June 30, 2005
Question from Frederick, Maryland, USA:
My four year old has had type 1 diabetes since the age of 15 months and is currently using an insulin pump. My husband and I are planning to adopt a child from China. We must travel to China to complete the adoption. If we both go, our son must come with us. We do not have anyone who is trained to take care of him for the 10 days the trip will last. I was wondering if there would be too many health risks involved in travelling with our son. One of us (my husband or I) could travel while the other stays home, if necessary. I was wondering what your thought were on this subject.
The real answer will lie in your own comfort zone as you look in the mirror: traveling such a long distance with a four year old would be trying enough, so his diabetes diagnosis will certainly add some stress.
But, this is NOT a reason not to travel with him. In fact, basal-bolus insulin plans, such as pumping, are rather ideal for the time zone and anticipated decreased activity changes. Your doctor may want to provide you a letter (for Transportation Security personnel) outlining his need to travel with this mechanical device and appropriate supplies. You will want to bring properly cooled extra supplies and insulin plus syringes, in case you should have a pump problem during the trip. Shortly after 9-11, there were directions that you should travel with ORIGINAL labels on prescriptions, etc. I do not know if people are so concerned with that now. So, no specific health risks; just some matters to keep in mind.
You could simply put him on combinations of long-lasting and rapid-acting insulin injections, while maintaining the basal-bolus plan, while you travel to ease your mind a bit. Your own doctor may have other ideas.
This may be a once-in-a-lifetime trip, so, weigh your thoughts carefully. I would wonder if your son will get any benefit from this trip (other than a new sister or brother!), but he might and certainly each of you will!
I think the real take home message is that you should recognize the need to have some reliable help for your son in case of future unexpected disruptions in the home routine. So, recruit a grandparent, good neighbor, babysitter, etc and start training them now! Maybe your own diabetes team can match you with a family with whom you can pool resources.
Good luck and congratulations!
[Editor’s comment: See Persons with Disabilities & Medical Conditions for information on the transportation of diabetes supplies. Be sure to discuss appropriate medications for diarrhea or nausea/vomiting with your son’s doctor. You may wish to take these along as well.