Travelling alone with Type 1 in China – by Rebecca
There’s no getting around it, travelling with diabetes is difficult, especially when you’re alone. But that shouldn’t stop anyone from doing it. As long as you test a lot and accept some days are going to be more unpredictable, the experiences you gain from travelling far outweigh the short term issues of diabetes management.
My most recent experience was spending almost five days in Beijing, after doing a language course in Hong Kong. It was a very crazy experience to say the least! Although managing my diabetes was challenging, I want to show that with the right care and preparation, it is completely possible to travel alone.
The biggest things I had to overcome*
*Please do not take this as medical advice. This just a list of my difficulties and how I dealt with them.
Change in weather
Going from 30C in Hong Kong to 18C in Beijing is quite a big deal in managing insulin doses. With many other things on my mind, I forgot to increase my background insulin before leaving Hong Kong (as background has a lag of around 24 hours). So, my first day was spent chasing down high glucose with higher doses of fast acting insulin (the one I take with food), and checking my ketone levels when I felt sick.
Over the next few days I steadily increased my background insulin until finally I woke up at a half-decent 7.8mmol/L, instead of waking up at 16mmol/L – not a good feeling. I took it slow because I was concerned about overdosing on background insulin, but was also keen to get my numbers out of the teens (mostly out, at least). Raising levels were particularly concerning as I was hiking the Great Wall, but I frequently stopped to take a little more insulin until it came under control.
Next difficulty: guessing carbs in food, and guessing how much exercise I was about to do afterwards (whilst also getting lost, miscalculating distances, running after buses etc). Not easy. It was usually nothing more than a guess. However, I was very keen not to go hypo whilst walking around the streets of Beijing.
Looking foreign and lost gives you enough to worry about, and I really didn’t want to sit around in a Hutong (maze-like residence backstreets) for half an hour waiting to feel better. So I generally under-dosed slightly to try to keep my average between 7-10mmol/L. 10 isn’t great, but it’s more pleasant than 3.
This is where my Freestyle Libre was incredibly useful. Although it wasn’t always accurate, it gives trend markers to show if I was going high or low. With just a quick scan, I knew whether I needed to have a quick snack or take another shot. I generally had to correct one way or another after meals, as most of the time I had little idea what I was actually eating, let alone the carbohydrate content.
Which takes me to my next point: injections in summer wear, ie dresses! Not ideal if you want your insulin to work fast by injecting into your stomach! I had quite a lot of groggy post-meal hypers after injecting into my legs, which wasn’t great. I could have waited before eating to let the insulin get into my system, but it would be a shame to let delicious food go cold.
But why a dress, if stomach injections are better for me? Because I decided to get a balance in life. I am not going to let my condition dictate the clothes I put on in the morning. It controls enough and I am not going to let it control how I look as well. This might not make sense to everyone, but I like wearing dresses, and if it means my diabetes care is not quite as good, then so be it. If anything, I’ve learnt that stitching some zips into them to make them Type 1 friendly would be a good idea next time I travel!
Snack in one hand and insulin pen in the other is hard (especially, again, in a dress). Usually, I ate then injected later, although that made my levels rise significantly and I didn’t feel great. My favourite street snack involved sticky rice which is high carb, high GI. This means rocketing glucose levels.
It depended on how much I wanted the snack and how quickly I could see myself injecting afterwards. Where I could, I sat down to eat and inject, but it’s hard to be in Beijing and not at least try some of the exciting, strange, unhealthy foods about. It’s all part of the fun and I didn’t want to miss out.
If this is your main concern, it shouldn’t be. I always increase my mealtime insulin whilst at the airport, because I know I get a little anxious during transfers, and increase it a lot on the plane (sitting still for a long period of time and sleeping).
Regarding security, I’ve never had an issue. Even the Libre sensor has never been questioned. I bleep on the scanner, they do a pat down, then send me on my way. Also, insulin doesn’t count in liquid allowance so I can take as much of that on board as I want. So for flights, the only concern I have is making sure I have enough sweets and snacks in my pockets during the flight, just in case I become hypoglycaemic.
I think I’ve covered the main issues – but you can find out more information about travel and diabetes on the Diabetes UK website or call the Diabetes UK Helpline, but if you have any questions for me please contact via my blog (if you have diabetes yourself or are just curious!)
It’s a lot to handle, especially if your levels start going wavy. However, if you take care of yourself and check your levels frequently, there is nothing stopping you from travelling alone.