Diabetes in High Places – by Helen May
After a week or so here and there under canvas with a bit of walking thrown in, I decided it was time to do it properly – 10 days walking through the Himalayas spending every night in a tent. I expected some highs and lows (and I don’t just mean the walking) and I think I got them.
The first low was very early – an overbooked connecting flight. So instead of having a day in Kathmandu, it was spent hanging around the airport and then ambling in the heat of Bahrain. The heat was not something I planned for. However, my trusty Frio bags kept my insulin safe and ready for a flight the next day.
Starting the holiday a day late, reduced the time to acclimatise: we were up very early the next day for long coach journey to Pokhara where our walk was to start. So our second night in Nepal was our first night under canvas. I always take some time to get used to sleeping on an uneven ground with the sounds of the wild (and snoring of fellow campers) permeating through the tent. Even so, I had no choice but to start the next day walking across a very rickety bridge and then uphill as soon as we woke .. after the usual breakfast of porridge (which I can only eat when I add muesli to give it some texture and have little memory of carb counting from the last similar trip). The diabetes behaved itself pretty well and did not detract from the lovely scenery and friendly people we met on the way.
The first few days continued in the same vein: up early, porridge with muesli then off walking through villages getting ever higher. Then it started to change: one morning we got up even earlier: before the sun and before breakfast, we left our campsite for an hour’s walk up another mountain to watch the sun rise over the 8,000m mountains (they know the meaning of high in Nepal).
The views were stunning but we didn’t have long to appreciate them as we were soon on our way again. Initially, back down to last night’s campsite for breakfast (finally) and then onwards and forever upwards (at least that’s how it felt). That day we walked for over ten hours. Towards the end of the walk, I was getting tired and I was needing a near constant supply of fruit and nut to keep my BG steady so I was very glad to see a clearing amongst the Rhododendrons which was to be our campsite for the night. There was very little else around us: no village or houses in site.
That was our longest day but not the most exhilarating: that was the next day. After a brief stop in a tea house surrounded by mountains, buckwheat and a goat but no one and nothing else, the path got narrower and the drop to our left got steeper. The temperature was dropping, we were getting higher and, although we saw no yaks, the yows (a cross between yaks and cows) joined us on our trek. Finally, we spotted some blue tents nestled amongst the snow-clad mountains ahead: our porters had reached the campsite before us, erected the tents and put the kettle on ready for our arrival at the highest point in our holiday. I don’t mean highest as in highlight (although the views were amazing): I mean the highest as in 4,000 metres (and we were still dwarfed by the surrounding mountains).
This was my first experience of diabetes and high altitude. I’d read a bit about the combination before I left home but, ultimately, no one really knows how they are going to cope with altitude until they reach it. Thankfully, the climb had been slow enough to allow my body to acclimatise so no sickness or headaches for me – phew. But what about the impact of the altitude on my diabetes supplies: my two diabetes concerns were my meter (which became less reliable at higher altitudes so I was less confident in my BG readings) and the cold affecting my insulin.
As we were only spending one night at this height and I have reasonable BG awareness, I decided not to take any alternatives such as “wee sticks”. But it was cold: I had already been sleeping in a fleece and a 3-seasons sleeping bag, this was colder (so cold that it snowed as we slept that night). This night my aluminum water bottle was filled with hot water to use as a “hot water bottle” and my sock-wrapped insulin shared my sleeping bag to keep it warm. I was constantly alert to lying on it in the night and it survived undamaged.
The views for the rest of the trek were still amazing but the cold, wind-swept and high campsite was the highlight. Thankfully, my diabetes kept itself under control and my supplies survived the heat of Bahrain as well as the cold of the mountains. The only real trouble was my camera dying part way through the trek but at least it survived for some great snaps during the first few days.