I just returned from a trip to a sunny – and extremely hot – island in the Caribbean: I went to Curacao, part of the famous “ABC Islands” that comprise the Netherlands Antilles. FYI, “A” is for Aruba and “B” is for Bonaire. Aruba is extremely popular with American tourists during the USA’s winter months because the air and water temperature is consistently over 80 degrees. Europeans and Netherlands citizens tend to gravitate towards Bonaire and Curacao. Of the three Islands, Curacao is the largest and most developed. It has a natural deep harbor that allows container ships to travel in and out without duress. Additionally, the island is home to a large oil refinery that processes crude oil from Venezuela. The year round population is generally composed of Dutch citizens and people of African ancestry whose ancestors were initially brought over as slaves.
As usual, the moment I landed on Curacao I had to immediately address my health problems in order to keep myself safe and comfortable. Traveling alone with Type 1 Diabetes necessitates a delicate balancing act. If I were with others, I could put some of the burden for my well being on them. All of my friends and family know I’m diabetic, so if an emergency develops they know what to do. Unfortunately when I’m alone, I can NOT count on anyone other than myself to make sure I’m shipshape. Sadly strangers are not reliable, even in the USA or Europe. If someone saw me passed out on the ground experiencing a hypoglycemic incident, they’d dismiss me as a drunk and I’d probably become comatose before anyone figured out what was really going on.
Here are a few tips for traveling with Type 1 Diabetes by yourself:
- ALWAYS have some source of sugar with you – This one isn’t up for debate. No matter where you are or how you feel, having a ready supply of sugar is a necessity. Some people carry a backpack with Gatorade, glucose tablets, and an emergency Glucagon shot with them, especially if they’re planning to be away from their hotel for several hours. If you’re more of a homebody – even on vacation – you still MUST have sugar with you, or at the very least have access to juice or soda via a bar or convenience store.
If you plan on driving yourself around, I’d also mandate a selection of snacks and beverages be available in your car. Driving hypoglycemic is like driving drunk. It’s stupid and not worth the risk. You never know what might happen while you’re in a foreign country driving around: flat tire, robbery, overheated radiator, traffic jams/delays, and car accidents will all prevent you from reaching your destination. When this happens you need to get some sugar in your body to tide you over until a meal is within reach. No exceptions!
- Figure out where food is upon arrival – Remember that having a meal in your body is better than no meal at all. As your body processes breakfast, lunch, or dinner you’ll have a viable supply of glucose in your system for at least 3-5 hours. After that, you need to eat again. Screw your diet, your safety is more important.
The moment you get into your hotel, ask the reception staff for directions to the nearest supermarket, 7-11, or fast food restaurant. Nowadays most countries in the world have caught on to the gas station/convenience store combination. That means if you ask a local person where the nearest gas or petrol station is, you can be reasonably assured that food will also be available. Don’t leave anything to chance. Know where you can go to get a meal in the event your day’s plans go awry. A guaranteed 7-11 hotdog for dinner is a much safer alternative to trying to find the nearest 5 star restaurant when you don’t know where you’re going.
- Create some sort of routine – Diabetes is a self managed chronic condition. Most of the time you’ll probably spend no more than 1.5 hours with your endocrineologist in the course of a year. Therefore, creating a routine for yourself is absolutely crucial to keeping your glucose numbers in check. Even though it might seem like a drag to plan out your days on vacation in advance, you’ll feel much better physically and mentally knowing when you’re going to eat and what kind of physical activity you’ll be doing.
This advice is especially important for those that like to exercise on vacation. If your normal routine is visiting the gym at 7:00 AM for an hour, you should try to maintain some sort of similar schedule when away from home. That way it will be MUCH easier to plan out insulin dosages, activities, and eating. Taking a planned walk on the beach in the morning is much better than a spontaneous jog late in the evening far away from your insulin and sugar supply. Take care of yourself and your diabetes the same way you would if you were at home.
- Constantly Play the “What If?” Game – In other words, always be prepared. Suppose you meet some other travelers at a beach, and they suggest riding jet skis for an hour. Before you commit, make sure you have a contingency plan for all possible outcomes, not the least of which might be motor failure several hundred meters away from the shore. If you’re stuck out a sea your insulin dosage from breakfast or lunch will STILL process sugar in your body. That means you might become low without any means to increase your blood glucose levels. If such a situation occurs, carry a plastic baggie with Lifesavers or glucose tables in your pocket while you whiz across the water.
Always remind yourself that you have Type 1 Diabetes and that you have to be ready for any sort of situation. Life is full of surprises, good and bad. Sometimes these surprises turn into life-changing events because we didn’t see them coming. If you have a backup plan to rely on, you’ll be much better off when it comes to managing your Diabetes on vacation safely.
I’m not listing these thoughts as if I’m paranoid and always second guessing myself: I’ve actually traveled quite a bit and done some crazy things; some of which were potentially very dangerous considering my Type 1 Diabetes. As a result, I’ve learned the hard way that you must do what it takes to feel your best, even if it means sacrificing some degree of spontaneity that most vacations are based on.
Type 1 Diabetes sucks. There are no two ways about it. Make your vacations memorable because you were able to successfully balance your Diabetes against the backdrop of being in a foreign land. Don’t walk away from your vacation with bad memories resulting from poor planning or random misfortune that puts your Diabetes in the forefront. In most cases, people can still have a carefree attitude while away from home despite the fact that they must manage a chronic illness.