14 Tips for Bringing Diabetes on the Trail
The date has been set. The packing list has begun. The companions have been chosen. I am off into the planning stages of my next adventure. Tony, Michelle, Brian and I will be hiking from one end of Catalina to the other over two-ish days. In addition to the usual hiking/backpacking preparations, I also need to make the diabetes preparations. And there are quite a few.
I recently came into contact with another diabetic hiker, Dylan, looking for tips. He is a ten year old who is hiking the Appalachian Trail this summer (a much bigger adventure than I can imagine) to raise money to purchase three Diabetic Service dogs, one for himself and two for fellow diabetic kids in his town. You can check him out at www.dcubed.org.
I'm always looking for cool new ways to solve diabetic problems on the trail and thought I'd share some that I have found along the way. I have a feeling there are thousands more tips out there just waiting to be shared. So your job is to add them at the bottom of this post, for Dylan and for Michelle and I.
So here are my tips, in complete random order, and probably useful only to some... (and they are just things that work for me, not in any way to be confused with medical advice or something I would advise you to do.)
FOOD, BASALS, and BOLUSES
1. I like my pump to be turned down to 45-55% for long hikes. I start it usually about an hour before the hike.
2. I cut back on boluses for food to the same percent.
3. I bring two bladders for fluids. One with just water for when I am higher than I would like, and one with what I call GatorPel. It's half Gatorade and half Propel. It gives me enough sugar to keep hiking and extra electrolytes (super important on a hike) from the Propel. When it runs out, I refill the bladder with water from the trail and pour in a pre-measured Ziploc with another dose of the GatorPel powder.
4. I never under-eat on a hike, even when I am higher than I'd like to be. I have found I burn at least 100 calories an hour on top of my usual daily calorie burn. Food early and often is very important.
5. I love to bring pre-measured trailmix in Ziplocs in an outside pouch so I can grab them easily without having to stop to get them out and slow everyone down. I make them with 240 calories of raisins, chocolate chips and Annie's cheddar bunnies (an organic version of Goldfish). For me that's a 2.0 unit bolus, or on the trail a 1.0 unit bolus.
6. Watch out for the overnight lows after a big hike. I have had to go to a 15% bolus at times. Other times if the day's hike was too strenuous my sugars would spike and become very obstinate. It really depends on the nature of the hike. After a few days on the trail, those results may also change.
GENERAL HIKING TIPS
7. Fresh socks, halfway through the day are AMAZING!!!!!
8. Dehydration is a really big concern on a hike, especially with diabetes. On my last hike, I ran out of water between stops in the hottest part of the canyon and could't take in calories because my stomach got so out of whack. And that's not a place I want to get again.
9. Bring enough food, quick acting sugars, and insulin supplies to last more days than you expect to be out there in case you get lost or stuck.
10. Find a way to refrigerate your insulin if it gets hot, or warm it if it gets cold. No one wants frozen insulin. Consider the moisture of the air also can ruin test strips.
11. Having a favorite food for a mid-day meal will do wonders for morale. Even if it seems like it's a pain to pack. Last hike it was a soda and a chocolate candy. So worth it!! It gave me something to look forward to before and something to revel in afterwards.
12. I have hiked the Grand Canyon with a glucose meter, and I have hiked it with a CGM. Let me just say, CGM's RULE!! If you don't have one, find a way to get one, even if it is just for the duration of the trip. With only a meter, I had to stop my group sometimes every 30 minutes to test. They hated it and we never got into a groove.
With the Dexcom, I kept it in my pocket and pulled it out about every 30 minutes to check. It also alerted me if I was dropping fast BEFORE I got low and had to stop hiking to correct and then wait for the sugar to hit before continuing on. But always keep a backup. On my last hike, my fellow Type per Michelle had her Dexcom go out within the first 30 minutes.
13. I've had a sensor pull out on other trips as well. You may want to consider additional measures to keep the CGM sensor on. I use SkinTac and have had excellent success (Just an FYI. This is not FDA approved or Dexcom approved) but those sensors stay on like no other.
14. Start your CGM an few days before your trip. I've found the first two days on a new sensor can be a little more off than later int he sensor's lifetime.
So what are your tried and true tips for taking diabetes on the trail?