Diabetes / Insulin Injections

[cold kettle]

I'm planning a 2011 thru hike. I'm insulin dependent D2, 3 - 5 shots per day. I'm trying to cut down on pack weight. So I'm wondering why I can't use hand sanitizer to clean the injection sites rather then packing in and out, the alcohol swabs and packaging. The sanitizers seem to be mostly alcohol any way. Any comments?

The professionals I've asked can't get past the whole wilderness / restricted access to medical care blather.

kettle

[chiefiepoo]

I'm a type 2 but using actos / januvia oral meds. Testing was my issue and I used sanitizer to prep. 62% alcohol vs 70% in the wipes. My Doc's greatest concern was how the exercise would change my blood sugar and I might drop too low. And it did, so i chose to skip some daily meds. I was on a 10 day trek in Glacier with a 35 y/o man who had some sort of internal pump. He did fine. Diet planning is a big part of my overall trip preparations.

[ShakeyLeggs]

Hand sanitizer on it's face may sound like a good idea it really is not. Reason being that the sanitizer has many other ingredients that the prep pads do not. Hand sanitizers have ingredients to soften skin and sometimes make it smell good. Whereas prep pads contain alcohol and purified water that's it.

The weight of the prep pads is minuscule compared to the harm the sanitizer may cause.

[lilygrrrl1]

In my humble professional medical opinion (as a nurse anesthetist)....

I'd have to agree with shakeyleggs.... MOST hand sanitizers have additional ingrediants that you wouldn't want to inject thru the skin surface. Not only that...that very purell bottle will have germs on it. Good (wilderness) injection practice calls for cleaning your hands first...and then prepping with alcohol pads.

To be safe you'll go thru more purell gel anyway....which then seems like the weight savings (of taking or not taking alcohol prep pads) is a wash.

I think the prep pads are worth their weight.

lilygrrrl1 (krinkles)

[Fog Horn]

It might be beneficial to wear a med bracelet or something on it with a worst case scenario first aid lesson in case someone needs to help you out. A lot of people don't know that insulin doesn't go into your vein for example, or that you may need a candy bar STAT.

I'm sure you can take care of yourself, but I'm a just in caser. Its just a thought.

[Pioneer Spirit]

My wife uses an insulin pump..change the infusion site every three days or so. Better insulin monitoring and delivery.

[cold kettle]

OKKK....the swabs are back in, thanks all. Maybe I can find some ultra lite swabs.

And Fog Horn, I wear a medic alert braclet and I have a waterproof luggage tag on the zipper pull of the pocket where i keep my insulin and that is prominently visible that states "Diabetic, If I appear in trouble/confused I'm probably low, give sugar" it also lists all my meds and emergency contacts. It sacrifices some privacy but..... Thanks

[Doc Mike]

Change to the pump. Fewer injections and significantly less chance of infection.

Doc Mike

[Trailweaver]

You probably have thought of this already, but you should keep your diabetic supplies (medication and candy) in the handiest, most easy to reach pocket you have for the quickest access in case of an emergency.

Just curious. . . and you certainly don't have to answer this if you don't want to . . . don't you need to keep your insulin cool? If so, how are you going to manage that on the hike?

[cold kettle]

The insulin containers that I am currently working on can stay at "room temp" for 30 days. I must protect them from freezing, so i sleep with them and my meter, but the meter still gets too cold sometimes.

And the candy does stay accessible, but there is no rush on the medication. Low sugar causes immediate impairment / passing out. High sugar damages various body systems but results from long term elevation. I have a much harder time keeping my levels up while on the trail.

[Bushman86]

hi every one i got my self a frio bag this should work for over 2000 mil walk :banana

[GreasePot]

hi every one i got my self a frio bag this should work for over 2000 mil walk :banana

I just got the frio also. But what do you do about insulin? Currently I'm using Levemir - which is good for 42 days without refrigeration. Do you get your doctor to write you a bunch of prescriptions and then buy vials when you are in a town? Right now I am using pens - which I really like, which you buy in 5 packs. However, storage for (the extra 4 pens) is an issue. I wish I could just buy one pen at a time.

Another question for you - if you're travelling, say in a car and going to remote trailheads - is there anyway to keep those extra pens cold ? I can switch to using vials, and just buy them as needed - but I would waste a lot of insulin that way, since they are only good for 42 days when not refrigerated - and the quantity in a pen is just right.

[mweinstone]

i wipe the first drop on my pants and test the second drop. that way its a clean sample even if i didnt wash. remember, thruhiking reduces the amount of insulin you need down to 20% of your normal in lots of cases.because your health increases so dramatialy.

[FORTIS]

Hi all. I have been a type 1 diabetic for most of my adult life. I'm currently using an insulin pump which functions using a single fast acting insulin. I had a couple of questions/concerns that I thought I might add to this thread.

1) As stated above insulin should not be allowed to freeze. I'm having a problem deciding where to wear my pump. I usually just have it clipped to my pant waist but this is tough with a pack on and it's exposed to the cold. I was just wondering what other pump users my suggest?

2) It is mandatory that I keep a form of sugar (I use glucose tablets) to raise my blood sugar level when needed. Lows can and frequently do happen at night. I will be hanging my food but need to keep the glucose tablets (think big sweet tarts :)) with me in my tent. Do you think this will pose a problem as far as attracting bears? I want to see bears but not in my tent :eek: Any suggestion would be appreciated.

Thanks,

Fortis

[Enic]

Hi, Type 1 pumper here too. I have often wondered about this while laying awake with tabs next to my head. I hang or put my food bag in bins, but always keep tabs or something with me. I guess I've been lucky not having a bear rip open my tent, but a few weeks ago took an over night and woke up at 0400 with a BGL of 32, and ate my tabs.

Soo... even on a lower basal than normal, I've been known to go low. Heck, last year my gf and I (both type 1s) were renamed Sweet and Low (the diabetic duo), by a few other hikers we met because we would always get bypassed while I was low. I would rather have a bear in camp, than die trying to get carbs out of a bear bag. Others may disagree. The best advice I have is use a bottle of tabs, or whatever treatment you have, that mice won't get into as easily.

Winter camping or winter sports in general, I've never experienced my pump getting too cold. I keep it tucked inside my pants in front at the waist.(Right next to trunk for core temp radiation and conduction.) My gf keeps hers in a pants pocket, or crammed into her bra somehow. My only freezing of insulin has been when I forget to keep the vial in my sleeping bag at night. (meters are another story. they tend to get to hot and too cold more... just like if left in the car, sometimes you need to warm up or cool them off before they function again.

[Snowleopard]

Bears: I don't think pure glucose has any odor. If you can find tablets that are pure glucose with no added flavor, animals shouldn't be a problem.

[Jack Tarlin]

My friend Bfitz has successfully hiked thousands of miles on the A.T. with diabtes. PM him here with your questions and I'm sure he'd be happy to help you.

[FORTIS]

Thanks Jack. I might just give your friend Bfitz a shout sometime.

Thanks to you too Enic for the great advice. I love the trail names, "Sweet and Low (the diabetic duo)"

Snowleopard, I'm for the plain unflavored tab but thus far haven't been able to find any. Back in the old days that is what I remember using. Now it seems everything is flavored.

[FORTIS]

Thanks Jack. I might just give your friend Bfitz a shout sometime.

Thanks to you too Enic for the great advice. I love the trail names, "Sweet and Low (the diabetic duo)"

Snowleopard, I'm looking for the plain unflavored tabs but thus far haven't been able to find any. Back in the old days that is what I remember using. Now it seems everything is flavored.

[Appalachian Tater]

When you use an alcohol prep pad to prepare the skin for injection, it is not only the alcohol but also the friction that cleans the skin. If you used alcohol gel, what would you apply it with and scrub with? You would have to carry something anyway.

You get fairly dirty on a thru-hike and maintain a baseline filth level between showers no matter how hard you try. Ordinary cuts and minor scratches seem to take longer to heal. The odds of an injection site getting infected are probably higher while hiking.

Because of these two reasons, I would stick with the prep pads. A week's worth won't weigh more than a candy bar or a few swallows of water.

[GreasePot]

I just figured out after four nights in my tent, that my meter doesn't work when it's cold. Do any of the meters work when they are cold? Does putting the meter in your sleeping bag keep it warm enough?

[mkmangold]

My wife uses an insulin pump..change the infusion site every three days or so. Better insulin monitoring and delivery.

Word. If you are a truly dedicated diabetic (most Type II's are not but you may be the exception), the pump is truly liberating. As far as the hand sanitizer is concerned, just look for one without added ingredients. They are available, even in the dollar stores.