Our three year old son has type�1 diabetes diagnosed about three months ago, and he is on Protaphane plus Actrapid at 7:30 am and 4:30 pm. We will be traveling from Finland to Maine, USA (a seven hour time difference) in about six weeks and our travel day lasts approximately 24 hours from the time we leave our home in Finland until the time we arrive at our destination home in Maine. When do we give the insulin injections on travel days?

Also, I have heard that Protaphane and Actrapid are under different names in the US. What are the corresponding names?

First of all, Protaphane is called NPH in the U.S. and Actrapid is the same as Regular. Both are available in any pharmacy.

There are some general preparations to consider in the interim before your trip depending on how long you are planning to stay. These should include a note from your doctor certifying the diabetes just so that a US customs officer doesn’t question the syringes. You should also be sure to duplicate immediate supplies taking one lot with you and having another in any registered baggage, for more complete guidelines you might want to explore Traveling with Diabetes.

As to insulin dose during the trip, it is difficult to be too precise without knowing a little more about flight times but I assumed that the 7 hour time difference was not included in your calculation, but what I would suggest would be to remain on Helsinki time and insulin scheduling for the 24 hours from the time you leave home. Check with the airline about food but take alternatives with you. The combined effects of excitement and relative inaction may slightly increase insulin needs. In any case, by the time you leave, he may be emerging from the honeymoon period and taking a higher dose. You will need to check this, but it seems likely that you will have given both an evening and a morning dose en route and that you will finally get to your destination in Maine fairly close to the time at which the next evening dose on Maine time would be due.

I would then check the blood sugar, and if your son is not hungry, I would omit the Actrapid and give a slightly increased dose of Protaphane. The next morning I would start with the usual routine.

You should probably discuss all this with your son’s doctor because there is still time to switch to a peak-free basal insulin like Lantus (insulin glargine) with a Humalog or NovoLog at meal times, but the increased flexibility that this would give might be offset by having to dilute the rapid acting insulin in order to give such a small amount.

I hope this will give some guidance and that you wont be too exhausted to enjoy the time in Maine!

DOB