Travel Patterns, Pretravel Preparation, and Travel-associated Morbidity in Travelers with Diabetes in Taiwan.

Abstract

Background: International travel poses unique health risks for individuals with diabetes. This study explored their travel patterns, preparations, and morbidity, as well as identify factors influencing pre-travel health-seeking behavior from primary healthcare providers.

Methods: This cross-sectional, questionnaire-based study recruited adults with diabetes who had traveled internationally within the past 12 months. Data on sociodemographic and clinical characteristics, travel patterns, preparations, and travel-associated morbidity were collected via questionnaires and electronic medical records. Multivariate logistic regression analyses were conducted to identify predictors of patients informing physicians about travel plans.

Results: Among 250 participants (median age: 65 years [57-69]; median HbA1c: 7.1 % [6.6-7.9]), 16.4% were on insulin therapy. The median travel duration was 6 days (5-10), with a median of one time zone crossed. Insulin-treated individuals tended to plan shorter trips to closer destinations than their non-insulin-treated counterparts. While 70.8% of participants carried medicines for acute illness, only 10.8% informed their primary care physicians about travel plans, and 11.2% experienced travel-associated morbidity, including acute illness, falls, and hypoglycemia. Predictors of informing physicians about travel plans included travel duration exceeding ten days (OR: 4.87, 95% CI: 1.34-17.63), insulin therapy (OR: 4.37, 95% CI: 1.21-15.80), taking preventive measures against hypoglycemia during travel (OR: 3.40, 95% CI: 1.26-9.14), and good antidiabetic medication adherence (OR: 2.96, 95% CI: 1.10-7.96).

Conclusions: This study underscored the impact of diabetes self-care practices on pre-travel health-seeking behavior and demonstrated how insulin therapy shapes travel patterns, highlighting the need for reinforced self-management skills and targeted pre-travel guidance, especially for insulin-treated patients.