People with type 1 diabetes taking insulin face many difficulties on long plane flights. For example, common challenges include adjusting insulin dosage and timing based on different time zones and the impact of jet lag on choosing a safe and effective insulin. In a previous survey, more than half of travelers with diabetes reported difficulties in managing their glucose levels during their journey. Many also had hypoglycemia (low blood sugar) during their travel or in the first day after arriving at their destination.
We know that many doctors are uncertain about how to adjust insulin for people with diabetes traveling for 6 hours or longer across multiple time zones. Some of the information available is actually “potentially harmful” because it may not be the most accurate. Currently, there is a lack of travel guidance and resources to help people with diabetes plan. This may confuse travelers.
No difference in two types of insulins
This pilot study included 21 people who traveled by plane from Hawaii, where they spent 2 days adjusting to that time zone, to New York where they spent 3 days, before returning to Hawaii. Researchers compared the use of insulin degludec versus glargine in travelers with type 1 diabetes using multiple daily injections. Insulin degludec was administered daily at the same time regardless of time zone, and glargine was administered per travel algorithm. There was no significant difference in glycemic outcomes between the two groups of the study. For example, neither group achieved more than 70% of time in a healthy range of 70–180 mg/dL during travel. They found that jet lag was greater on glargine U100 in eastward travel, but not westward. Also, fatigue was greater after westward travel on glargine. Sleep was not different between the two types of insulins. In conclusion, in adults with type 1 diabetes using multiple daily injections of insulin and traveling across multiple time zones, glycemic outcomes were similar comparing insulin degludec and glargine U100.
More research needed
Despite the lack of information and guidance for people travelling with insulin, it is a very important topic for people with diabetes and their families. There is a need for further research to develop more evidence-based recommendations and explore how we can use new technologies to help. Also, there is a need to understand the personal challenges that come with traveling while taking insulin. That will help us create new approaches to reduce these challenges for those living with type 1 diabetes.