How my journey with diabetes has changed while backpacking – by Scott Brady
I have learnt a number of things during my time away which I have shared over past blogs, in the hope that it helps more people with diabetes to travel the world with confidence. Because diabetes should never hold you back from travelling! I also wanted to take some time to provide information on my new blood sugar monitoring equipment within this blog that requires no finger pricks.
Carrying six months’ worth of diabetes equipment in two backpacks is never easy, but the storage requirement for the insulin itself requires a lot more care and attention. Moving from place to place, I stored my insulin in a number of different Frio bags to keep it cool. Of course, this was placed in a fridge overnight (after checking its temperature) at wherever we were staying. A fridge became a key criterion for us when picking out accommodation.
Impressed with how resilient insulin is
In the main part, our storage and transportation techniques worked well and I didn’t come across many problems. However, I did notice a slight change in the effectiveness of my insulin during the last month, particularly in relation to the time that it took for my Humalog to start lowering my blood sugar. It would eventually have the same impact, but at a slower rate, which had the potential to cause problems. I would stress that I didn’t have these problems until we were five months in, so I was pretty impressed with how resilient the insulin was overall. However, should I look to go on a trip for longer than five months in the future, I might try to source some insulin while abroad, or have visiting friends / family bring some with them to freshen up the supply.
Combating the slower impact of my Humalog marked some changes in my routine. For example, I ensured that I was testing my blood and injecting my Humalog about 30 minutes before eating so that my food didn’t cause much of an initial spike. I also started to eat food with fewer carbohydrates to assist me with control. These differences were fairly small but helped me continue to keep my diabetes on track during the last month of backpacking.
I would really like to emphasise how achievable backpacking with diabetes is. Although it does take more planning than the normal person, there is nothing that I experienced over the six months that would in any way dissuade me from going again or make me nervous about backpacking with my diabetes. I hope some of the tips and experiences that I have given here and previous blogs provide some good ideas of how to keep safe and well controlled.
Unobtrusive and painless
Another major change to my diabetes management since being away is my recent purchase of the “FreeStyle Libre” blood monitoring machine. This is a device with a small sensor which is self-applied to your upper arm and reads your blood sugar level every five minutes. It is really unobtrusive and completely painless, and I can even cover it up with sports tape so it’s not visible at all to increase my confidence. Scanning also works through my clothes, so is extremely practical.
Since its application, I have significantly reduced the amount of finger prick tests that I do, dropping from around ten per day to just one. Other than giving my current blood sugar level, the trend (e.g. whether it is currently rising or falling) and a graph showing movements in your blood sugar levels throughout the day and night (for the past 90 days) is also provided. Whenever I want to know my blood sugar level, I can now have it within two seconds.
The thought of this kind of machine, or anything diabetes-related that was fixed permanently to me like an insulin pump, has always been something I have avoided. However, with some gentle encouragement from my girlfriend, I decided to try it. Since starting to use this machine almost three months ago, the things I have learnt about my diabetes have been staggering.
Being diagnosed almost 20 years ago, I didn’t think there would be too many moments where I would learn significantly more about my diabetes management and I was always fairly confident with adjusting insulin doses for food and exercise etc. However, this machine has since taught me things that have undoubtedly already reduced my HbA1c.
Catching hypos before they occur
Seeing the full trend of my blood sugar levels has allowed me to start flattening the fluctuations that occur around meal times. Although I was usually injecting the correct amount of insulin that would bring me to a good blood sugar reading before my next meal, I had no idea of the spikes that would occur due to insulin and food working at different times. This is not information I have ever had before. It has been really interesting to see what happens at the times I wouldn’t normally test, giving me the opportunity to change my habits to ensure that I stop these spikes.
On top of that, I now have the current trend of my blood sugar, including rapidly / slowly increasing, stable and slowly / rapidly decreasing. This is fantastic to catch hypos before they occur, knowing when my short term insulin has started to take effect and generally whether the current reading I have is likely to change significantly within the next 30 minutes.
However, a machine of this kind does take some adjusting to. For example, if my blood sugar levels were rapidly increasing after eating, I started to inject more units only to find that I would go low once my original insulin dosage had started taking full effect. This took some acclimatising to, but I am now getting the hang of using it to time my injections appropriately. I have become a strong advocate of this type of machine, and would say that the only real disadvantage is the price. I decided that I could justify the cost and make it work to improve my control, however hopefully this will reduce over time.
If anyone has any questions on backpacking with Type 1 diabetes, or on the “FreeStyle Libre” machine, please ask in the comments and I will be happy to answer.