A 21-year-old white male has had insulin-dependent diabetes mellitus since the age of 13. This disease is well controlled by insulin therapy and diet, and he has no diabetic complications. His blood sugar, verified (by blood glucose test strips) four times a day, is within the normal range. The patient would like to take a long trip, through various countries, with a friend, traveling by various means (bus, airplane, and train) and living in various kinds of accommodation, including camping grounds. Before the final decision, the patient comes to you for advice about the feasibility of the trip and possible changes in diet and insulin therapy during such a trip. Which of these recommendations would you make?

1. Patient should only take the trip on the condition that he strictly follows the same diet and insulin schedule
2. Cancellation of the trip because it is too complicated to change therapy when traveling
3. Adaptation of the patient's diet according to food availability and travel schedules. Suggestion as to how the insulin schedule could be modified according to daily activities and travel time, and how the doses could be changed if necessary
4. That under the circumstances, the patient could eat without restriction, readjusting insulin dose according to blood tests
5. The patient should not eat concentrated sugars (candies, beverages, pastries, etc.) and should lower the dose of insulin to avoid hypoglycemia while traveling

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