Hiking with Diabetes

[Treker45]

A big surprize to me was I was just diagnoised with type 2 diabetes 2 weeks ago. I have been getting all the information I can on this and have a question on hiking and maintaing your sugar levels. I showed the Dr my hiking foods, dehydrated, and he seemed happy with it, but are there food list by hikers for dealing with this?

Any information would be appreciated as I still plan to continue hiking as I have been.

[DaleTr]

I suddenly was diagnosed with type II also apoprox 6 months ago. Its been a little spooky. The occasional numbness and dizziness. I am finding that exercise is my best friend. I do ensure I carry extra food as all the hiking definitely lowers my blood sugar numbers. I sometimes feel awkward telling someone that I am hiking with that if I look disoriented, etc to please ask me to eat some food. I visit doctor next week and also will share my hiking diet and see if he has recommendations.

[Buzz_Lightfoot]

A big surprize to me was I was just diagnoised with type 2 diabetes 2 weeks ago. I have been getting all the information I can on this and have a question on hiking and maintaing your sugar levels. I showed the Dr my hiking foods, dehydrated, and he seemed happy with it, but are there food list by hikers for dealing with this?

Any information would be appreciated as I still plan to continue hiking as I have been.

My condolances. I've been dealing with Diabetes for 25+ years now and it is no joke. They will tell you "You can live an almost normal life!" but that darn word "almost" grows bigger all the time. It preys on your mind. When I am having a bad day at work, etc. and I have this fantasy of running away to a cabin in the woods the fantasy bubble pops with "Oh, I still need insulin!" I went through denial, anger etc. for a while and finally I am at "acceptance". Try to work towards "acceptance" quickly. It will not be easy but once you are there it won't prey one your mind as much and drag you down as badly.

Here are some do's and don't while hiking:

DON'T: Denial. "I am hiking so my blood sugar will not climb." Wrong. It will not be as bad, exercize is good for it, but it it will not go away. There were times in my "denial" phase where I would not take my shots while hiking. I would have to get up 4 or 5 times a night to pee because my blood sugar was so high. Denial is your enemy.

DO: Carry your blood sugar test kit with you and test your sugar levels any time you feel you are not "right". Be aware of your body's signs. Lethargic, excessive urination, high sugar. Nervousness, cold sweats, shakes, and (if really bad) irrational behaviour, low blood sugar. Low sugar is a common problem with hikers. Your doctor will prescribe a method for lowering your blood sugar. It may be pills, shots or an insulin pump. You will need external insulin at two seperate times. When you eat to balance out your sugar intake and ALSO you need a constant "slow drip" all the time. This is called the basal rate. The problem is that while hiking you are burning sugar faster and this slow drip is ofter too much hence you burn off too MUCH sugar and have a low sugar reaction. I can't speak for pills since I never have had them prescribed for me but with injection therapy you will use two types of insulin. Long acting for the basal rate "Slow drip" and short lasting, fast acting insulin for meal times. Since once you have injected your long acting there is no way to "turn it off" the only way to offset a low sugar condition is to eat something with a lot of sugar. (Emergency glucose tablets, orange juice or my favorite, snicker's bars ). With an insulin pump it is easy to turn it back. You can program a lower, temporary basal rate while hiking. This brings me to my next "Do".

DO: ALWAYS carry emergency glucose tablets (or an equivilant). If you go hypoglycemic (low sugar) and have no way to counter it miles from the trailhead you will be in SERIOUS trouble.

DON'T: Let this condition keep you inside. This would be a crying shame.

Remember this, with whatever blood sugar control method your doctor prescribes, you are essentially trying to control an automatic system for maintaining correct blood sugar levels manually. You WILL get it wrong from time to time. It is inevitable. That is why you should test your sugar ANY time you have any doubt and compensate based on the reading with a shot of fasting acting insulin (high sugar) or a glucose tablet (low sugar). Your doctor will give you the numbers for how much. It may sound difficult now however after a time this "balancing act" will become second nature to you.

Good luck,

BL

[Desert Reprobate]

Also, cuts and abrasions on the lower extremities seem to take forever to heal.

[Old Grouse]

You didn't mention whether you are required to test daily or to take insulin, carefully watch your diet or intake, etc. All I need to do is take a pill twice a day and eat at more-or-less regular times. I like to chew the occasional handful of raw almonds while I hike. It seems to even things out.

[mudhead]

I sometimes feel awkward telling someone that I am hiking with that if I look disoriented, etc to please ask me to eat some food.

No need for feeling awkward. I get goofy if I need water and/or salt.

I know a guy that becomes crabby when he needs crackers. He scowls, tells me to ****, then eats. What friends are for...

[mbanja]

If I start speaking in tongues - tell me to eat a snickers bar.

Here's an easy couple ways I've found to manage it:

Most endocrinologists that I've talked to recommend the same thing - an extra 30g carbohydrate before two hours of exercise.

Also, and this cannot be understated - test at least every two-three hours while hiking even if you think you don't need to. I've felt low and been high and vice versa depending on what time of year and the terrain I've been hiking.

The foods you eat may spike your bs through the roof at night if you cut down on basal pills or insulin. This has always been a problem for me. I use less than half of the basal insulin that I normally need and barely any of my short-acting mealtime insulin. At night (after I gobble down a half pound of elbow macaroni) I have to make sure I've taken enough to cover it.

Simple carbs will help with quick energy. I love fruit leather and snickers. Complex cards and protein will get you through the long haul. You gotta have a good combination of both, otherwise your BS will look like the elevation profile on your trail map.

[TD55]

One thing I have learned for sure, everyones metabolism is different and what works for one person may not work for another. Each person has to find a balance between types of food, amounts of food, exercise (hiking pace) and medication(s). This requires lots of testing, sometimes five or six times a day until you find your "balance". I could say what has worked for me, but there isn't much purpose to that since it may or may not work for another person.
One thing I did find extremely helpful is a book called Diabetes- Fight it with the Blood Type Diet by Dr. Peter J. D'Adamo. When I keep to the foods listed as OK for my blood type and avoid the ones not listed for my blood type my sugar levels are much easier to control.

[HikerRanky]

I was diagnosed with prediabetes the Tuesday before Thanksgiving 2008, and have been successful in controlling mine with diet and keeping an close watch on my glucose level. I hike with my testing kit and carry a decent food supply with me.

When I first got the diagnosis, I started doing a lot of online research. A couple of the best places I found to help me was http://www.rainforesttreks.com/diabetes.asp. The gentleman that has that site is a Type I diabetic but gives a good amount of information on diabetes and nutrition.

The second site is http://diabetic.friendsinhighplaces.org/. This site is for diabetics of all types and really gives me inspiration that I can do anything.

Randy

[man2th]

heres what i carry for my hypoglycemic episodes, the small tubes of cake icing. its a quick fix till i can get a real meal in me....and i know it sux but check your blood glucose often.

[NoGaHiker]

Type 2 here for over 5 years. Test, Test, Test. I found a "balance" by keeping close tabs with testing and paying attention to what I ate, how much, how often and the time/distance I had covered. I have gotten where I can tell when I am getting hypoglycemic by my energy level and can just about keep it dead on by nibbling on gorp, snickers, etc about every hour and eating complex carbs at mealtime. It is kind of like putting gas in the car. When it gets low, I can't go. One other thing, some meters do not give readings in colder weather. So, if you rely closely on your meter, be careful when out in the cold.

[TunesKnits]

I don't have diabetes, but if I were hiking with a friend who did, I would want to know. And I would want to know what to do in case of emergency. Also, if someone came upon you while you were alone and not thinking clearly or feeling well, it would be helpful if you had a med card in an easy to see/obvious spot, or bracelet so they would know. You could put one of those med bracelet tags on a zipper pull on a pocket where you have a med card and emergency food. I think the cake icing is a great idea or one of those Gu or Gel Food packages, kept only for that emergency need. You would not have to shout it to the world, but doing a little prep for your friends seems reasonable. Good Luck! Glad you are going to keep hiking.

Tunes (who does have food allergies requiring hiking with an epi pen and Celiac disease which makes eating on trail challenging...)

[Buzz_Lightfoot]

I don't have diabetes, but if I were hiking with a friend who did, I would want to know. And I would want to know what to do in case of emergency. Also, if someone came upon you while you were alone and not thinking clearly or feeling well, it would be helpful if you had a med card in an easy to see/obvious spot, or bracelet so they would know. You could put one of those med bracelet tags on a zipper pull on a pocket where you have a med card and emergency food. I think the cake icing is a great idea or one of those Gu or Gel Food packages, kept only for that emergency need. You would not have to shout it to the world, but doing a little prep for your friends seems reasonable. Good Luck! Glad you are going to keep hiking.

Tunes (who does have food allergies requiring hiking with an epi pen and Celiac disease which makes eating on trail challenging...)

Trouble is there are two situations that might occur that would cause an unconscious diabetic. Very low sugar and very high sugar. You treat high sugar with insulin, low with sweets. Use the wrong treatment and you stand a chance of killing the diabetic. I would be very hesitant allowing a novice to treat me.

The trick to hiking with diabetes is to be AWARE of yourself. Constantly think about how you are feeling and confirm by using your test kit. Being diagnosed with diabetes does not mean the end of hiking. You just have to learn to be more aware of your body and what it is trying to tell you. If you remain vigelent there is no reason why you should get yourwelf into an emergency situation.

BL

[Lillianp]

Trouble is there are two situations that might occur that would cause an unconscious diabetic. Very low sugar and very high sugar. You treat high sugar with insulin, low with sweets. Use the wrong treatment and you stand a chance of killing the diabetic. I would be very hesitant allowing a novice to treat me.



BL

Well, I guess I'm not technically a novice, as I've been trained and certified as a First Responder, but one of the things we learned was that since our training isn't as in depth as say a paramedic's or a doctor's, that if we couldn't tell the difference between low blood sugar and high, to always give sweets or glucose or something, as it takes longer for the high blood sugar to become as dangerous as low blood sugar does in a short period of time.
For us, giving sugar would either dramatically help the person or it would not harm them as MUCH as not giving sugar to a low blood-sugar person.
...Not saying this is a perfect solution, nor would I necessarily recommend it, but that is what I was taught four years ago.

[take-a-knee]

Well, I guess I'm not technically a novice, as I've been trained and certified as a First Responder, but one of the things we learned was that since our training isn't as in depth as say a paramedic's or a doctor's, that if we couldn't tell the difference between low blood sugar and high, to always give sweets or glucose or something, as it takes longer for the high blood sugar to become as dangerous as low blood sugar does in a short period of time.
For us, giving sugar would either dramatically help the person or it would not harm them as MUCH as not giving sugar to a low blood-sugar person.
...Not saying this is a perfect solution, nor would I necessarily recommend it, but that is what I was taught four years ago.

What you were taught is correct. Pushing some D50 (dextrose)on someone in a diabetic coma won't really screw them up more than they already are, but it'll wake someone in insulin shock wide awake.

There is quite a bit of confusion in this thread about the difference between Type I and Type II diabetes. The former is caused because your pancreas isn't making enough (or any) insulin. The latter is caused by prolonged consumption of refined carbohydrates, the body's cells down regulate insulin receptors and it simply doesn't work any more to allow glucose to enter the cells, or your pancreas can make enough insulin for a 200# body and you now weigh 400#.

Type I- high blood sugar, low insulin

Type II- high blood sugar, high insulin

[Buzz_Lightfoot]

Well, I guess I'm not technically a novice, as I've been trained and certified as a First Responder, but one of the things we learned was that since our training isn't as in depth as say a paramedic's or a doctor's, that if we couldn't tell the difference between low blood sugar and high, to always give sweets or glucose or something, as it takes longer for the high blood sugar to become as dangerous as low blood sugar does in a short period of time.
For us, giving sugar would either dramatically help the person or it would not harm them as MUCH as not giving sugar to a low blood-sugar person.
...Not saying this is a perfect solution, nor would I necessarily recommend it, but that is what I was taught four years ago.

Interesting. Still learning new things after all these years. Thank you for that tidbit. I'm curiuous though, since diabetes is so common anymore why are not a glucose test kits part of yout "kit"?

BL

[Treker45]

Thanks for all the info, I am still working through the acceptance stage I guess still. I met with a dietitian and he was great explained a lot on carbs and such. I met with my hiking partners this weekend for our annual hike planning meeting and I informed everyone in case someone would be concerned about hiking with me. Intresting reaction.........the others talked about high blood pressure and other ailments, so I didn't feel so bad. I lost some weight and am on the "pill" and my numbers have dropped. I think I will have more of a concern of low sugar levels while hiking and am carrying tablets and a meter to be sure.

I don't plan on giving up hiking that woudl kill me for sure!

[Buzz_Lightfoot]

Thanks for all the info, I am still working through the acceptance stage I guess still. I met with a dietitian and he was great explained a lot on carbs and such. I met with my hiking partners this weekend for our annual hike planning meeting and I informed everyone in case someone would be concerned about hiking with me. Intresting reaction.........the others talked about high blood pressure and other ailments, so I didn't feel so bad. I lost some weight and am on the "pill" and my numbers have dropped. I think I will have more of a concern of low sugar levels while hiking and am carrying tablets and a meter to be sure.

I don't plan on giving up hiking that woudl kill me for sure!

There you go! And remember, you can always tell everyone that you are extra sweet!

[LaurieAnn]

Hey guys... I was diagnosed in late January. I was pergnant at the time (miscarried) and went straight on Lantus and NovoRapid. By the end of April, with some dietary changes and weightloss, I managed to get off the NovoRapid and onto Glucophage but I still take the Lantus (albeit a small dose of between 10 and 15 units a night). \

In less than two weeks I go on my first wilderness trip since being diagnosed. My endocronologist suggested that I cut the Lantus back considerably the nights before I hike.

So... my questions for those of you using a basal insulin.... are...

How do you keep it from getting to warm/cold or spoiling?

Did you find that during hikes you had to discontinue taking the basal insulin?

[mbanja]

I have to cut my lantus in half and i use almost no novolog except for the huge carb depthcharge dinner. Your experience will vary of course. I take 26 units of Lantus every night. On the trail I take about 13-15 depending on how many hours I'll be hiking (usually high teens mileage over 9 hours).

Your insulin is fine at room temp for about a month. If you really want to get creative you could just put it in an empty pill bottle (protection from breaking) and stow it with your platy or camelbak. It would cool it down a couple degrees, but it's really not necessary for section hiking.

Gonna catch heck for this one, but chances are that if you increase your exercise regimen, and don't freak your system out you may well be off insulin and pills in a while. Type II is reversable for many people, but as Type I- I may be just jealous and speaking out of place. Diabetes is incredibly individual, it would be really great get a major hospital to put together a grant to fund a whole bunch of diabetic thru-hikers just to measure changes in insulin intake. Not gonna happen....