Q: Since our daughter’s numbers have been stable lately, we decided at the last minute to go away on a week-long vacation. However, ever since we got here her blood sugars have been high, and they’re not coming down much with corrections. Can vacation be that much of a disruption?
A: It sounds like what you’re experiencing on your vacation is a crash course in the many variables that can lead to high blood sugars.
For starters, how long did it take you to reach your destination? If your daughter tends to be physically active (which helps the body use glucose), sitting still for hours cooped up in a car or on an airplane (or tour bus) could be enough to produce a higher than normal reading. On long car rides or during long delays at airports, we also tend to snack more. This, too, can contribute to higher numbers if extra food isn’t covered with insulin.
Even time zone changes can affect blood sugar numbers. If you’ve traveled from California to Florida, for example, the time change can easily create disruptions or confusion about the correct time to administer insulin doses or eat meals.
If you’re like most families on vacation, you’re probably eating breakfast, lunch, and dinner in restaurants. There may be no way to get around this, but be aware that sometimes, no matter how diligently you try to estimate food portions, restaurant foods can contain hidden fats and sugars and more protein than expected -- all of which can make management of blood sugar numbers trickier.
Sometimes, out-of-range numbers are just a normal by-product of excitement about being on a trip. This is because excess adrenaline is a known trigger for high blood sugar. The anticipation of being away for a few days, the thrill from a really scary ride at a theme park, or even apprehension over something like passing through airport security... All these things can lead to a child’s producing more of the stress hormone. You can do your best to keep your daughter calm, but this may be one factor that’s a little more out of your control.
When numbers are running high, go through the same management steps you would at home, including testing for ketones, adjusting insulin, and monitoring your child’s blood sugar a little more closely to see if you can trace it to a particular food, event or activity.
You may feel comfortable making the judgment call on how to proceed, but don’t hesitate to contact your care team from your hotel room to troubleshoot. Your child’s doctor or diabetes educator can help walk you through some steps that perhaps you haven’t thought to take or can work with you to figure out an appropriate insulin adjustment. Chances are you will come up with a solution that works.
--Jenny Booher, R.N., C.D.E., is a certified diabetes educator at the Center for Diabetes & Endocrinology at Akron Children's Hospital in Ohio.
How Other Parents Deal
“If our vacation involves driving for more than five or six hours, I now have no problem splitting the drive into two days. We keep it fun by choosing to stop someplace that has an interesting attraction or at a motel that has a pool so we can get some exercise. We’re fresher to drive the next day, and we find that limiting long car rides is helpful for keeping our son’s numbers where they should be.”
-- Maggie L., Chicago, Ill., mom of 9-year-old Jacob
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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