I want to preface this post by saying that I am a type I diabetic, and diabetes is a major part of my life. BUT, I do not identify myself as such.
Sometimes people are even surprised to learn, after knowing me for a while, that I have diabetes. I strongly believe that if I am in control of my diabetes, it doesn’t have to be in control of me. I don’t want to be thought of as “the girl with diabetes”. I would rather be recognized for my winning personality (insert big cheesy teethy smile here). I am also a lot of other things, I am a sister, daughter and friend, an artist, vegetarian, and nature-lover. And now a wander-lusting world-traveler.
I want to encourage diabetics out there to take the best possible care of themselves and never let diabetes be an excuse for not doing something they want to do (except for maybe emotional-eating a tub of Ben & Jerry’s in one sitting).
I have gotten lots of questions from friends, doctors and nurses, family and fellow diabetics about what it is like to travel as a type 1 diabetic, and how I manage. Before I even begin I want to say that I am not trying to tell anyone out there how to manage their personal health. But I do hope that other diabetics (and their families who worry about them) might read this and be inspired to never let living with diabetes stop them from living their dreams.
Here is a list of 6 rules I try to follow that make extended travel with my diabetes possible. It is my sincerest intention that other diabetics with dreams of travel might read this and realize that diabetes doesn’t have to hold them back!
1) PLAN YOUR SUPPLIES
Pack LOTS of supplies. Take more insulin than you think you might need. It’s not usually hard to get supplies overseas, and I have bought lancets and pen-caps in other countries. But they aren’t always sold the way you may be used to at home. For example – In one city in Argentina where I bought pen caps (the needle tops that screw onto my insulin pens), they were sold individually rather than by the box. I was able to talk a pharmacist into selling me a full box at a reduced price – but if you don’t speak the language that could be difficult to ask for. I expected to be away for 2 months on my last excursion. I brought 5 months worth of insulin with me. This turned out to be a very good thing because I ended up being away for 4 months! It was also recently recommended to me that I should research the ease and availability of obtaining additional insulin and supplies in the countries I visit before getting there. This is a fantastic idea in case a crappy situation is to arise and I need to access insulin in a pinch while away.
It may be important to keep in mind if you are going to be in less affluent countries that there is a worldwide insulin shortage. Insulin producing companies try to keep all pharmacies stocked at all times – but if you need insulin at the last minute, it is possible that not every pharmacy will have what you need in stock. So it’s always best to plan ahead. * This is information I recently learned on my travels when I met two traveling employees from Novo Nordisk – one of the world’s leading insulin producers.
**Also want to add – over a year after writing this article, it is becoming increasingly more challenging to “stock up” on medication, here in the states. Insurance companies are cracking down and will literally not allow you to refill a prescription “too soon”. I have gotten an override on this, but it took more frustrating hours on the phone explaining my circumstances than I care to think about. It also helps to ask your doctor to go with the “more is more” theory and overprescribe as though you are actually on higher doses. This will help your supply last longer.
2) TAKE CARE OF YOUR INSULIN
Consider how you will store your insulin. Luckily, today, insulin is a bit heartier than it was when I was a child. The insulin I use today does not need to be constantly refrigerated like it used to. My doctors have told me that once I open a new insulin pen it is completely fine to keep it in my purse, or backpack for the week or 2 that it takes to use it up (this may or may not be different with different types of insulin, so ask your doctor). All hostels and hotels have at least a fridge somewhere. Not every place I stayed in had a kitchen available for use, but most hostels do. You can always store insulin in their community refrigerators. In the event you are in a hostel without a shared kitchen – nobody will deny you a little fridge space (if you ask for it) for medical reasons.
I have on occasion been concerned about my insulin when I knew I would be in extreme heat for an extended period of time. Before I went hiking in Costa Rica, in the sweltering rainforest, I bought a thermal cup from a sporting goods store which is meant to keep liquids either hot or cold for an entire day – though I think it may work even longer. Before venturing into the heat, I filled it with ice and put my insulin pens that I needed for the day in the cup. This worked like a charm and kept everything nice and cool while I was sweating my ass off during my hike up a volcano.
3) CARRY EMERGENCY SNACKS AT ALL TIMES
This is something I try to do all the time no matter where I am, even if I am just going from home to the corner store. Any diabetic knows what a serious matter a low blood sugar can be. When you travel, snacks may not always be easily accessible. Transportation by airplanes, buses, or trains, and hiking or camping in nature, are examples of when it’s important to take extra precautionary measures before embarking. I never leave for any of these types of endeavors without making sure to have more than enough emergency food and drink on hand. I don’t recommend candy bars if you plan to be outdoors in extreme heat (for obvious reasons). But other packaged foods like nutra-grain bars, and certain types of cookies have a good shelf life in any climate. Whenever possible it is always good to have a container of juice on hand as well.
It is good to keep in mind that you cannot bring liquids past security at most airports (However, domestic flights within Argentina allowed outside liquids). Most airports allow you to buy your juice and water after you have passed through security, to carry with you on the plane. However, in Mexico and Bolivia I have had post-security checks in which they did not want to allow my liquids purchased at the airport on the plane. However, in both instances, after talking with a supervisor, I was allowed to keep my juice and water. People frequently forget that water can be equally important for diabetics to have on hand as the emergency sugar snacks are. High blood sugars make us thirsty and dehydrated, and our bodies crave water to flush out the excess sugar. So while there are not many up sides to being a diabetic – at least we can use it to keep our food and drinks at the airport!
4) CHECK YOUR BLOOD SUGAR FREQUENTLY
Be in control of your diabetes. Don’t let “it” be in control of you. The only way that I have found I can do this is by checking my blood sugar as often as possible. I always ask my doctor to write a prescription for more strips than I might actually need – because I always want the option to check my blood sugar. In my experience, the more often I check my blood sugar = the better my A1C is.
When traveling, it is easy to be distracted. You are out of your regular routine. You are eating foods you may not normally eat. You’re sleep schedule may be totally different. You may be more physically active than normal with running around cities and hiking up mountains. You may be less physically active than normal with all the time you spend as a blob on the beach. All of these changes in routine can have a significant effect on a diabetic body. And the only way to counter-act and fight back is with your best weapon – the glucometer.
For me, the hardest part is fighting the distractions and remembering “I haven’t checked my sugar in a while”. But the unfortunate reality is this: type I diabetes is a full time job, and the only job I can never quit and take a vacation from. I take it with me on my travels and I need to work at it constantly.
Setting phone alarm reminders can be helpful!
5) EXPLAIN THE BASICS TO GUIDES AND TRAVEL BUDDIES
Sometimes it is important to inform the people you are with that you have diabetes. Whenever doing any type of sporting activity, I feel it is important to let the people around me know. When I have gone white water rafting, I was not allowed to bring a bag with me either time. Both times I informed the guide ahead of time, who held on to snacks for me in a water-proof container. It is easy for blood sugar to drop during heightened physical activity, so I always plan accordingly and choose to let people know in advance, so there is never any surprise. Luckily, I have never passed out and had a serious diabetic emergency, but I want people around me to be prepared if it ever were to occur. I also find that if I am spending a lot of time with one person or a group of people in my travels, it is good to let them know basic procedure for the same reasons.
6) LISTEN TO YOUR BODY
I’ve said it a few times and I will say it again. I will not let diabetes control my life. As long as I keep a tight watch over my blood sugars and correct often, I am able to do all the things I want to.
Of course, I still have to be reasonable. And sometimes my diabetes is stronger than my will. I hiked to Garganta Del Diablo in Tilcara, Argentina (click to read about my Tilcara adventure). A couple weeks later, I tried to do it again. That day, however, my sugar was running high. I realized pretty early on in the hike that I had made a mistake by taking on – literally – an uphill battle. I apologized to my friends and told them to go on without me. I was very upset and felt a bit defeated by my body that day. A hike I had already done (which had been challenging the first time, but doable), I actually could physically not do this time. It was frustrating and discouraging. And at a time like this, I had to accept that I am, in fact, a person with extra physical challenges.
My reality is that I have to listen to my body even more than the average person – and when my body tells me “today I need a little extra rest and TLC”, it is important that I give it the attention it needs.
So there you have it. 6 important rules I try to follow that make traveling with diabetes a reality in my life.
Again, I want to say that I am not a doctor and do not intend to give medical advice to anyone. I only want to encourage other diabetics to follow their dreams. Work out a plan with your personal doctors and LIVE YOUR LIFE (In fact let’s make that rule #7)! That’s my only real advice, but if some of my tips and tricks can be helpful to others, that’s great too. I would genuinely love to hear from other traveling diabetics. What things have you tried or discovered to help you manage your diabetes while away from home? I think this is a great discussion for the diabetic community at large! I felt like this silly picture of me “holding up a giant bolder” was somehow a good metaphor to end this post with.