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.

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  1. Bruce Fraser says

    Thanks for posting this blog, Helen. Our youngest son, now 15, has been diabetic for four years. He was sooo interested in my walk on Kilimanjaro (I only got to 18,000 ft before having to turn back with pulmonary oedema) last year that he wants to join me in other high altitude treks in the future. Your posting has really kindled his appetite once again!

  2. Sharon Fowler says

    Well done. I think you are very brave, with the fast acting insulin i am on my sugars go up and down at a drop of a hat. Would not fancy being in the middle of nowhere for long.

  3. Gordon Round says

    Dear Helen,
    Great to read your blog, i’m just about to embark on something similar, if not a little less risky myself. I’m crossing the Alps, dressed as Indiana Jones, from France into Italy for Diabetes UK. I’m type 2, so managing my Glucose whilst simultaneously burning 1000’s of calories a day will be a relatively new experience for me! I wonder if you ever felt your Diabetes made you feel lethargic during your trip? I have to fight the “can’t be bothered” feelings often when it comes to anything arduous.
    Anyway, congrats on your trip, sounds amazing!

  4. Helen says

    Hi Gordon
    Good lunck on your Alpine trek – sounds very exciting.
    The only time I find my diabetes makes me feel lethargic is when I have high blood sugar – if my readings are within the recommended range, I find I have far more energy. The other lethargy I find on this trips is on the third or forth morning when the excitement of the trip has started to become normal and I haven’t got the hang of sleeping in a tent but that’s nothing to do with diabetes.
    I hope you keep your diabetes in enough check (I never achieve perfection so don’t beat yourself up if you get it a little wrong) and have a wonderful experience.


  5. Helen says

    Sorry Gordon – I forgot to add…looking forward to the Indiana Jones photos and, perhaps, a guest blog :-)

  6. Carl Villarin says

    Hi helen, I’m sure this is a really great expedition of yours. Nice view there.

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