Travel – Diabetes Amigo

Living with Type 1 diabetes doesn’t mean you have to anchor your dreams of adventure, especially when it comes to cruising. From managing blood sugar levels on the open water to navigating dietary needs at sea, this journey requires thoughtful planning.

Know Before You Go / Sea Sickness / Ship Security / Packing Checklist / Supplies

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Know Before You Go

Guest Services at the various cruise lines are familiar with people living with diabetes and typically offer the following services/exemptions:

Sharps containers for in-room use (some public restrooms may have sharps disposal)
- Tip: Skip a sharps container and use a needle clip instead
Portable medi-coolers for insulin storage or ice buckets
Mini fridges to maintain the temperature of beverages (i.e., juice or milk)
Free Wi-Fi for the management of medical devices (i.e., CGM or pump data), but typically requires a letter from your doctor
Liquids exemption – allows you to board the ship with water, juice, and shelf-stable milks that are used for lows/hydration. This exemption also applies to liquids when reboarding the ship from ports of call.
Food exemption – allows you to bring food on board for the treatment of lows.

As soon as you book your cruise, email Guest Services for any special needs/requests to allow time to gather any requested documentation and to ensure availability.

Travel Insurance
Consider if travel insurance is something you need. Some travel insurance plans cover medical transport, if needed.

Sea Sickness Prevention

If prone to motion sickness, it might be a good idea to prepare your body for the motion of the cruise ship. Consider taking any of the following the night before the start of the cruise.

Motion Patch

Bonine

Ginger Supplement

If feeling sea sick during the cruise, a ginger candy or tea can help settle your stomach.

Ginger Tea

Cruise Ship Security

Be prepared to have your diabetes supplies and other carry-on items scanned. Cruise ship boarding is very similar to flying and going through TSA at the airport. The person wearing medical devices will also be asked to walk through an X-ray/body scanner machine.

Consider which supplies you are comfortable having x-rayed, and/or check the user manuals for each medical device to determine whether x-raying is permitted. Many people with diabetes have their supplies x-rayed and report no issues. I avoid having medical supplies/devices (CGM, Omnipods, backup pumps, and spare meters), and the person wearing them go through an X-ray.

If cruising internationally, bring copies of your prescriptions, the medication box, and/or a letter from your doctor.

T1D Packing Checklist

The Cruise Packing Checklist is organized by topic and includes items for diabetic supplies, chargers, extra adhesive, considerations for water activities, seasickness, and other miscellaneous needs during a cruise. The quantity of supplies is not listed because it will vary based on your length of stay and travel type. It is recommended to bring triple the required supplies.

Download the editable MS Word T1D Cruise Packing Checklist:

T1DCruisePackingChecklist Download

Packing T1D Supplies for a Cruise

Bring all your diabetes supplies on your cruise as carry-on items. An organized carry-on bag is key for getting through security efficiently. Consider packing your diabetes supplies in three (3) packing cubes:

Non X-Rayed Supplies
- CGM Sensors
- CGM Transmitter
- Ominpod Pods
- Spare Glucose Meter
- Blood Ketone Meter
X-Rayed Supplies
- All other supplies
Sick Day/First Aid Kit

Only the non-x-rayed packing cube needs to be removed from your carry-on bag and handed to security so that it will not be scanned. Keeping only the supplies that you don’t want x-rayed separate makes getting through security faster.

T1D on the Cruise Ship

A few random tips that are helpful for managing Type 1 Diabetes while on a cruise ship:

Take a tour of the boat to familiarize yourself with the ship’s medical services and first aid stations.
Develop a plan for time change zones (especially if pumping) and if any considerations are needed to manage your blood sugar/insulin delivery.
If pumping, call your pump company to request a spare/backup pump for travel.
If using a phone with cellular service, keep the phone in airplane mode or request free Wi-Fi.
At mealtime, ask your server (or take food from the buffet) for a snack to keep in the room for overnight lows (PB&J or cookies) or to take on excursions.
Bring storage bags for ice and food storage.

Cruise with Other People Living with Type 1 Diabetes

If you are looking to cruise with others who live with Type 1 Diabetes, consider the 1 Sweet Cruise.

Water activity requires special considerations for Type 1 Diabetics. Water parks like Great Wolf Lodge, Legoland, Disney’s Typhoon Lagoon, Knott’s Soak City, etc. are all manageable with preparation and thoughtful actions while at the parks.

Research / Supplies / BGs / Hot Tubs / Sunscreen

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Research

Water parks typically have procedures for guests with special needs. Research the water park’s website or call to get information about how the park supports Type 1 Diabetics. It is helpful to know the park’s requirements before arriving (i.e., clear bag for supplies or sizing requirements for coolers). On each park’s website, look for Accessibility or Special Need Guests options.

T1D Supply Bag

Bring your daily diabetic supply bag including glucagon, Gvoke and/or BAQSIMI into the water park. Keeping the daily diabetic bag secure, accessible and at the right temperature are the main considerations.

Keeping Supplies Secure
- First Aid or Life Guard Station – inquire if the water park will hold your diabetic supplies (including a disconnected insulin pump) at the First Aid Station. Most water parks have accommodations for special need guests and will securely store your supplies for free.
- Seats – choose a seat where you can see from all angles. Your seat location is not only helpful for locating/seeing your kiddos throughout the day but also for keeping an eye on your personal belongings. Our family typically has one family member that stays at the seat to keep supplies and belongings safe and to create a “home base” (a meeting spot where the kids know they can always find a parent). We will trade-off through out the day who sits at home base to give each parent a break.
- Visibility – keep supplies tucked away and not out in the open.
- Tags – consider adding a tracking device to your supply bag, phones and/or personal items. AirTag and Tile are popular brands of tracking device tags.
- Lockers – if available, lockers can help keep your supplies secure.
- Waterproof Phone Bag – Lots of cell phone users (not just diabetics) keep their phone around their neck in a water tight pouch while at a water park. Consider a separate phone bags for Continuous Glucose Monitors receiver/phone and the pump controller/PDM.
- Dry Bag – keep your supplies tucked away in a water tight bag.

Keeping Supplies Accessible
- Lockers – rent a locker inside the water park to keep your supply bag safe. Lockers are great option if unlimited access is available throughout the day.
- Bag with A Cooler – if you feel safe keeping your supplies at your seat, consider a beach bag with a cooler. The cooler in the bag helps keep the supplies dry and separate from other personal items.
- Rent a Cabana – the trend of renting a cabana is available at most water parks. It is an expensive option but it might be a good solution for keeping supplies accessible, visible and secure.

Keeping Supplies at the Right Temperature
- Lockers – lockers can get hot (typically a metal box that heats up in both indoor and outdoor water parks). Keep supplies cool with ice packs or look for lockers in the shade.
- Frio Wallet – a Frio Wallet will help keep insulin vials and pens cool and does not require a fridge/freezer to activate.
- Insulated Bottle – add ice to insulated bottle, wrap your insulin pen/vial in a paper towel or Frio bag (adds insulation so the insulin is not directly in freezing water if the ice melts), place the wrapped insulin pen/vial in sandwich bag and secure with the bottle’s lid. A coffee travel mug works well because of the wide mouth design (any insulted water bottle works though).

Insulated Tumbler with LED Temperature Display

Blood Glucose (BG) Levels

Every Type 1 Diabetic’s blood glucose levels respond differently while at indoor and outdoor water parks. Variables that can effect blood sugar include water, water temperature, swimming, exercise, heat, excitement, adrenaline, etc. Be prepared for hypoglycemic (low), hyperglycemic (high) or blood sugars that stay in-range. Make adjustments to basal or I:C ratios based on the individual’s body and how it responds to exercise/water/heat.

Checking BG Levels
- My kiddo wears Dexcom for a Continuous Glucose Monitor (CGM) and prefers to not carry his phone/receiver at a water park.
- A parent will typically wears the phone in a water proof case in hopes of getting a connection while waiting in line together. We never go more than 45 minutes without a BG reading.
- If we are unable to get CGM data, we manually check BGs every 45 minutes at our seat. Time goes by fast when you are having fun, so I set a timer on my phone to remind me to test BG levels.

Keeping Low Supplies Dry and Close
- Low Supply Carrying Options – Lines and stairs at water parks make it hard to get to low supplies. Keep a few supplies with you in a water proof case.
  - For boys, swimming suits with zippered pockets can store low supplies.
  - For girls, board shorts with pockets can store low supplies.
  - Waterproof Fanny Pack – store a CGM receiver/phone and low supplies in a waterproof fanny pack.

Hot Tubs and Blood Glucose Levels

Being in hot water can cause insulin to be absorbed faster. For insulin pumps users other than OmniPod you will have to disconnect and store your pump. This can cause blood glucose levels to rise faster than expected due to not receiving basal insulin while in the hot tub.

Sunscreen

Keep your skin protected even indoor water parks. Sunburns can cause high blood glucose levels and ruin your fun. When applying sunscreen stay clear of medical device’s adhesive patches (sunscreen can make the adhesive malleable and device will just slide off) and OmniPod insulin pumps (sunscreen causes pods to crack/leak).

Category: Travel

Cruise with T1D