Endocrine Abstracts

Introduction: The prevalence of diabetes has risen in recent years, leading to a growing number of travellers with diabetes. While travel can be therapeutic, it poses specific challenges for diabetic patients, requiring meticulous precautions.

Objective: To assess the occurrence of complications during travel and diabetes control after travel.

Methods: Cross-sectional study using a questionnaire, including out-patients with type 1 (T1DM) or type 2 diabetes (T2DM) aged ≥ 18 years and who had past travel experiences while diagnosed with diabetes at the Endocrinology Department at Tahar Sfar University Hospital Mahdia between October and December 2023.

Results: Twenty-one patients were included. The mean age was 57 years ranging from 35 to 73 years. Eighteen patients (85%) had T2DM. Among them, eight patients (44%) were on insulin therapy. The onset of diabetes occurred at 10 ± 6 years. The duration of travel had an average of 30 days and a median of 15 days. Ten patients (47 %) traveled alone, while 11 patients (52%) traveled with their families (n=11). Fifteen patients went on a pilgrimage to Saudi Arabia. Only six patients (28%) sought pre-travel advice and had a pre-travel consultation. None of the patients brought a medical prescription for their diabetes treatment during travel. Eleven patients (52%) were non-adherent to treatment. This was attributed to the lack of time and organization in 4 cases (36%), episodes of hypoglycemia resulting from changes in exercise patterns in 3 cases (27%), a shortage of rapid insulin analogs in one case, and a lack of therapeutic education, along with deviation from dietary measures in the remaining cases. Acute metabolic complications occurred in 4 cases (19%) during the trip, with two cases of hyperglycemia and two cases of ketoacidosis. A three-day hospitalization for ketoacidosis was reported in a patient with T1DM who had a shortage of rapid insulin analogs for 2 days. A significant decline in diabetes control after traveling was observed in 61% of the patients (n=13), as determined by comparing HbA1C levels before and after the trip, with an average increase of 1.08 % (t= -2, P=0.028).

Conclusion: Our series was characterized by a high frequency of altered diabetes control during and after traveling. This can be attributed to the absence of pre-travel advice, insufficient education regarding potential emergencies, and a lack of thorough review of diabetes. Diabetic patients must be guided in understanding that they can travel with diabetes, not from diabetes.