Nobody sees the spreadsheet of what travelling with diabetes requires.
Not an actual spreadsheet — though I have kept one of those too, in particularly anxious moments before a big trip.
I mean the one running constantly in the background.
The one that's open before the holiday has even started, tallying insulin quantities against flight duration, cross-referencing time zones, calculating how many extra sensors to pack for a three-week trip in case one fails mid-trek.
The one that doesn't close when you lock your phone or fall asleep.
The one nobody else in the planning group chat knows exists.
Travelling with diabetes is, by most external measures, entirely possible. I've done it across forty countries. I've managed blood glucose in airport terminals and night buses and beach bars and all kinds of remote guesthouses. I wouldn't trade any of it.
But there is a load that comes with it that nobody sees. Not your travel companions, not the people in the security queue watching you unpack your medical bag, not the waiter who brings you something you're about to spend twenty minutes trying to carb-count. A load that is invisible precisely because you've become so skilled at carrying it.
This is about that.
The planning that happens before any packing
Most people begin preparing for a holiday when they start thinking about what to wear. For those of us with diabetes, it starts earlier — sometimes weeks earlier — and in a completely different place.
There's the medication audit: what do I have, what do I need, what's expiring, what's the prescription lead time.
There's the insurance question — because standard travel insurance often doesn't cover diabetes, which means finding a specialist policy, reading the small print, and declaring everything honestly before a single bag is packed.
There's the diabetes travel letter to arrange, ideally well in advance of departure, because surgeries are busy and a rushed generic letter is often not the same as a letter that actually works at a foreign border or security checkpoint.
And then there's the mental preparation that's harder to itemise:
Researching the food in the destination country.
Thinking through what a hypo looks like in a place where no one speaks English.
Working out where the nearest hospital with a full emergency department is before you need it rather than while you need it.
Checking that your insulin cooler is charged, tested, and reliable enough to handle whatever climate you're flying into.
None of this appears on the shared holiday planning document. None of it shows up in the group chat. It's just quietly done, by you, in the margins of ordinary life, before the holiday has officially begun.
The mental diabetes arithmetic that never stops
There's a concept in diabetes management sometimes called the mental load — the constant, background cognitive work of keeping yourself safe.
Counting carbohydrates.
Watching trends.
Deciding whether that number warrants action or observation.
Factoring in that you walked more than usual today, that you're stressed, that the heat is doing something to your absorption, that you had a glass of wine with dinner and need to think about what that means at 3am.
At home, this arithmetic is so familiar it becomes almost automatic. Abroad, it intensifies.
Every meal is a new calculation. The same dish in a different country can behave completely differently on your blood sugar — a bowl of rice in Japan is not the same glycaemic event as a bowl of rice in Portugal. Street food portion sizes are unpredictable. Restaurant meals arrive when they arrive, not when you planned to bolus. And the baseline variables — your activity level, your sleep, your stress, the heat — are all different from what your regime was built around at home.
The result is that you are making more decisions, with less reliable information, in higher-stakes circumstances, for the entire duration of the trip. Not just at mealtimes. Not just when something goes wrong. Continuously. In the background. While also trying to, you know, enjoy yourself.
The psychological burden of living with diabetes is well documented — Diabetes UK describes diabetes distress as a real and common experience, distinct from clinical depression but significant.
Travel doesn't cause it, but it applies a particular kind of pressure to it. One that's worth acknowledging rather than just pushing through.
The moments that make you feel different during a trip
There are specific moments, scattered through every trip, that quietly remind you that your experience of travel is not quite the same as everyone else's.
The security queue, where you unpack your medical bag into a tray while the person behind you shifts their weight impatiently.
The restaurant table where you check your glucose before ordering and catch someone staring.
The flight where you have to explain, for the third time, why you can't put your medical bag in the hold.
The morning of a big day — a long hike, a boat trip, a once-in-a-trip experience — where you spend the first hour not fully present in the excitement but managing a number that won't cooperate, watching the clock, calculating, waiting.
None of these moments are catastrophic. Most of them pass in seconds. But they accumulate. And the accumulation — the low-level, continuous awareness that you are navigating something that other people in the room are simply not — is its own kind of tiredness. A tiredness that rarely makes it into the holiday stories, because by the time you're telling them, you've edited it out. You always edit it out.
It's not self-pity. It's not even, most of the time, distress. It's just the texture of a different relationship with travel. One that involves more management, more vigilance, more quiet problem-solving in moments that other people experience as pure leisure.
The things people say (and don't say) when they know you have diabetes
Well-meaning people say things.
Can't you just eat less sugar?
Is that allowed on your diet?
I don't know how you cope.
You're so brave.
The bravery comment is the one I find most interesting. It's said kindly, always. But there's something in it that frames managing diabetes as an act of courage rather than simply a fact of life — as if every insulin injection is a small heroism rather than just something you do, routinely, without drama, because the alternative is not doing it.
What most people don't say — because they don't know to — is anything that acknowledges the invisible work. The planning, the vigilance, the calculations, the low hum of worry that sits underneath even the best trips. Not because they don't care, but because it's invisible. You've made it invisible, through competence and practice and the perfectly reasonable desire not to make your diabetes the main character of every shared experience.
And so you carry it quietly. Which is both a testament to how well you manage and, occasionally, genuinely exhausting.
The particular weight of being your own safety net
Travelling with diabetes means travelling with a continuous awareness that you are, ultimately, responsible for your own safety in a way that most people aren't.
If something goes wrong — a severe hypo, insulin exposed to heat, a pump failure, a DKA that creeps up slowly through a day that already feels off — the first line of response is you.
This isn't a reason not to travel. It's a reason to travel well-prepared, which is a different thing entirely.
Knowing how to keep your insulin safe across every kind of journey.
Having a clear plan for what to do if something goes genuinely wrong abroad.
Knowing where the hospital is before you need it.
Carrying the documentation that means someone else can help you even if you can't help yourself.
Preparation is, in this sense, not just logistical. It's psychological.
The trips where I've felt most free — most genuinely present in the experience rather than managing it from a slight distance — have been the trips where I prepared most thoroughly. Not because nothing went wrong, but because I knew what I'd do if it did.
That knowledge creates a kind of spaciousness. A quiet permission to stop monitoring the horizon for problems and start actually being in the place you came to see.
What nobody tells you — and what TD1 Travellers should say more often
The diabetes travel content that exists tends to focus on the practical. The checklists, the storage tips, the security rules, the insurance policies. All of it necessary. All of it, this website included, worth reading.
But the practical articles don't often say: travelling with diabetes is also hard in ways that have nothing to do with logistics. That you can do everything right and still find travel with diabetes tiring in a way that's difficult to explain to someone who hasn't done it. That the invisible load is real, and carrying it well is genuinely skilled work, and you deserve to have that acknowledged — not by a doctor, not in a clinical setting, but just, plainly, by someone who knows.
So here it is: if you travel with diabetes and sometimes find it exhausting — not medically, not practically, but in the quiet, cumulative way of doing something complex that nobody fully sees — that's not weakness or poor management or the wrong attitude.
It's an honest response to a real thing.
And you're not doing it alone. There is an entire community of people with type 1 or type 2 diabetes running the same background spreadsheet, making the same invisible calculations, carrying the same load through departure halls and border queues and restaurant menus in languages they don't speak.
All of them, like you, doing it quietly. All of them, like you, also having the most extraordinary time.
The two things are not in conflict. They never were.
💬 We'd Love To Hear From You!
Does this resonate? Is there a part of travelling with diabetes that you carry quietly, that you wish people understood better?
Share it in the comments below. The more honestly we talk about the invisible parts, the lighter they become.
