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Vacationing Well - With Diabetes

You may not be able to take a vacation from your diabetes, but you can certainly treat yourself while on vacation. All it takes is a little advance planning.

Endocrinologist Dr. Linda Gaudiani, Medical Director of the Braden Diabetes Center and Inpatient Diabetes Care Program at Marin General Hospital, offers some sensible advice for managing your diabetes while on vacation. This informative podcast covers everything from health and safety precautions to managing diet and alcohol while managing to have a good time!
Vacationing Well - With Diabetes
Featuring:
Linda M. Gaudiani, MD
Dr. Gaudiani is the president of Marin Endocrine Care and Research a specialty practice in Endocrinology, Diabetology and Metabolism since 1985 and now part of the Marin Health Care District. In addition to her endocrinology practice, she co-directs the Marin Endocrine Bone Density Services.

Learn more about Linda M. Gaudiani, MD
Transcription:

Bill Klaproth (Host): Trying to maintain a diet and workout regimen while on vacation can be tough, but for people with diabetes it can be especially challenging. Here to talk with us about preparing for vacation for diabetics is Dr. Linda Gaudiani, an endocrinologist and the Medical Director of the Braden Diabetes Center and Inpatient Diabetes Care Program at Marin General Hospital. Dr. Gaudiani, thank you for your time. So we certainly know about the challenges and temptations of vacation, but for a diabetic, not being prepared can cause serious medical issues. Is that right?

Dr. Linda Gaudiani, MD, FACP, FACE (Guest): Absolutely, Bill, and now that we face the summer months, we have some especially challenging time because often our summer vacations involve new sports and new activities that can really change diabetic control. So I think the important message is be prepared. I'd like to just ask folks to make a plan just for their diabetes just like they'll make a plan for other aspects of their vacation, and probably end up having a better time.

And some of those things will be actually planning where you go, and how you go, so that you have access to what you need. That will vary according to the person.

Bill: So planning ahead, Dr. Gaudiani, very important. So what can happen if someone misses their care for a week if they don't plan ahead?

Dr. Gaudiani: Well they can have big fluctuations in their blood sugar. Their blood sugars can go too high, leading to possibly complications which in- especially in the case of a patient on insulin can be serious. They can also have low blood sugars that in the immediate can actually be even more serious. So those changes in diet and exercise, Bill, that are part of our vacation, really need to be thought about ahead of time.

Bill: So let's talk about that preparation, and I know you've got great tips, Dr. Gaudiani. How should a diabetic person prepare for vacation then?

Dr. Gaudiani: I think they have to think about how they're going to pack. I think they need to have a diabetic ID. It's also very helpful for them to have a written note about their current treatment regimen, and perhaps a treatment letter, especially if they're going to be taking an airplane. That may help facilitate their travel plans. They should have a list of their medications. Uh, I also recommend that people carry their medications in two different places in case a particular case or bag gets lost, and that they bring back-up medications and syringes.

Uh, also it's really very, very important to protect your insulin, uh, from the heat and the direct sunlight, and so how we carry our medications can be important.

Bill: And what about preparation for people with type II diabetes?

Dr. Gaudiani: Well I think for those patients, trying to stay as close as possible to their regimen of diet and exercise is really important, and not to forget taking their medication. Often people do choose to have very different diets, and some of that can be accommodated really, especially if patients continue to monitor. So now our blood glucose monitoring devices are so simple and so small and easy to use, for most patients- uh, taking medication.

I think that they do best to have a glucose monitoring kit with them so they can monitor their blood sugars and be sure they're staying in the goals that their physicians have set for them.

Bill: And you mentioned earlier- uh, talking about traveling on an airplane. So is it a good idea then to alert family and friends and other people you meet along your trip and your journey that you're a diabetic?

Dr. Gaudiani: Well I think it's very important. I think it gives your friends and your family an opportunity to look out for you better. I think it gives your servers an opportunity to assist you, folks on the airplane, even waiters. They are usually very accommodating if you let them know you have diabetes. And when we consider how much of the population is now affected by diabetes and pre-diabetes, you'll almost always find someone in the crowd that joins in and says, "Yes, me too." And then you can feel less lonely in- uh, having to pay attention to this.

Bill: You were mentioning exercise earlier. So what about exercise in general? And then of course managing diet and alcohol? How should a person with diabetes manage those things? How can they keep up with exercise, and manage that, you know, when they're at the restaurant? "Oh gosh, I- I'm on vacation. I want to have this, and I want to try that, and I want to have this drink." Help us with that. How do we do that?

Dr. Gaudiani: Well I think a little bit of moderation goes a long way, but I also think folks need a break from their everyday, and that's one of the reasons we go on vacation, so diabetes should not get in the way. It's very important to individualize this information though, and these recommendations. I am not purporting that people should go off and do whatever they want, especially if they're on insulin or requiring regimen. That can really be disruptive.

However, for most type IIs, they can have some variations in their diet and make up for it. One rich meal followed by a lighter meal. Um, a rich meal one day followed by more exercise the next day. As long as they're monitoring and they're keeping their blood sugars in a safe range of 80-180 or 200, they know they're probably okay. Not monitoring and changing the regimen, that be- might be more problematic.

Bill: And I was just thinking about exercise, Dr. Gaudiani. I would imagine if someone is going to keep up with that, and they should, and if they're going to a really warm weather locale, they should try to exercise early in the morning or very late in the afternoon when it's a little cooler out?

Dr. Gaudiani: Yes, that- that's a pretty good idea, Bill. I think common sense is always part of this. Um, exercise under intense situations can cause more fluctuation. However, we have elite athletes who are diabetics certainly, and again this comes down to planning ahead with your physician, and having the appropriate monitoring. I do feel that patients need to have a break from their diabetes, and a little bit of change on vacation can really be accommodated if there's planning beforehand.

Bill: And that's such a good message that you bring up, Dr. Gaudiani. You know, we all need a break, and especially people that are living with diabetes. Um you know, they have more challenges in their daily lives than someone without diabetes. So I love your positive message of, "Hey, you know what? You need a vacation, you need a break. It's okay to have a little fun, but in moderation and being smart about it."

Dr. Gaudiani: Exactly, and I think this all comes down to education. Usually, uh, our patients today have access hopefully to advice through their physicians, or nurse practitioners. They may have access to a diabetes center, such as ours at Braden, where they can talk to a certified diabetes educator, and really understand the particular side effects of the medications they are on.

Sometimes I actually adjust medications before a patient goes off and depending on the vacation they're going to have. Up or down, depending on their particular regimen, and it's important to understand about your medications. Again, safety has to do with how much education and how much preparation, and that's what our motto is all about at Braden is traveling through life well with diabetes, and of course that's what vacation is all about, taking that travel. It's so important.

Bill: So true, and lastly, Dr. Gaudiani, if you could wrap it up for us, what's your final message for people traveling with diabetes, or for people with diabetes in general?

Dr. Gaudiani: Well, I think the wonderful message is that the lifestyles that have been shown to really be very, very supportive in providing good outcomes for diabetics; the exercise, the healthy diets that are now recommended, moderation, and your weight are really the kinds of things that are healthy for all Americans.

So it's a positive lifestyle, and I think now the focus especially of the medical field in diabetes, starting with the new American Diabetes Association's recommendations, is that treatment isn't one size fits all anymore. Treatment is all about patient-centric recommendations that take into account individual types of diabetes, individual patient needs.

So I would say to patients of diabetes, reach out to your caretakers and make sure that your regiment fits comfortably for you, and then it will be easier for you to stick with it, including the changes that allow for happy and wonderful vacations.

Bill: Such a great point, and thank you for wrapping that up for us, Dr. Gaudiani, and thank you so much for your time. For more information, visit www.MarinGeneral.org. That's www.MarinGeneral.org. This is The Healing Podcast brought to you by Marin General Hospital. I'm Bill Klaproth, thanks for listening.