Travelling across time zones

[Tonysmum]

Hi,
I didn't want to hijack another post i saw about travelling with a pump, as my question goes in another direction.
How do you handle basals while travelling across time zones?
Tonys basals go from .05 to .85 so it could make a difference if we get it wrong. We will be going to England in July to see the family. The time difference is 8 hrs over a travelling time of 13 hrs outbound, 16 hrs return. I will be checking in with the endo's offfice to get their opinion, but it would be good to get real peoples experiences, too.
Thanks

[kgm0612]

I recently traveled from the East coast to the West coast..... a 5 hour and 50 minute non-stop flight from Boston to Seattle. What I did was turned the time on my pump back one hour every 1 hour and 45 minutes. I also ate small snacks during the flight. When I arrived in Seattle, I was now on West coast time. I did the same thing on the return flight back to Boston.

Karen

[Funnygrl]

I've heard that it's best just to change to the time zone you are travelling into when you get there.

[Dervish]

I'm on MDI, not a pump, but when I asked my doc about it, he said that it's best to just allow the extra time to pass between shots because being high for a few hours isn't that big a deal, while being low for a few hours can be serious trouble. Extrapolating from that, I'd guess the pump equivalent would be to maintain basal at the lower rate until you get there and are ready to change the time, then bolus for the high that will probably result.

[xMenace]

Can you please post his hourly basals and the exact travel departure and arrival times, to the hour anyway.

You are right;there could be major issues with those swings.

Ask your endo how fast his body is expected to adjust to the new time. I suspect he has a big dawn phenomenon, so you really don't want to up the basal for it only to have it kick in 6 hours later than expected.

[Tonysmum]

Karen - I like the idea of the smooth(ish) change your method should give.

The idea of changing the pump clock to local time on arrival could cause problems if his body is 8 hrs behind (or ahead) what the pump is doing to him. not a bad method if you have stable basals though.

I agree that erring on the side of being high is better as more frequent testing can reveal any need to take a correction if necessary. Although creating the high condition by way of less basal insulin may not be necessary because the inactivity of flying may take care of it naturally.

xMenace - thanks for the PM, I PM'd you back

I understand the YMMV principle, thanks for all the input

[HollyB]

When we did the overnight cross-Atlantic flight we decided to leave Aaron on his nighttime basal for most of it, as the flight resembled nighttime more than anything else (not that it resembled any actual part of his normal day). Then when they served "breakfast" at about 3 am our time we switched to Dublin time, as that was sort of the start of his day -- so he got his morning basal and bolus amount. We stayed up that first day (except for when Aaron fell asleep sprawled all over the tour bus!) so it worked out really well.

[notme]

I flew to Englad a few years ago with my pump and I changed my pump to local time about half way across the pond. We flew out at 4:00 pm for an overnight flight and we started getting ready to sleep by 7 pm our local time. The flight attendants have you close the shades and they shut down for the night shortly after a dinner service. I took a melatonin and changed my pump to London time. When we arrived my blood sugar was in the 130 range.

[Blue Knight]

Some of my flights last as much as 26-30 hrs, especially going to India on business, so I just keep my pump time in CST and once I get to wherever Target needs me I just change the time on my pump to the local time. I do the same thing on the return.
Recently I went from Minnesota - India - China - France and back to Minnesota and I had no problems at all with any of my BG readings.:)

[notme]

My basal rates change very little from day to night. I have three profiles. The biggest issue I have with changing time zones is eating at odd times and the lack of exercise. When we traveled to Africa (about twenty hours of flight), my blood sugar was high. I did a lot of movie watching and eating.

The time zone change on a pump makes little difference. You can change in flight or wait till you arrive. Pumps are perfect for travel. The bigger issue is getting to your destination without eating too much and keeping your blood sugar in the normal range.

[xMenace]

I've attached a graph I did of his basals. Yellow is the pump setting and blue is the basal applied with a lyfecycle proration for humalog. Novolog is pretty much the same.

The key question is what is the DP going to do. If he adjusts his basals when he gets there, he'll miss almost all of the DP basal loading. If the DP doesn't kick in because he's awake, he'll be fine, but if it kicks any anyway, he'll skyrocket.

If he adjusts at regular intervals, say every 1.5 hours, he'll be adjusting into a DP load that probably won't happen until much later, if at all. He'll risk going severely hypo.

I think I'd adjust when I got there and test every hour for the first morning. I think I'd also be wary of the second morning too.

Gong home could be more dangerous. He could double up on the DP loading and really get into trouble.

I'd definately consult an endo first.

[Tonysmum]

OK, so what I'm seeing is the yellow basal insulin being applied in anticipation of the actual bodily requirement in blue, right?
So, now, as I understand it, it comes down to the nature of DP and it's relationship to the body clock or sleep cycle. Is it expected to kick in after a certain number of hours of sleep, or would it kick in even if he didn't get any sleep?

Wow, Blue Knight, that's some travelling!

I am glad to see a lot of you don't have much of an issue with time travel, and maybe I'm overthinking it a bit. But I think I will brush up on DP and consult the endo, just to be sure.
Probably the best way to tackle it is to test more often, and correct occasionally.

Thanks to all for sharing your experiences, it helps.

[rzrbks]

I'm on MDI and I just keep to the same time. So if it's 11:30 (my injection time)here and it's 4:30 there, I inject at 4:30 and that way I don't have to worry about it.

[xMenace]

OK, so what I'm seeing is the yellow basal insulin being applied in anticipation of the actual bodily requirement in blue, right?
So, now, as I understand it, it comes down to the nature of DP and it's relationship to the body clock or sleep cycle. Is it expected to kick in after a certain number of hours of sleep, or would it kick in even if he didn't get any sleep?

Wow, Blue Knight, that's some travelling!

I am glad to see a lot of you don't have much of an issue with time travel, and maybe I'm overthinking it a bit. But I think I will brush up on DP and consult the endo, just to be sure.
Probably the best way to tackle it is to test more often, and correct occasionally.

Thanks to all for sharing your experiences, it helps.

The blue is when the yellow takes effect. Ya, the big feature in his basals is his DP. My own graphs are similar, except for a bigger hump in the evening and a drop in the night. The principal I think is to move the basal load with the DP, but I have no idea what affect travel has on DPs.

I plot my boluses too. When I display things like this visually, I find it easier to plan for events such as driving home after work.

[xMenace]

The only reference I've ever found, and I can't find it again, suggests that 35% of us have wavy basal requirements and the rest are more-or-less flat, flatliners.

It is easy for a flatliner to keep their BGs stable under a MDI regimine. I was always up and down like a yo-yo, but I never figured out why until I pumped.

I'm convinced everyone has a unique pattern.