Sitting in the dark at 3:30am in the snow, wind and cold trying to cram a few more dry mini wheats down I can't help thinking it would be easier if I didn't have diabetes. Well no helping that now it's time to get that dry cereal into you and grab the ice ax because you have a snow chute to climb. Sheer stubbornness got that crappy cereal down thankfully. No offense to mini wheats, I like them well enough below 12000 feet. But up there, well at least they did the trick. According to the stats almost 300 million people have it right now with more every day. It seems like everyone either has it or knows someone who does. To many this may seem like sentence of doom. So I thought I would write a little something about how it's not. I have had type 1 (that's where you are diagnosed young and are insulin dependent) for 25 years or so now. Guess what, I do fun stuff all the time. Most people have a basic idea what diabetes is. For ease I'll sum it up as the bodies inability to make insulin or enough insulin to make use of the food you eat. So as far as outdoor activity goes there are some things you really should follow. But honestly they're not that different then what you should all ready be doing anyway. So here they are:
1. You really have to prepare ahead of time for what you expect to be doing. But really you should be doing that on a mountain or hike or anything that takes you away from civilization anyway. As you are checking over your gear make sure that you have the needed supplies with you. Extra socks, extra batteries for your machine, extra food, medicine etc. Make sure to try to anticipate how long you will be out for and what the conditions are like. Simple things like the weather can affect your output and the time you're out. And honestly better safe with extra food and supplies then sorry when you encounter adverse weather or an injury and run short. Try to do your best guess at how long something will take you then tack on what might seem like a ridiculous bit of extra time (I often go with a +25%) and use that to make your plans. It's not a good idea to leave behind things for speed or just thinking you will be fine. Remember anyone can get hurt and if you have diabetes you won't fair as well as someone else could without the basics. So who cares if your friend says all he needs is a water bottle and a twinkie? You are the primary provider for yourself. So make sure you bring enough! I have run into people constantly who are out of food and in rough shape and guess where they get some food from?
2. You will be burning a lot more calories then sitting at home reading Summitpost so you need to prepare for that as well. I have had to reduce my insulin intake by half during trips. You can take it late, you can take less of it, whatever works best for your situation. Everyone reacts to this sort of output a little different so don't expect to get perfect results the first few times your out. Experience will help you determine your best approach. Trust me. One of my first 12 hour days all I brought was gatorade, nuts and granola bars. Sure that sounds ok but when you have to eat more often then the average person during a climb you end up never wanting to see those stupid granola bars again after! So bring some variety. Try to bring high carbohydrate foods and juices. Basically what your average person brings just more of it and maybe slightly more carb oriented then them. Remember your body needs protein but protein won't keep your blood glucose levels from plummeting. So bring variety. Protein, carbs and also some fast acting sugar like juice. Juice will act fast, carbs will last a long time and protein can give your muscles needed fuel. If you are out with someone that has diabetes you don't have to be afraid that they are going to slow you down or that you have to babysit them. They should be able to take care of themselves like anyone else if they're going to be out there. You just need to be aware of what you need to do if something does happen.
MMM summit food!!!
3. Sure some people may find it embarrassing to tell others about their ailments but it could be a real help later if something were to go wrong. For those with someone that has diabetes just try to keep it in the back of your mind. You don't have to be afraid that they are going to go into a coma while belaying you on that really dicey pitch but you should be prepared to stop a little more frequently to allow them to check their blood glucose levels. Never be to shy to say you need to stop for a second or to tell the person that maybe they should stop and check. It doesn't matter how close that ridge looks, if you don't give priority to taking care of yourself then you could create an unpleasant situation that could have easily been avoided. A few signs that the person may need to eat are slurred speech, confusion or the person being pale and shaky. If not given attention to right away the person can lose consciousness. Again your not their babysitter but there are a lot of things to distract you on a climb and another set of eyes on anything is beneficial. For the diabetic, it's a good idea to have the person with you learn before hand how to use your medicine and what to do if there is a problem.
Sometimes I feel like a walking pharmacy!
4. Okay so you're cold and wet but try to make sure your supplies aren't. If it's really cold then keep your supplies in a water proof bag close to your body. Keep it in your sleeping bag at night. If it's really hot, again a water proof bag but try in the dark recesses of your pack next to your water. Personally I have wrapped socks or undershirts around my vials of insulin to give them extra padding just in case. A note of caution though. Keep it covered and protected but try to allow quick access to it as well. Somewhere safe but also somewhere that you don't have to strew the entire contents of your pack all over the place digging it out when you need it. Another helpful bit is to make sure to change your socks if they are wet. Diabetics are prone to infection, especially in their feet so do what you can to avoid blisters. Yes that does mean not taking your brand new, fresh out of the box boots on a big climb. Try to break them in at home first. Wear them around the house, at work wherever. Sure maybe it looks funny but it's better then oozing blisters later!!
Remember exercise is good for everyone and especially for those with diabetes. You don't have to let it limit what exercise you do. And don't be afraid to ask someone who has it to come out with you. Chances are good that they won't end up falling over dead when you are miles away from a grocery store. My daughter was diagnosed with type 1 diabetes 4 years ago. She is 8 now and goes out hiking and climbing with us all the time. It's good for her because it shows her that she doesn't have to be limited by diabetes. Plus it keeps her active which reduces the chance of complications later in life from diabetes. She has learned it's just something to work around not stop work all together. So with a little extra planning even kids that have diabetes can get out and enjoy the mountains and forests too. So to sum up plan, prepare, and take care of yourself while you're out there. Then it doesn't matter whether you have an ailment or not. You'll be enjoying yourself either way.
Thank you for reading it. I would say that overall my water consumption is the same as your average person. When someone with diabetes doesn't take enough insulin they get thirsty because their body's trying to rinse out the excess sugar. I try to keep my levels in a fairly normal range wherever I am so don't experience that because that sort of thing is hard on the body.
I wanted to add a couple comments to your very informative article!
As someone who camped and hiked with diabetics for many years I have developed a few practices that ensure a safe and happy trip for them as well.
#1 - We always split up some of the diabetic person's extra supplies that is, someone else always carries some of the extra insulin etc. This was invaluable the time we were snowshoeing and the diabetic person's insulin was accidentally frozen.
#2 - At least two other people are trained to inject the insulin. The first time I traveled with a diabetic we had only the diabetic capable of doing this and he was 15 so I learned to do it. Next trip I was along but I had to go home early due to a family emergency; those staying back were not happy to designate a sub for me but eventually came through.
Obviously these situations applied to younger hikers etc. but we had full parental support. The young man I mentioned above is now in his late 20s and very active in outdoor activities today.
Great article for pointing out that diabetics can enjoy the out-of-doors successfully. But people should always be aware that others around them, not even in their own group could be diabetic and occasionally need a little support in an outdoor situation; not to mention the millions of us who are pre-diabetic and Type 2 diabetics! I had gestational diabetes and unless I eat regularly I have trouble with maintaining my energy level and preventing headaches etc. I have to watch my weight and exercise to avoid Type 2 diabetes down the road. And every first aid kit I carry today has sucrose tablets in it.
I've always noticed that most people I meet in the outdoors are
not drinking enough water, especially HERE in Arizona.
When I was growing up in Utah, my friend's mom had a diabetic
attack while she was driving. We had to go find her and we gave
her a candy bar - I believe it was a Three Musketeers bar.
I always felt very sympathetic toward my friend for having a
mom with this health condition, but it gave me a better
UNDERSTANDING of how unfair life really was and was a powerful
dose of reality, for sure.
Yea it is good if someone else knows how to give the person their insulin. I find it most important for them to know how to use the machine to check their glucose levels (which are sooooo much easier now then when I was a kid). That way if they can't check themselves the other person knows what to do. Give food, or give insulin. I go out bouldering solo as well but I make a mental effort to pay attention to how I'm feeling and I take quite a few breaks... you know for the sake of a drink or snack...not to rest my tired limbs....
Yea lots of times I carry some sort of chocolate bar with me if I'm out hiking. Usually I bring fig newtons. I don't know why but they have become one of my snack staples. I guess it's because they are small and it doesn't take much to bring up a persons sugar levels. 2 fig newtons= 1 whole sandwich.
Climbing with diabetes is really the great task. My friend is also suffering from diabetes and he also like to do climbing and cycling. Insulin is always helpful for him to control blood sugar level in his body. I will appreciate such people who are living with diabetes. Low blood sugar symptoms