More severe symptoms include vomiting, ataxia, mental status changes, fever and cyanosis. Acetazolamide should be avoided in those allergic to sulfa drugs. In most cases travel during pregnancy is safe but not recommended after the eighth month of pregnancy. Patients should be encouraged to discuss travel plans with their physician. Most airlines no longer require physicians' notes for travel, but they do recommend contacting your physician for travel advice.
Most diabetics can travel extensively overseas if they adhere to several common sense principles.
Arrangements should be made beforehand on how to contact their physician by telephone and locate a local physician. Brittle diabetics with frequent episodes of ketoacidosis and pregnant women should be careful to keep their travel short and simple if at all possible. Adjustment in insulin dosage when crossing more than six international time zones is not easily reduced to formulas and will need to be individualized depending on time of departure, stopovers, susceptability to jet lag, itinerary after arrival, etc. Contaminated undercooked foods may also cause parasitic infections with long incubation periods. To help prevent these conditions, the traveler should be encouraged to thoroughly cleanse and cook all meats and vegetables.