My 10 year old daughter has had type 1 diabetes for two years and is using Mixtard 30 twice a day, we are travelling to Australia, and I wonder how you would recommend handling her injections bearing in mind the eight hour time difference. We depart at 8:00 am and arrive in Sydney 8:00 am (their time) but 12:00 midnight (our time). Please advise the best way to adjust to the local time.

It’s not easy to properly answer your first question regarding how you can keep your daughter under control over the journey to Australia while on two Mixtard30 shots daily. I’m not prone to use such a regimen in children and adolescents nor adults even in normal daily life — then you may imagine how negative I might be on this difficult occasion of a long journey across eight zone times!

The only answer is to switch to an intensified insulin regimen based on Humalog or Novolog before each meal plus Lantus (insulin glargine) or NPH at dinner or bedtime. Ask your diabetes team for further help.

MS

[Editor’s comment: See Traveling with Diabetes.

SS]