| If using insulin pump |
- On arrival, adjust time setting on the pump to the local time. No other adjustments are needed.
|
| If using multiple daily injections |
| Brief stay |
- Administer the basal insulin at the same time that it would be administered in the home time zone.
|
| Longer stay |
- Use gradual adjustment:
- Adjust the timing of basal insulin injection by 2 hours each day to a time that is more appropriate for the new time zone.
- or
- Switch to insulin degludec:
- Insulin degludec has very long duration of action, so no time adjustment is needed.
- Degludec should be started at least 1 week to 10 days before the planned trip so that dose adjustments can be made.
- When making this transition, the total basal insulin dose should be decreased by approximately 20% and then adjusted as needed.
|
| If using a fixed-dose regimen with NPH* |
- Monitor blood glucose.
- Continue the usual regimen until ready to depart from the home time zone.
- If the child develops hyperglycemia before the next-scheduled administered NPH dose, treat with additional doses of rapid- and short-acting insulin.
- Give the next dose of insulin (with the usual doses of NPH and other insulins) before the appropriate meal in the new time zone (typically at breakfast or dinner).
|
| Other guidance |
- Transport insulin in carry-on luggage; refrigerate in a cooler (do not freeze) during long trips.
- Carry food and carbohydrate preparations (eg, glucose tablets) on the plane to ensure ready access when needed.
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