I spent the last week on a whirlwind trip to the other side of the world for work and I wanted to share my experience in case it might be helpful for someone else. Some of these tips have been shared before, but I wanted to compile them in the same place.
I am US American and flew to Mongolia, spent 3 full days in country, and flew back. Total travel time one way was 33 hours, including a 6-7 hour layover each in Atlanta, USA and in Seoul, S Korea. I traveled alone for the first time, but my accommodations were provided by my employer, including arrangements for travel between the airport and the hotel. I was gone for just under 7 days.
I have traveled internationally before diagnosis, but never alone, so this was both my first solo trip and my first trip post diagnosis. Even without those things, this trip would be ridiculous, but as it was I was extremely anxious before leaving and have definitely learned quite a bit.
Packing and Preparation: Because of the short duration, I did not check a bag on the way out, but I did on the way back. As such, I tried to pack as lightly as possible while covering all of my bases. Even so, I took double the amount of diabetes supplies I needed. I didn’t want to try to navigate a foreign pharmacy when I can’t speak the language if I could help it. I also planned out and premeasured snacks for the plane, including an empty water bottle to fill once I got through security. I ended up with two bags and a small cooler to take on the plane on the way there, and 3 bags and a small cooler on the way back.
Before I left, I looked up information about hospital/pharmacies in Mongolia on the US State Department website. At least for Mongolia, there is a helpful list of medical providers, as well as information about emergency lines and translation services, located on the Embassy's website. Remember that part of the job of your country's embassy is to help citizens living/traveling in foreign countries access emergency help. I didn't end up needing this information, but being familiar with the information available from the Embassy helped me feel more confident about being able to handle emergency situations.
Supplies:
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Travel sharps container - this one is a nice size and can be opened and closed without being permenantly sealed.
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Frio insulin pouch - standard diabetes travel gear
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Compression socks - even with these socks after so long traveling my feet had swollen. I can’t imagine what they would have looked like without the socks! These are milder compression socks, which I tried since I've not used them before. I think I'll be trying some higher level compression on my next flight since I still had swelling.
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Electrolyte packets - I got some no-cal flavored electrolyte drink packets to mix with water in case I got travelers stomach. This did end up being very useful since there weren’t many low carb electrolyte drinks easily available.
Security stuff: If you are traveling internationally where you can’t speak the language, make sure to put your pump site someplace you would be comfortable revealing. Language barriers are difficult, and foreign security officers did not understood “insulin pump” but when I showed them it was attached, they understood. I didn’t have any issues with insulin/needles/supplies or with my cgm.
I wanted to note that I did have a slight issue with my cooler coming through US Customs - they wanted to see inside to make sure I wasn't carrying any meat/fruit/etc. It wasn't a big deal, but it was something I wasn't anticipating.
At the airport: If you have a travel rewards credit card, I highly recommend looking at your airline’s lounge options. With the Delta Gold skymiles credit card, I was able to use the delta lounge on my layover in Atlanta. For $30, I got food, booze, comfortable chairs, and a shower. Well worth it with this much travel, especially since airport food is expensive no matter what. Regardless, I was glad that my itinerary had longer layovers so that I wasn't trying to rush through security and had plenty of time to stretch, hydrate, and eat.
Flying: Make sure to disconnect your pump set on take off and landing and check your tubing for bubbles periodically. I did find some pretty big bubbles at least once, so it’s a good precaution. I also recommend trying to get an aisle seat so you can drink plenty of water/use the restroom and also move around and stretch to prevent clots. I have other risk factors for clotting, so this was absolutely essential for me.
Food: Since I was traveling alone, I opted to let my blood sugar run a little higher. This also let me be a little more relaxed about food. Estimating carb counts for unfamiliar food is difficult, but I monitored my cgm after meals and administered corrections as needed and stayed mostly in range. This is when it is important to remember that there is no evidence that a short period of time with poorer control increases risk of complications. I just tried to relax and enjoy the ride.
Insulin: I ended up needing about 20% more insulin because of the relaxed eating/higher carb foods. I also tried to use the hotel fridge for insulin and it almost froze (thankfully, Frio works to insulate as well as cool, so even though the Frio case froze, the insulin was ok). I ended up leaving my insulin in the Frio case outside of the fridge for the remainder of the trip.
Weather: The weather in Mongolia was very cold. Daytime highs were around 15F/-9.5C and lows were around -5F/-20C. I left my backup supply of insulin in the hotel, but I didn't have any issues with my daily supply of insulin (pump + backup vial + backup pen) freezing. My pump stayed in my pants pocket under my coat and my backup insulin stayed inside a small back inside my backup. I didn't spend more than about an hour outside at a time though.
Other thoughts: The one thing I struggled with was staying hydrated. Mongolia has a very arid climate and is at a much higher altitude than I am used to (~4500ft, where I live at about 800ft). CDC recommends not drinking tap water in Mongolia, which limited me to bottled water. Although the hotel provided some, as did the site that I was working on, I still probably didn't drink enough. Next time I travel, I'll try to focus more on staying hydrated, and I might consider taking some water purification tablets if I can't drink the local water.
I hope this info has been helpful. If you have questions, feel free to ask, and definitely share your travel tips in the comments!
Some pictures from my trip: https://imgur.com/a/sLTwhRE
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