Travelling with diabetes Part II
I know I know, I was not active on my blog for some time now, but I have some good reasons! As you may know, I went on vacation, and before that I had family over for a couple of days, and then I had a small work contract, but don’t worry I am back for good now!
As promised, I decided to write an article about how I managed my diabetes during my trip in the Caribbean. It was not always easy since I was on a cruise ship and you probably already know, this means unlimited foooood!! However, I’ll try my best to give you some useful tips to use while on vacation by sharing my own experiences.
THE BIG WORRY: SECURITY POINT
In my last article about travelling with diabetes, I wrote about passing through security while being a diabetic and all of the struggles that can come with it. You probably want to know what happened with me this time? Well, you would be surprised to know that I didn’t really have any problems! I travelled from Canada to the US first and of course I got some questions about why I can’t go through the X-Ray machine and why my sensors and my loaner pump can’t go either. I asked for a female pat down and the TSA agent was right there so it was pretty quick. When I came back from the US however, I had to wait to get a female pat down and I was getting really impatient, especially because the other TSA agent was so unaware of my situation, but I waited 10 minutes this time and not 30 minutes, so we can say there’s progress. Another security point that I had to pass almost every day was on the ship. Every time we would get off to visit a new island, we had to pass security to go back on the ship. I couldn’t go through the X-Ray machine because of my Dex and my pump so I needed a pat down every time, but thank god the female agent was always there, she actually knew me at the end of the trip! On another note, it’s just funny how us diabetics always get those looks saying: '' why does she need a pat down?''. They see that 24 year old girl getting a pat down and you can realllly tell by their looks that they’re confused. I came back from Jamaica after staying there for half a day and I am pretty sure people thought that I came back with something illegal ! However with all these confused looks, I am still confident and I ask for a pat down in front of everyone, why should we be shy?
HOW TO MANAGE INSULIN AND FOOD
While being on vacation, your diet is certainly going to change, especially if you are in an all-exclusive, or in my case, I had unlimited food served on the ship. I was eating so many carbs it was unreal. Normally I eat between 100-120g of carbs per day, and there I was eating around 70g per meal, and I don’t even want to tell you how many meals I was having. I was getting a burger just cause I felt having a snack! My blood sugar levels were low sometimes (thank god for the candies that I brought with me), or a little bit high, but they would always stay between 10 and 14 mmol\L almost all day. I’ve had good blood sugar levels at the end of the afternoon, close to dinnertime, so at least it was not always high.
So how was I able to manage my insulin with all of these carbs? First of all, if you want to go on a trip and eat somewhere most of the time, I really recommend being comfortable with calculating carbs on your plate without any measuring cups or spoons. I have an app that helps me calculate my carbs (Figwee, check out my post The sweet life of Judy and Diabetes) but it needs Wi-Fi to work and the Internet on board was really slow so it wasn’t really helpful. Most of the time I was eating at a buffet and we all know that buffets are like a dream, but also a big nightmare for diabetics because, in my opinion, it is almost impossible to precisely calculate the carbs that we are eating, and on top of that, we grab food more than once so that means that we have to take more insulin in a small period of time. In my case, I was getting food, coming back to my table and then was starring at my plate for a good 30 seconds just to figure out the carbs on it. A lot of food that I was getting didn’t have any carbs, like a salad and fish, but the other part of my plate was full of fries, pasta, bread, pizza, rice, you name it. The trick is to separate your plate mentally and go food by food, so for example: rice 30g, pasta 25g, fries 35g. Then I would add it all up, put it in my pump and I’m good to go. For those using insulin pens, you take the total of carbs and divide it by your ratio. Another trick is to use your hand, as one fist represents one cup. I was also using a combo bolus with my pump for a couple of reasons: 1. I was eating a lot of fat 2. It gave me the freedom to get up and grab more food 3. If I put too much insulin, I was able to stop the injection after eating.
HOW TO MANAGE INSULIN AND ALCOHOL
This is another main worry when going on vacation: alcohol consumption. I personally don’t let diabetes get in the way if I feel like having a mojito. Of course it always depends on my BG level because if it is very high or low, I don’t want to make it worse. I used to drink strong alcohol with juice, but now I like the sweet drinks category more, like a good amaretto sour or a pina colada.
The first thing that I do when getting a drink is to look at the ingredients on the menu. They usually write what’s in the drink, like sugar, lime/orange/ pineapple juice, etc. This gives me an idea of the carbs that are in the drink and if there’s actually carbs in it. Remember, if you get something with plain alcohol (except wine and beer), there’s no carbs in that. I then tell myself that one small cup of juice has 30g of carbs, so there should be the same amount in my drink. Usually, I would give myself around 4 units of insulin for a glass (according to my ratio), but since alcohol tends to bring the blood sugar down, I give myself the precise same amount of 3U every time and then adjust my dosage later on if I need to. Another important thing to remember is that when drinking wine, and even though it has carbs in it, it is better not to give yourself insulin. Again, I am not a doctor and every person is different, but I noticed that I would always go low after drinking wine so my nutritionist recommended that I stop taking insulin when drinking wine, plus this beverage doesn’t have a lot of carbs anyways.
The important part when drinking alcohol is night time because the hypo effect can happen a couple of hours later and last for a couple of hours too. When going to sleep, always keep juice boxes and candies next to your night table in case you go low. Another trick for Dexcom users is to put your low alert a little bit higher, so let’s say your machine starts beeping at 4.3 mmol/L, I recommend to put it higher at around 4.7 - 5 mmol\L for 2 reasons: 1. When we drink, our sleep tends to be deeper so it is safer to wake up earlier 2. Alcohol can lower the BG level pretty quickly so it is better to treat it at an early stage. When you are comfortable with all of that, you will be comfortable doing it again and again and you will be able to enjoy a couple of drinks by the pool or when discovering the nightlife in a new city!
I can say that in general, I managed my diabetes pretty well since I didn’t get any major hypers or hypos. I got a big hyper once but it was because of a technical problem with my pump. I was changing it and I don’t know exactly what happened, but I think that I didn’t properly attach the tubing to the cartridge so some insulin was leaking out of it but I was unaware of that. Thank god I didn’t go to the buffet after that, but I still ate a veggie burger with FRIES, so imagine the panic after realizing that I got no insulin and that my BG level was at 24 mmol/L . I did the smart thing and used my pen and started giving myself insulin step by step because I didn’t know if I still got a little bit of insulin through my pump. Happily, my BG level came down after 1-2 hours!
So a couple of things to remember while being on vacation:
- Let diabetes adapt your new lifestyle and not the opposite. I know it can be hard but try as much as you can !
- Be comfortable with measuring carbohydrates on your plate.
- Don’t be afraid to try out new things, but just keep in mind your insulin dosage and if you need to modify it.
- If you’re using an insulin pump, always keep with you an insulin pen.
- Be careful of lows following up alcohol consumption: always keep hypo lifesavers like candies or juice with you.
Us diabetics are never really on ''vacation'' because our mind is always worrying about diabetes stuff: it really is a full time job without any breaks. The only way to enjoy a vacation is to be positive : we can’t do anything about it for now and if you’re lucky enough to go on vacation, that’s all you need to focus on!