3 Tips To Keep In Mind If You're A T1 Diabetic And You're Going On Holiday (That Will Help You Avoid Hypoglycemia)
There’s nothing worse than hypoglycemias getting in the way of you enjoying your holidays.
Last week I was going around Bali, having the time of my life. Nature (with a capital N) surrounding me at every corner and after months working in an office, I was finally breathing fresh air. That was the setting for an excellent, regenerative holiday.
Except that for the first couple days, hypoglycemias were popping up a little more frequently, disrupting my days and getting in the way of fun.
It took me a while to sort this out, but with a little bit of thinking, I was able to recognize my mistake and fix it.
In fact, there was one huge variable I had somehow forgot to include in my diabetes equation: the sudden increase in light cardio. One can expect to be more active when on holiday, and I was indeed! I was doing what a traveller does: hiking, exploring, walking around places all day long. And all this movement is like giving insulin!
Except that I was too slow at recognizing this - I was too slow at adjusting my ratios.
When I understood this, I immediately took action and reviewed my diabetes management strategy, by doing three things: tactically reducing my long-acting insulin; monitoring my blood glucose trends more closely; carrying around more snacks than usual.
So here are the three tips that allowed me to get back on track with my blood sugars and enjoy my holiday:
Tip #1: Tactically Reducing Long-Acting Insulin Dose For Increased Activity
With all that additional walking, I was effectively staking insulin on insulin.
No wanders I was trending low all the time! And since all hypoglycemias occurred hours after my meals, I knew the problem was in my long-acting insulin. So I decreased it (by 20% to 40%, depending on how active I was during a day), confident that movement would replace those units.
Result: hypoglycemias disappeared, and my blood sugars got back into the normal range.
Tip #2: Adapt The Diabetes Management Strategy More Frequently
Holidays are a much more dynamic context than normal life, and the diabetes management strategy should reflect that.
No one day was like the other: one day I hiked, another day I hiked twice as much, and another day I was swimming in the sea. These scenarios required timely and proactive adaptations to my ratios and my insulin strategies. I know that hiking causes faster drops in my blood sugars than swimming, so I kept track of everything in my journal and used the new data to inform any new adjustments.
It felt a bit weird to change my insulin ratios so frequently, but by tracking everything down, I was confident these adaptations would work - and they worked.
Tip #3: Carry MORE Fast-Acting Carbohydrates Than You Think
One day during a hike in the forest around Ubud I ate 5 bananas, gave zero rapid insulin and my blood sugars hovered at 100.
Had I not carried those extra bananas with me, that hike would have ended up very badly for me. I wasn't planning to eat them: I just happened to put them in the bag for no specific reason, and they literally saved my life. I had not forecasted that my body would be burning carbs at such a higher rate than usual, so those extra fast-acting carbohydrates I had kept me alive (remember, I was in the forest and without them I would have been in a severe hypoglycemia).
I learned that when hiking, on holiday and in general, I should always bring at least twice as many fast-acting carbohydrates (local fresh fruits) in my bag.
To recap, the combination of these three actions brought my blood sugars levels back to where they belong, in the 100s zone, and allowed me to enjoy my holiday without blood sugar dramas:
I decreased my insulin on days where I was much more active than usual (hiking, swimming, etc.)
I kept track of EVERYTHING I did and how my blood sugars behaved, to gather more data and inform how to adapt my insulin strategy on a day-by-day basis
I learned to bring at least TWICE as many carbs with me when going outside - with all that walking and moving around, you never know when the hypoglycemia is going to hit. Over-prepare.
And by the way, after walking around every nook and cranny of Bali, I can safely say it is an absolute treasure everyone should visit. Even more so if you live with Type 1 Diabetes - don't let the disease prevent you from having the best time of your life!
