From Birmingham, Alabama, USA:
I am with a group of seminary students (one of whom is Type 1 diabetic) going on a trip to the former Soviet Union (Siberia and Kazakhstan). We will be in some rural areas for about two weeks, and we've been assured that we will get some sickness (stomach virus, etc) because of the foreign environment. Medical conditions are fairly primitive. What advice would you give to the members of the team as to how best look after this team member with diabetes? She considers herself strong enough, with a strong stomach, and she has not been in the hospital as a result of viruses in the past (she had the flu earlier this year). Recommendations?
There is no specific way, apart the general rules valid for everybody such as vaccination, to handle your trip. If your diabetic friend has been educated enough by her diabetes team on how to manage stress situations, such as the frequent gastroenteritis (gut sicknesses) that often happen among people travelling to poor countries, then she should be able to monitor her blood sugar and to adjust her insulin dosages to the changing environment (although in case of persistent diarrhea and impossibility to swallow, hospital help could be necessary to help your friend and restore good health).
Additional comments from Dr. Tessa Lebinger:I suggest that before your Seminary Student with diabetes makes her final decision whether or not to make this trip, she speak with her physician and get more information regarding the infectious risk and medical facilities where you will be travelling. Her physician should be able to advise her (or recommend her to an infectious disease specialist who can advise her) regarding what immunizations she should obtain before travelling. At the very least, she should probably obtain vaccination against Hepatitis A and B if she is not already immunized (as should all members of the team). You should also find out if it would be advisable to take any prophylactic antibiotics to decrease the risk of catching "traveller's diarrhea". (Everyone should avoid unboiled drinking water and fresh fruits and vegetables). You probably should bring your own bottled water with you. Don't forget that ice is also a problem as is rinsing your mouth with tap water after you brush your teeth. You might want to bring along an antiseptic mouth wash. Soft drinks can also be a problem if you drink them with ice.
She should discuss with her physician whether she should take along any medicine to treat diarrhea and/or vomiting should they occur. She should make sure to take all her own diabetes supplies (insulin, syringes, blood testing equipment) and extra supplies as the brands she uses may not be available (and it may be difficult to obtain any supplies at all in some parts of the former USSR). It might be helpful if another member of the team carries some extra supplies in case hers are lost.
She should go prepared with at least a week's worth of wrapped food that will not spoil at high temperatures. A case of Power Bars might do well.
Last Updated: Tuesday April 06, 2010 15:08:54
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