Diabetic Advice For Specific Activities
There are three sections here. Hiking and camping is just under the links that will take you to mountaineering and scuba diving
Mountaineering
Scuba Diving
Hiking and camping.
If you are into nature and remote places such a holiday can be really relaxing and there is no reason why a diabetic cannot enjoy it as well as a healthy person. One just needs to take a few sensible precautions.
As usual these can seem tedious – gone are the days of just throwing a few clothes and high energy rations into a backpack and setting out.
Don't let this put you off -hiking is excellent exercise and getting away from it all releases plenty of built up pressure – it is worth the minor inconveniences.
So what should one do?
Try and go hiking with at least one other person, it is much safer. Make sure this person knows what to do for you in case of a diabetic problem like hypoglycaemia.
Insulin users, or anyone who may suffer from hypo’s, should also take along a Glucagon Emergency Kit and before the trip you need to teach your companion when and how to use it. Remember that if you need it you will be in no state to give instructions on the spot.
Make sure someone knows where you will be each day and when you expect to return. Likewise make sure they have your mobile phone number – you will be taking along a fully charged mobile phone in case you need to call for help won’t you?
Take along a first aid kit. Cuts, blisters, bruises, insect bites or nettle stings can spoil your trip and affect your blood glucose. You need to have stuff available to deal with them.
If you do get blisters or any form of skin injury then treat them immediately with antiseptic lotion and an antibacterial cream and take measurers to prevent them getting worse or reoccurring. NEVER pop a blister – this is just an invitation for bacteria to enter and cause an infection. There are blister plasters available that can be put over a blister.
Don’t forget the suntan lotion – sunburn is not a good idea for a diabetic because of the chance of infection.
If you use insulin remember you will need to keep it cool in something like a Frio wallet and never pack it in the outside pocket of your backpack where the sun can get to it.
Pack your glucose meter and strips in a cool place as well.
Take more medication than you expect to need – accidents happen and you may be away longer than planned. Split this medication between yourself and your companion in case one of you loses their backpack or breaks your supplies in a fall.
Pack plenty of snacks, extra food and water. You must remember to drink enough to avoid dehydration.
Make sure your shoes fit properly. You really do not need foot ulcers or blisters.
Suggestions when buying hiking boots are:-
Buy ones that are ½ a size bigger than the shoes you usually wear.
Make sure they have plenty of toe room but the heel fits snuggly. If your foot moves up and down at the back you will get blisters for sure.
Try to get ones with plenty of internal cushioning but which also offer solid support for your foot.
Wearing two pairs of socks when hiking, a thin pair under your normal socks, is a good idea, and if you intend to do this remember to wear those two pairs of socks when buying new boots as well.
If possible buy boots that have a thin polypropylene liner as these will keep your feet dry in wet weather.
Socks are important. There are very good ones made, some especially for diabetics. They are more expensive but in the long run are worth the money.
They can be purchased from a number of sites online.
Here are a few suggestions:-
Gean-Edwards.stores
HealthyLegs.com
BizRate.com
FootSmart.com
If you are going to camp out overnight remember to store your food and supplies where animals cannot get to them. Always keep some emergency supplies in the tent with you.
A hole dug in the ground, somewhere where there is shade, works well as a fridge for a short while.
And finally, remember that being active changes your need for medications. You may need to adjust these, so check your Bg’s with your meter frequently.
Mountaineering
If you think that as a diabetic you cannot do this then believe me you are wrong. Take for instance the Italian Marco Peruffo, a type 1 diabetic who climbed the sixth highest mountain in the world, the Tibetan peak Cho Oyu, (8153 metres, 26748 feet).
I love mountains. Living on the Somerset levels, as I now do, I tend to go into ‘mountain withdrawal syndrome’ and require a visit to Scotland or North Wales to get the required treatment so as to survive another year.
However I am not one of the mildly insane type (just joking folks) who feels a need to climb the dashed things just because they are there! Living amongst them or taking a cable car up the Nevis Range or a mountain railway up Mt Snowdon is more my style.
For this reason I am not even going to try and offer advise to diabetics who suffer from this mild form of insanity, instead I am going to point you to sites where fellow sufferers offer very useful advise from a basis of knowledge – in other words they have ‘been there, done that’ and are much better equipped than I to help out.
So try out these sites:-
InsulinDependence.org
Idea2000.org
Mountain-Mad.org
Scuba Diving
This is not aimed at the serious diver who has gone through the correct channels, got the correct training and knows the risks. This is for the casual holiday maker who thinks “Wow, they offer diving here, I think I’ll give it a go”
Some resorts offer ‘fast track’ courses for holiday makers that give a few hours of instruction and then take you out into the sea. Though there are responsible instructors out there, there are also a lot of unscrupulous folk after a fast buck. Even for healthy people this has been known to cause problems and for a diabetic the chances of problems are increased.
For a long time it was thought that insulin dependant diabetics could not scuba dive, but things have changed.
There are still factors that will preclude you from diving however. They are not there to spoil your pleasure but to save your life and possible the lives of those diving with you.
They are:-
1. If you suffer from hypoglycaemia unawareness or have, at any time in the past year, had a hypo that needed recognition or treatment by another person, don’t dive.
2. If you are unable to predict in advance what affect exercise has on your blood sugars, don’t dive. For example you need to know that a certain amount of exercise will lower your blood glucose by such and such an amount.
3. Blood glucose levels above a certain number make it unsafe to exercise, and scuba diving is just another form of exercise. If the results of an HbA1c test, taken within the last 3 months, are 9% or higher then you should not dive. It is a known fact that high blood sugars lead to dehydration (remember all that time running off too the bathroom?) and dehydration increases the risk of decompression sickness.
4. If hypo attacks cause you to lose consciousness or make you disorientated then you should not dive. You REALLY don’t want to get confused underwater and try and smell the ‘flowers’. Corals really do not smell great, specially when you are inhaling water and not air!
5. If you suffer from one or more of the various diabetic complications, like neuropathy, nephropathy, advanced retinopathy or heart problems you should not dive. These complications are often accompanied by poor circulation and this can mean that the nitrogen that builds up in your tissues during a dive may not be removed sufficiently quickly by the blood and that can result in what is known amongst divers as 'the bends' or, to be more medically correct, decompression sickness.
If you do not have any of the above problems and really want to go diving during your holiday then it would be a very good idea, in advance, to go and see a diving doctor (not your normal GD) and get a letter from him certifying you as fit to dive. This can avoid any disappointment at the other end.
I knew a type 2 diabetic on oral meds (Metformin only) who went on a holiday to Egypt armed with a letter from her normal GP saying there is no reason for her not to dive. When she tried to book on a course they refused to have her unless she saw a local diving doctor.
Fair enough, that does at least show they were being diligent. However the doctor there refused her permission. Why? He said that as she was taking diabetic medication she could not dive! That made no sense and put a real damper on her holiday, especially as her boyfriend went off and had all the fun!
So go armed with a letter from a diving doctor and a phone number where he can be contacted if the diving school or local doctor insist they want more proof.
Do NOT, under any circumstances, try to hide your diabetes just so that you can dive. This is not safe for you and grossly unfair on the people diving with you.
Though some dive masters may be unwilling to accept the responsibility of a diabetic on their dive most will be prepared to accommodate you.
Your dive master needs to know you are diabetic so he can plan the dive accordingly. If you discuss your situation with him he will then know how long a dive to plan, how strenuous it should be and what depth to go to.
Dives that go deeper than 90 feet are not recommended as the nitrogen narcosis that can occur at that depth may mask the symptoms of low blood sugar.
Both your dive master and your dive buddy should be aware of what being a diabetic means. In other words explain the ‘whys’ and ‘hows’ of hypoglycaemia. They need to know what signs to look for when underwater and what to do about it if they occur.
The common signs are odd behaviour, like impatience, irritability and stubbornness when given an instruction. Also shaking, increased heart rate and lack of co-ordination.
They, as well as you yourself, should carry a source of carbohydrate with them. This sounds complicated – I mean, you cannot exactly munch on a sandwich 30 feet underwater! However you can suck the icing (frosting) from one of those pre-filled plastic tubes.
There is also a product available in the US and possibly elsewhere, known as Insta-Glucose. It is a glucose gel in a tube that just requires you to twist the cap off and swallow the contents. I believe it tastes of cherry. Divers like it as they say it survives the salt water and pressure better than other products and works fast.
These are the basics. I suggest that if you are still interested in diving you visit DiabetesSelfManagement.com. Here you will get expert advice for the diabetic diver.