Having diabetes shouldn't get in the way if you want to see Paris, take a cruise, or simply spend time with your grandchildren in another state. Here’s practical advice to help you travel safely with diabetes.

First Stop: Your Doctor's Office: Schedule a visit with your physician some weeks before taking an extended trip. Be sure your regular vaccinations are up-to-date, and check on what medications or vaccinations are recommended before visiting certain parts of the world. The Centers for Disease Control and Prevention (CDC) has the latest information on vaccination and medication recommendations; visit wwwn.cdc.gov/travel/default.aspx. (The American Diabetes Association [www.diabetes.org/home.jsp] and the National Diabetes Education Program [www.ndep.nih.gov/] also have good information on traveling.) In addition:

• Get a signed letter from your doctor stating that you have diabetes and listing the medical supplies you require, such as insulin, syringes, pumps, or lancets. Carry this letter with you when you travel.
• If you don't already have a bracelet, necklace, or some other form of identification showing that you have diabetes, now is a good time to get one.
• Be sure you have more than enough diabetes medication in case of an emergency.
• Ask your doctor how your travel plans will affect your diabetes medication requirements. With most pills, it is reasonable to gradually change the time you take them if you cross many time zones. If you take only one shot of long-acting insulin a day, you will have to gradually change the timing of that shot -- for instance, increasing the time between shots by three to six hours every 24 hours. Most people are on long-acting and short-acting insulin. Our recommendation is to test frequently and take the short-acting insulin before every meal, whatever time that may be, with adjustments made in the dose if your blood glucose is higher or lower than usual.
• If you are traveling to a country where English is not widely spoken, learn how to say, "I have diabetes" and "Please get me to a hospital" in the native language of each country you plan to visit.
• If you do need medical treatment while abroad, it's best to know ahead of time how to get it. One good source is the International Association for Medical Assistance to Travellers (IAMAT) website, www.iamat.org, which features a directory of qualified, English-speaking physicians around the world.

Pack Right. If you are flying, your diabetes supplies should be in your carry-on bag. Here are diabetes essentials to pack:

Insulin and oral diabetes medication. Take twice as much insulin and oral medication as you would normally need for the duration of your trip. Insulin stays good for about a month at room temperature, but extreme temperatures will damage insulin and may make it entirely inactive. Don’t keep insulin in a suitcase that will be stowed in the cargo compartment of a plane that may freeze, and don't leave it in the glove compartment or trunk if you're in a car that may overheat. Be sure that all insulin and injectors are in their original packaging with their brand labels. Keeping all of your insulin, syringes, and other tools for diabetes management in a separate pouch can make security screening easier.

Syringes, lancets, and test strips. As with diabetes medications, double up on syringes, lancets, and blood glucose and urine ketone test strips, too. You can bring an unlimited number of unused syringes in your carry-on bag as long as they are accompanied by insulin or other medication that requires injection. Bring some extra batteries for your equipment, since you never know when you'll need them.

Emergency medical kit. Include such items as glucagon to treat hypoglycemia (make sure one of your travel partners knows how to administer it), other prescription medications, over-the-counter pain relievers, a first-aid manual, anti-diarrheal medicine, insect repellent, sunscreen, and talcum powder (to keep your feet dry if you're doing lots of walking).

And finally … Bring a diabetes identification card or a medical alert necklace or bracelet (if you're not already wearing one). If your insurance policy covers emergencies abroad, bring necessary insurance paperwork. You have to plan what to carry with you at all times, too. Never leave the hotel without some source of sugar you can use if your glucose drops. Be careful to take your insulin, pills, and testing supplies with you every day in case there is a delay getting back to your home base.