context: When you have diabetes, a vacation or a business trip means a little extra planning. Changes in what you eat, how active you are, and time zones can affect your blood sugar levels. Here are some tips to make your travels easier. Make an appointment with your doctor to go over your travel plans. Get twice as many supplies as you usually need to travel, and bring extra prescriptions and a letter from your doctor explaining that you have diabetes. If you need vaccines, plan to get them 3 to 4 weeks before your trip. Some of these shots can throw off your blood sugar levels. Be prepared. Know what medical facilities you can visit in the area. Bring your doctor's name and phone number and keep it with you at all times. Bring a list of the medicines you take and keep it with you at all times. Always carry and wear medical identification that tells others that you have diabetes. Keep medicines, syringes, and blood sugar testing supplies in your carry-on luggage. Don't put them in checked luggage in case the airline loses your bag. Also, the cargo hold isn't heated or insulated well, which could damage your medicine and supplies. Take enough medicines and supplies to last an extra week in case you get stranded or stay longer than you planned. If you're traveling with someone, ask if he can carry some of them for you. Always carry hard candy, a small snack, or glucose gel or tablets in case your blood sugar dips too low. Let the airlines, cruise ships, and tour guides know in advance that you have diabetes. Wearing a medical alert bracelet/necklace that lets people know you have diabetes is a good idea. To make your trip through airport security hassle-free, try to: Make sure you tell security that you have diabetes and that you're carrying medical supplies. You can take them through security checkpoints, but they must have a prescription label on them. All of your supplies should have a proper manufacturer's label. Security will allow you to carry syringes if you have insulin with you. If you're wearing an insulin pump, you must notify security. They will need to inspect the meter. You must request that they not remove the meter. If you are traveling on an airplane and you need an insulin injection during your flight, follow your usual procedure with one difference: Put only half as much air into your insulin bottle as you normally would. The pressure is different in airplanes than on the ground. Time zone changes of 2 or more hours may mean you need to change your injection schedule. Check with your doctor for special instructions. Keep the temperature of your insulin between 33 F and 80 F. Don't freeze it or keep it in the sunlight. Follow these tips to keep your feet healthy away from home: Pack at least two pairs of shoes so you can change them often. This will help prevent blisters and sore pressure points. Pack comfortable shoes, socks, and a first aid kit to treat minor foot injuries. Do not go barefoot. Instead, wear shoes that are specially made for ocean or beach walking. Protect your feet at all times when you're walking by the pool, in the park, on the beach, or swimming in the ocean. Do not wear open-toe shoes, including sandals and flip-flops. If your toes aren't protected, you raise your risk of injuring them. Follow your daily foot care routine. If you have an emergency and you don't know where to go, try to reach the American consulate, the Red Cross, or a local medical school. Try to learn helpful phrases in the local language such as: " I need help" or " I have diabetes, where is the hospital?" or " I need sugar." Another resource for English speakers who need to find medical help is the International Association for Medical Assistance to Travelers ( IAMAT) (www.iamat.org). You can reach IAMAT at 716-754 4883.