more informed about diabetes devices and the issue is usually easily resolved.

Traveling in Extreme Temperatures

From the sweltering heat of Egypt to freezing Tibetan plateaus, managing insulin and supplies in extreme conditions requires some creative solutions. Cooling bags work well for hot climates, while in sub-zero temperatures, we keep insulin close to our bodies or in sleeping bags overnight to prevent freezing. We also do this for anything that uses a battery, as batteries perform badly in cold conditions.

Lessons Learned: Start Small and Build Confidence

Through years of travel, we’ve learned that preparation is key. Risks are part of the journey, but they can be managed with planning and the right tools.

Start small with lower-risk adventures to build confidence and refine your methods.

Traveling with diabetes may involve extra effort, but the experiences it unlocks make every bit of planning worthwhile. Our adventures have woven rich memories into the fabric of our lives and our children’s upbringing. So, plan well, dream big, and don’t let diabetes hold you back from living your best life.

Adventure awaits!

Further information on travelling with diabetes can be found with our advocacy team. If you have questions or would like to speak to our team about your experiences, please contact the advocacy team via email.