Travelling long-term as a type 1 diabetic is a particular challenge. While the spirit of adventure calls, you have to be constantly aware that diabetes is always with you. What are simple decisions for other travellers become complex considerations for us.
Daily confrontations
As a type 1 diabetic travelling long distances, you are faced with numerous decisions every day that may seem trivial at first glance, but actually require careful consideration. Even seemingly simple things like eating can become a challenge because they have a direct impact on blood glucose levels.
Examples of challenges
| The challenge | Our strategy |
|---|---|
| Hidden carbohydrates: Many dishes, especially in foreign countries, hide carbohydrates that are not obvious at first glance. A supposedly simple salad can contain more carbohydrates than you would expect due to a sweet dressing. Local specialities such as curries, sauces or marinated meat dishes can also contain sugar or flour, which can cause an unexpected spike in blood sugar. In the Philippines in particular, we initially underestimated the heavy use of sugar, which is particularly high in ready meals such as a simple tomato sauce. | Before eating, we ask ourselves: “What else could be in here that I can’t see?” It often helps to ask for the ingredients list or search online for typical ingredients in the dish. If we are unsure, we dose the insulin conservatively and check our blood sugar more frequently after eating so that we can correct it if necessary. In supermarkets, we always look at the ingredients to avoid nasty surprises afterwards. |
| Estimate portion sizes: In many countries, portion sizes are different to what we are used to. What appears small at first glance may actually contain a large amount of carbohydrates. It is particularly difficult to correctly estimate the carbohydrate content of typical local buffets or street food. In Vietnam, there is a lot of deep-fried food, whereby the blood sugar level looks good at first, but only rises afterwards due to the fat. | We try to compare the portion sizes with known foods and then calculate the insulin requirement. For new dishes, we check the blood glucose level within the next hour and correct it by injecting again if the values are too high. By writing down how much we have injected for a meal, it makes it easier to inject the same food again in future. |
| Unfamiliar foods: When travelling, we constantly encounter new and unfamiliar foods. In Asia, for example, there are many fruits that we have never tried before, such as durian or rambutan. The uncertainty about how these affect blood sugar is a challenge. | When it comes to new foods, we try them out slowly. We try small amounts and measure our blood sugar afterwards to see how our body reacts. It’s a constant process of learning and adapting. As with estimating portion sizes, we pay particular attention to the blood sugar level in the next hour after eating so that we can react correctly. This is because it has often happened that we have had too much and then I have had to eat or drink something else. That’s why it’s better to leave a little space in your stomach when you’re making new dishes in case you’ve overdone it. |
| Trusting the sensor: The reliability of our glucose sensor is crucial, but the sensor values do not always match the actual blood glucose. A value that is too high or too low can lead to wrong decisions that affect the entire day. | If we have the feeling that the sensor is not reading correctly, we compare the values with a traditional measurement. We use our blood glucose meter in particular if we have unusual readings or symptoms such as lack of concentration or prolonged tiredness. |
Mastering daily confrontations
The daily confrontation with diabetes when travelling requires constant attention and flexibility. Over time, you develop a sense of how different foods and situations affect your blood sugar. But it remains a constant challenge that requires a lot of experience and mindfulness. Those who are aware of this challenge and prepare themselves accordingly can explore the world safely, even with type 1 diabetes.
Storing insulin
One of the biggest challenges when travelling long distances is the safe storage of insulin. Problems can arise, especially in foreign countries with different standards.
Our concerns:
- Other people’s fridges: Can I put my insulin in the fridge of someone else ‘s accommodation? What if the fridge is shared or even has mould?
- Transport routes that are too long: train delays, no shade in the waiting area or not finding a taxi to take us to our accommodation after a long flight can all be unexpected reasons that can extend the previously calculated transport route. Therefore, if possible, have enough ice cream with you in advance or look for help in the surrounding area, such as shops at the airport or small stalls on the street.
- Power cut: What happens if the power goes out? This happens more frequently, especially in remote regions, and it pays to be prepared.
Our tips:
- Have backup plans: Always have a plan B ready, for example a cool bag with ice packs, in case the fridge breaks down.
- Check fridges: If possible, check the hygiene and reliability of the fridges in advance or look for alternatives.
As this topic is very complex, we have written a complete article with our tips on the safe transport of insulin.
The management of fluctuations
When travelling, blood glucose levels may fluctuate more than at home. Changes in diet, climate, exercise and stress levels can have an unpredictable effect on blood glucose levels. What to do if the values get out of control?
What to do in case of strong fluctuations?
- Our opinion: If blood sugar levels fluctuate too much, it is important to take a break. This should not just be a few days, but rather two weeks to give the body a real break. During this time, we try to adjust the amount of insulin so that the values stabilise again. There is no point in simply travelling on and hoping that the values will stabilise on their own. Ignoring the situation makes it worse and can have serious long-term health consequences.
Illness while travelling
Long-term travelling also means that you will have to deal with illnesses at some point, which can range from aches and pains to being bedridden for days on end. With type 1 diabetes in particular, it is important to take such phases seriously.
Our tips:
- Flexible travel plans: We deliberately keep our travel plans open and flexible so that we can react quickly in the event of health problems. After extreme activities, such as kilometre-long hikes, we often take breaks to give our bodies time to recover.
- Booking accommodation: We book our accommodation via Booking.com and make sure that it can be cancelled or changed at short notice. This gives us the opportunity to adjust our location if a longer rest period becomes necessary.
Listen to your body
Facing diabetes on a daily basis while travelling requires constant attention and flexibility. Fluctuating blood glucose levels and illness are inevitable companions on long-term journeys, but they don’t have to mean the end of the adventure. With the right preparation, an open travel plan and awareness of when breaks are necessary, the world can be explored safely even with type 1 diabetes.
Conclusion
Long-term travelling with type 1 diabetes is possible, but only if you are well prepared. It is crucial that the body is optimally adjusted to the medication before travelling and that you have gained sufficient experience to react appropriately in different situations. There should be no rush and the disease should never be ignored. Even if the consequences of high blood sugar levels are not immediately visible, they can cause considerable damage to health in the long term.
And if all else fails while travelling and things turn out differently than expected, the path leads back home. This is by no means a failure, but rather an enrichment and a courageous admission to yourself that you have reached your limits and that you can no longer go any further on your own.
Careful planning and awareness of your own limits are the key to a safe and fulfilling journey. Because even though diabetes is our everyday companion, we want to prioritise fun, which is only possible if we look after our health together.
You can find out more about this topic on our page on travelling with type 1 diabetes and challenges in other countries.
