Diabetic hiker

[rene]

I am planning a thru hike for spring 06. I am a type 2 insulent dependent diabetic. I am currently involved in weight loss and conditioning program. As I lose weight I am able to decrease the amount of insulin I inject.

Everything I read states that food consumption can amount to 4000 + colories per day. These are mostly carbohydrates. Any advice from other diabetics that have hiked long distances on how to manage my blood sugar, and cope with the obvious high energy needs would be of great help to me.

Rene

[whitedove]

I'm not a diabetic hiker but here are a couple websites that may be helpful.



http://www.backpacker.com/technique/...6,2023,00.html

http://www.nursingdiabetics.com/diab...ckpacking.html


Good luck on your thru!

[Needles]

I am also a diabetic and I can tell you what worked for me, but remember it might not work for you so I would highly suggest that you speak to your doctor about this.

In 1997 I attempted a thru-hike and found that I really didn't have that many problems. The key I think it lots of testing and knowing how to adjust your insulin dose based on your test results accompanied by knowing how much you are eating and excersizing. My biggest problem at first was being too conservative with my insulin and finding my blood glucose levels running too high. After a week or so when I became convinced that I wasn't going to be hypoglycemic all the time I started to increase my dosages and brought everything under control.
I was on a tight control regime before I started hiking so taking an injection and testing with every meal was something I was already used to and this made controling my diabetes on the trail much easier. With this type of regime you are able, within reason, to eat just about anything you would like to but you have to keep an eye on your carb intake so that you can adjust your insulin dose to cover the carbs you are eating. Of course I am a type 1 diabetic and my pancreas does absolutely nothing to control my blood glucose level. With type 2 diabetes I suppose it is possible that your pancreas could still be producing some insulin and regulating your blood glucose levels to some extent, so again, discuss this with your doctor.
I kept glucose tablets, the type that come 10 to a sealed plastic tube, next to me at night in my tent or in the shelters. To avoid mouse problems I placed the tube of glucose tablets inside an empty nalgene bottle which seemed to work quite well as they were never bothered by mice or any other critters.
I would highly suggest taking a few shorter hikes to see how your body is going to react and to get used to caring for your diabetes out on the trail, and once again I also suggest that you talk to your doctor about all of this

[dharmabum86]

I too am a type II diabetic, eventhough I was diagnosed at 21. I have never been "overweight" but, have lost a total of 23 pounds and have a rigorous workout schedule. I am not insulin dependent, but I have been able to decrease my oral meds by almost 2500mg (metformin) since I've been working out. My thru-hike is planned for 2006 as well and I have been seeing a nutritionist/dietician to discuss options on my meals. I was very suprised by the things that I am able to have on the trail. I have also been dehydrating my meals to ensure all the nutrients, sugars, carbs, etc. balance out. It's really hard to give advice, as you know each diabetic is different. Definately, experiment with shorter hikes where you are easily accessible in case of emergency or take a buddy. I'm a nurse but I don't always remember what I know because I get disoriented therefore I do carry a tag on the inside on my pack that identifies me as a diabetic and what to do if I'm found lying on the trail! LOL!!! As far as the nutritionist goes, it's much more affordable than you think. Actually, my insurance covered my first few visits! Happy hiking and see you on the trail!
OJ

[phatfish]

Hi there, been lurking for a while and had to chime in on this one.

Type 1 diabetic, and I've been on 100 mile and 200 mile section hikes. I'm not sure the type of insulin you take is comparable so take this with a grain of salt. I've found that while snacking and even during lunch that I really don't need any short term (novolog) insulin. Only during the larger (carb intensive) evening meal did I need that boost. My long term insulin requirements (lantus) were decreased by ~40%. Again, take this info with a LARGE grain of salt and listen to your own body.

But what I really wanted to tell you about was the best way I found to carry my insulin.
http://www.friouk.com/
Have to give credit to my mom for finding this one out. Ideal trail insulation. The pouches have hard pellet crystals in them that absorb water and as they slowly dry out cool by evaporation. It works perfectly and doesn’t even need to be recharged (soaked in water) very often. I use the "dual pen wallet" and find that I can fit/cram enough insulin (sort and long term) for about a month in it.
http://www.coolerconcept.com/pages/DuoPen.htm

Side note: I too am planning a 06 thru hike.

[CynJ]

My mom was a type II insulin dependant diabetic on many many meds when I took her to FL (from CT) a couple of years ago. We weren't hiking but doing DisneyWorld.

I was concerned about her medications and insulin while traveling and the best piece of advice I had gotten about it was to use a big chain pharmacy as they are all connected via computer so if you lose a bottle or have a problem they can look you up quickly.

Another suggestion was to make sure that your tester is a common one -so that you won't have a problem finding supplies for it should you need to.

Good luck!

[Seeker]

two points...one-i'm going to quit whining about blisters, sore backs, cuts, or pulled muscles... the fact that some of you will even venture out for a weekend or week, let alone do a thru-hike, is an inspiration...two-if you do run into a problem with your blood sugar, how do i recognize it? what can i do to help? what shouldn't i do?

[phatfish]

two points...one-i'm going to quit whining about blisters, sore backs, cuts, or pulled muscles... the fact that some of you will even venture out for a weekend or week, let alone do a thru-hike, is an inspiration...two-if you do run into a problem with your blood sugar, how do i recognize it? what can i do to help? what shouldn't i do?

Trust me, there are a lot worse things than diabetes to have. It’s mostly just an inconvenience...and another 1lb to my base pack weight.

I've been extremely lucky to have a very good feel for what my blood sugars are up to. I have always been able to care for myself *knocks on wood*. That said there are a few things you can be aware of.

Note: this is for a type 1 diabetic

#1. Low blood sugars are the short term (I could die) issue to worry about. Don't think "diabetic, oh they need insulin". If you see us acting goofy, shaky hands, slurred speech, etc ask if we need some sugar. And if we are passed out try to get some form of sugar into us that won't choke us. Most of us will carry some gel or a glucagon (emergency sugar syringe) on us. Just don't inject us with any insulin!

#2. If you know a fellow hiker is diabetic and happen to see them fumbling around at night offer to give them a hand. I keep some sealed sugar tablets with me at night, however usually I will also need to eat something more substantial as well. The only thing worse than getting up in the middle of the night to get something from your bear bag is doing it with a low blood sugar.

Thanks for your interest in helping us!
Oh, and I still complain about my blisters and chafing

[orangebug]

What about keeping a Jolly Roger or two in your first aid kit? Pure sugar and can sit under your tongue for rapid absorption.

(Maybe that should be a Jolly Rancher.)

[CynJ]

the glucose tablets are faster - different type of sugar

[phatfish]

What about keeping a Jolly Roger or two in your first aid kit? Pure sugar and can sit under your tongue for rapid absorption.

Be careful what you put in the mouth when someone is passed out! I hope you're not suggesting a jolly rancher for this! Gel and maybe powder rubbed inside the cheek/gum area are best if someone is really out of it. As for treating lows, just about anything with sugar/carbs will work just fine. Glucose tablets might be a little faster. just a little. Hard candies on the other hand are not fast at all because they have to be sucked rather than chewed.

I was concerned about her medications and insulin while traveling and the best piece of advice I had gotten about it was to use a big chain pharmacy as they are all connected via computer so if you lose a bottle or have a problem they can look you up quickly.

I forgot to comment on this. You never know what type of pharmacy you might run into on the trail or while traveling. It's best to stay flexible and to keep extras in case of lost/broken/contaminated vials. I had my doctor write me undated 30 day prescriptions so that during re-supply or unexpected problems I can get a prescription filled without being handed a huge 3-6 month supply. I also found the mapdana http://www.antigravitygear.com/store/index.php?cPath=1 to have pharmacy numbers along the trail (I'm sure other guides do as well). That way I could also call ahead and make sure they have/order the supplies I need.

This worked for me, however I'm sure some diabetic who has thru hiked will have more/better advice.

[bfitz]

When I'm hiking at a normal pace I burn about 30 grams of carb per hour all esle being equal. Basically I test frequently, and slowly consume carbs as I go. I'm a type 1 diabetic. The biggest danger is low blood sugar, sometimes when your hiking and it gets a little low you get a kind of "high" where you don't realize that your hypoglycemic, so I test ten or even fifteen times a day...and just calculate what I'm burnung carb-wise and feed it back in. Then I take a bit less insulin for meals and stuff because of the exercise if I need to, or just eat a bit more food. The important thing is to guage how much sugar your burning off per hour and put it back in.

[bfitz]

I carried glucagon and taught other hikers how to use it on me. Never needed it, but almost always carry it. Never worried about keeping insulin cold or anything like that, and you can buy it without a perscription almost anywhere, but they won't sell you needles in either vermont or NH without a scrip (I cant remember which, though) Powdered juice, like gatorade or koolaid is your best freind, and those little Gu energy gel things you probably carry gu or something like it around anyway. Everything is the same, just be prepared...know a little about the town up ahead and where the pharmacy etc. is before you get there, and let everyone know your situation. You'll be fine, its the best thing for it if you can keep eating decently (dont just eat tons of ramen and pig out in town like everyone else...take your alpha lipoic acid and chromium supplements...

[justusryans]

My mom was a type II insulin dependant diabetic on many many meds when I took her to FL (from CT) a couple of years ago. We weren't hiking but doing DisneyWorld.

I was concerned about her medications and insulin while traveling and the best piece of advice I had gotten about it was to use a big chain pharmacy as they are all connected via computer so if you lose a bottle or have a problem they can look you up quickly.

Another suggestion was to make sure that your tester is a common one -so that you won't have a problem finding supplies for it should you need to.

Good luck!

While We are not diabetic, we do have serious medication issues. We would be interested it what others did to alleviate any problems with obtaining prescriptions. Help would be appreciated.

[Blissful]

I take a prescription for my thyroid, normally you can get a year's prescription from the MD if you are medically up to date - then just have someone get it from the pharmacy and send it via a maildrop. That's what I plan to do for 2007.
As it is, best also to clear a thru hike with an MD if you have medical problems.

[peter_pan]

In 2004 the homemade gear contest at Trail Days was won by a guy whose buddy made an insulin refrigerator from a machined piece of aluminum with an alum screw cap that threaded onto a 1 qt Nalgene and fit in one of the OR insulators for the Nalgene...Fill with cold spring water and stays cool all day...refill next cold water sounce... Don't know his name ...but... Backpacker Magazine sponsored the contest and took all of the winners names... Nothing was ever published, but they may still have a lead on the inventor.

Good luck with your hike.

Pan

[justusryans]

I take a prescription for my thyroid, normally you can get a year's prescription from the MD if you are medically up to date - then just have someone get it from the pharmacy and send it via a maildrop. That's what I plan to do for 2007.
As it is, best also to clear a thru hike with an MD if you have medical problems.

My doc has cleared me for our thru-hike. Due to the medication I'm on my doc won't write more than 90 days in advance. Although I just have to do a phone interview to get my refills. The problem is I won't have anyone at home to send it to me. My wife is going with me on our thru. So, the only alternative is to get them filled on the trail.

[phatfish]

In 2004 the homemade gear contest at Trail Days was won by a guy whose buddy made an insulin refrigerator from a machined piece of aluminum with an alum screw cap that threaded onto a 1 qt Nalgene and fit in one of the OR insulators for the Nalgene...Fill with cold spring water and stays cool all day...refill next cold water sounce... Don't know his name ...but... Backpacker Magazine sponsored the contest and took all of the winners names... Nothing was ever published, but they may still have a lead on the inventor.

Good luck with your hike.

Pan

Ah, I met that guy during my section hike in SNP that year! Darn, I'm bad with names. I know he was hiking with some guy that had a feather in his bandana and a travel guitar among others. I think their smoke breaks and beer runs let my friend and I keep up with them till we got off in harpers fairy. I want to say buckwheat and kip were some of his hiking partners...

I do find however that the frio pouch I talked about above to be a great lightweight option (nalgenes are heavy!). That device was pretty slick though.

[bfitz]

His name was ketone.

[CynJ]

I think justusryans if you look at CVS's or Walgreen's websites you can find out what towns they are in and just have your doctor "call in" your prescription to whatever town you will be hitting. Edited to add: And if there is a problem with him calling into an out of town/state pharmacy -just have him call the refill into your hometown CVS and they will have it in the computer when you get to whatever CVS is handy

The other thing is to find out if your insurance company does the prescriptions by mail thing. If they do - you can generally get 3 months worth of a script mailed to you.