I’ve been debating with myself whether I should write this piece or not… I don’t want my travelling experience to be defined or remembered by my diabetes… but I can’t ignore the huge portion of my brain that is consumed by questions of insulin, sugar levels and calculations between the two while I’m on the move.
Travelling has been inspiring, challenging, exciting, scarey, amazing, exhausting…and completely worth all the extra effort it takes for a diabetic to live the spontaneous and unpredictable life of a traveller. Be
fore I set off on my travels, I had a little look for articles or blog posts from fellow type 1s who have backpacked, and didn’t find much. My diabetes has been extremely difficult to control and my hba1c very high since I diagnosed over 14 years ago. So, as someone whose diabetes has played a huge part of my life, I’m going to share some of my travelling experience.
It’s been 100 days since I left home, the last 79 of which I have been backpacking my way around Europe… with a few more to go. We didn’t do the whole book in advance kind of trip.. we are going one day at a time, seizing opportunities, risking homelessness, and embracing the unknown… It’s the best and the scariest way to travel. 100 days is a lo
ng time to be away from my pharmacy, among other things. Which brings me to the first pressing question of a travelling diabetic..
How do I do the whole insulin thing? Pump vs pens
I was on the insulin pump back in Sydney, and liked being on it (as much as you can like being attached to a machine 24/7). But I looked at the consumables (sets and lines) that I’d have to carry for the 3 to 4 months I planned to backpack, as well as the insulin, and realised it wouldn’t physically be possible without bringing along a suitcase in addition to my pack.. which kinda ruins the whole backpacking thing. So I switched back to pens and stocked up on 6 months worth.
The best thing, I was told, for travelling with insulin is Frio Bags.. little insulating bags that are activated by water and supposed to keep insulin cooled for 48 hrs… I haven’t found them to be that effective. They are heavy in my pack, and the insulin always comes out a bit warm.. but they’ve been better than nothing. So on planes, trains, cars, buses.. the insulin is in these packs. As soon as I get somewhere I find a fridge and put it in. It’s been a bit stressful at times because if my insulin isn’t cool it stops working properly… and if it’s damaged, stolen from a hostel fridge, or lost that’s my life line gone. We have been mostly couchsurfing and staying with friends, so that’s been easy, and every hostel has had a fridge and I’ve never had any stolen.
So storing and transporting insulin has been annoying but ok. A few weeks ago I had a very bad patch of high sugars and suspected my insulin was damaged.. it is possible to buy insulin over the counter in most countires in Europe. Novo rapid for example was about €55 in italy, €45 in france and CHF 75 in switzerland. Levimir is more expensive by about €20 per box.. but when it comes to living or dying, that’s not a lot of money to pay. In every country that iI’ve asked, you can walk into a pharmacy and show your current insulin, and they’ll give you new insulin without a script.
The second question of a travelling diabetic…
What to do for hypo food?
I dont hypo very much, but I usually have fruit or some kind of snack on me, and for the immediate emergency, I carry little cafe sachets of sugar in my diabetes kit.. I take them from cafes when i get a coffee and keep a supply on me at all times! When visiting museums and galleries, you’re often not allowed a big bag, so my small diabetes purse with sachets is fine.. I add them to water or just have them straight in an emergency. Explaining to security during a hypo why you’re breaking the no eating policy can be very stressful.
Counting carbs on wine tours, pub crawls, pizza and gelato eating frenzies in Italy and other crazy food indulges you don’t want to miss out on while travelling, is nearly impossible. I have all but given up. I found upping my background insulin, especially on days when I’m stuck on a bus or train for most of it, is helpful. Some days I will do a lot of walking, swimming and bike riding, which usually means it will be a better sugar day. But I have been very high for a lot of my trip.. bringing me to…
This has by far been the toughest thing. Running on high sugars for days at a time, while trying to make the most of my short time in a new city is very challenging. I don’t want to miss out, but I also have to look after myself and listen to my body. Sometimes it means an early night. Sometimes it means a day of reading in a park. For travelling diabetics, sleepness nights of high sugars, plus the overwhelming high induced exhaustion only diabetics can relate to, lack of routine, new foods, more alcohol than usual ,injecting up to 9 times a day, and the endless drone of checking sugars levels 10+ times a day and getting frustrated at the wild numbers, only intensifies the travelling experience of being generally rundown. Getting reading after reading in the 20s, only to plummet overnight and scramble around in the dark for food, gets old very quickly. I’m going to be honest and say.. I’ve struggled, emotionally and physically. There’s no point saying “You can do whatever you put your mind to!”, when your body can’t keep up- know your limits.
Being down about my diabeties is the loneliest and lowest experience, especialy when I’m away from my family and support network. I’ve had less down days than I thought I would, but I think its important for me to have them. Some days I need to cry and be angry at my body, so that the next day I can get up and refuse to let it stop me from having the life I want.
On my down days, I worry about being a burden on those around me, and I feel totally misunderstood when my high sugars wreak havoc with my mood and energy. But I keep thinking of all the things I want to do with my life and each of them is a reason to not let diabetes win.
Being a diabetic traveller means you have to do a bit more prep and planning, expect that some days will be horrible, and that sometimes you will have to take things as they come and not do absolutely everything. Being flexible and gentle with yourself is the best advice I could have recieved. Learning your own body and its needs is imporant for all travellers. As a diabetic you can definitely travel and do it for as long and as far as you can get insulin for! Fear is the biggest enemy.