Malaysia & Thailand, 2014
My first taste of overseas travel without my family came in 2014, when I spent a month in Malaysia and Thailand with mates during my uni break. There is no doubt that Australians are extremely lucky to have such a robust and well resourced healthcare system, and so it was only natural to assume that overseas infrastructure would not meet the high standard we are used to back home.
I was gladly proven wrong. Whilst the healthcare systems in Malaysia and Thailand perhaps weren’t as comprehensive as the Australian system, I must say that overall I was pleasantly surprised. I cannot speak for the more rural north of the country but in southern Thailand you will have no issue locating pharmacies and international medical clinics. Sadly though, few small pharmacies stock insulin and strips so I would recommend finding a big chain pharmacy, should the need arise. The medical clinics also stock limited types of insulin and strips. I was only able to find Accu-Chek strips and Actrapid insulin. If you have a Accu-Chek meter I would recommend bringing that.
Kuala Lumpur and Penang in Malaysia did not tend to sell any insulin or strips over the counter so I would recommend going to a hospital if you need supplies. Ultimately you should aim to alter your domestic routine as little as possible so the best option is always to bring the meter you use regularly and enough strips for the whole trip.
Finding fast sugar was very easy as there were convenience shops and stalls open 24/7 should you hypo. Conversely I really struggled to find slow carbs as most dishes are made with white rice and noodles in both countries. Certain 7/11s stock wholemeal bread and crackers but that was all I was able to find. Personally I have a pump so I found that keeping my basal rates slightly lower accounted for the lack of low GI foods. For those using pens or needles, I would recommend having a pack of wholemeal crackers handy in your bag.
Drinking is a common part of travelling but it is important to remember that this can be one of the most vulnerable times to be a diabetic. Keep in mind you do not have the same support network and familiarity you do back home so it’s important to take it easier. In saying that you are there to enjoy yourself. Check sugars regularly and stick to your normal drinking routine and don’t be afraid to enjoy a few naughty piña coladas on the beach. South-East Asia is a very hot part of the world and this may cause your sugars to drop more rapidly, particularly when you add alcohol to the equation. Lower temporary basals and administering less long-acting insulin may be advisable, but this course of action should not be undertaken before consulting with your endocrinologist or relevant medical professional.
Finally, keeping my insulin cool also proved challenging but a lot of hostels and hotels have communal fridges where I kept it in a locked lunchbox. You should never feel uncomfortable asking to put your insulin in a fridge and explaining the importance of it remaining cool, even if it is not a fridge for visitors. It is fine to ask to use the staff fridge.
You should note that certain hostels will actually lock fridges overnight. If this is the case, simply put the majority in the fridge but leave out enough for one night should you need it in an emergency.
Ultimately the trip was fantastic and I had no major issues with my diabetes. If you pack everything you need beforehand and are both vigilant and adaptable you should have no issue visiting Malaysia and Thailand. The most pronounced difference was definitely the scarcity of low GI carbohydrates, so my biggest tip would be to carry a packet of low carb crackers in your bag.
Both were beautiful and exciting countries and I would recommend anyone to travel there.