Today I was reminded today of the struggles of traveling as a diabetic. In all of my years I think I could count on one hand the number of trips, both short 1 day and week longs, where I have been able to maintain a good, consistent blood sugar. It is inevitable, my blood sugars will spike in times of travel. If I don’t see a spike it is because I have over emphasized travelings effect and find myself in the familiar place of eating simple sugars so I don’t have to give up the wheel to my wife (not that she is a bad driver I just enjoy driving…wink…wink).
I’m convinced that the changing of moderate/low activity to NO activity when flying or traveling is the main culprit in a spiking blood sugar in travels. There are other factors of course. The stress, excitement, etc when traveling to a place. Very seldom are you traveling all day(s) to a place where your emotional state remains in a constant equilibrium. You are normally excited, upset, stressed or some other blood glucose altering state when you are traveling. There are also the added effects of people like me who, especially when you are sitting down, feel as though you need to be eating or drinking something or you just can’t function. Knowing all of that, the change and reduction in activity is remarkable to how it raises blood glucose.
Starting a diet competition about a month ago, my blood sugars have been running lower than normal with pretty consistent blood sugars. I’ve been battling lows for weeks as I try to increase my exercise, eat little to no carbs, and find my true basil insulin rate. In the middle of that we agreed to meet my wife’s family at a hotel to celebrate our oldest sons 4th birthday. The kids love getting to see each other, swim in the pool, and sleep with grandma and grandpa. It always ends up being a highlight for everyone, except for those who have to pack the kids things and make 10 trips to and from the car to unload it all, but that would be looking at the glass half empty. In the end of the day it is a blast for all!!! This day was not a huge trip. It was a 3hr 15min drive to the hotel. Having not been hit by a high blood sugar in a couple days (and yes that is rare for me) I get an alert from my CGM that my blood sugar is starting to get out of range. I’ve got it set at 200 and I was shocked to see it go up out of nowhere. I had an egg white omelet at the house in the morning with some coffee and that is it!!! I was shocked that I peaked so high 2 ½ hours into the trip. I just thought with a sugar free tea and no carbs in me, the spike wouldn’t happen. It wasn’t as fierce as a lot of my travel highs, but was still there, and I was reminded again how activity is the grease on the wheels of insulin. Without activity, insulin just doesn’t have a chance to work, even if that activity is very small.
This brings a big dilemma and one that I’ve fought against people of different opinions most of my life. I would argue these people are ignorant of what they are talking about, but of course that doesn’t seem to keep them from expressing their opinion. I think the phrase “ You can’t” and typically “you shouldn’t as a diabetic do _____” should be scrapped from the vocabulary. Unless you are talking about being a pilot or Navy Seal that just shouldn’t be said. Many people don’t tell you not to go on a trip, but I have heard so many times that its “hard to do with diabetes”, or “ maybe you should focus on something else you can manage with diabetes”. That was a big one for me in football. Some people said it would put an extra strain on my body and that it wasn’t a good idea. Well news flash. As a defensive end in the NFL I am trying to get past a grown man to the quarterback. Some of those grown men are 6’ 7” tall and weight 370 lbs (seriously Leonard Davis you were a huge man) and very emphatically don’t want you to get back there. My point is there is not a defensive end in the NFL who doesn’t have a “strain on their body” trying to do their job. It comes with life. A business leader will have stresses that can affect his blood sugar and other health problems, but should they not run a business, NO!!! You look at the risk, try to approach it and manage it the best you can, but anything you do in life will have some positive and negative effects on your body. And as the point of this blog is trying to make, sitting on your rear have a negative effect as well. So my suggestion is live life, chase your dreams, and make diabetes work around you. I’ve gotten on a bit of tangent, but my passion for this seems to find its way through and I feel as though it is worth saying.
So what do you do when you travel? Well simply put you need to check you sugar more often (CGM thank you!!!) and crank up your insulin levels just a bit. I typically start with just a few more cc’s in my basil the morning of (I take a basil shot in the morning and at night). I then give myself a little insulin when my blood sugar starts to get over the 150 mark. Typically I would love that number, but when traveling I like to get my sugars to stay a little closer down. You may find that your insulin required when riding in a car or plane with increase dramatically. Your 2 cc fix may jump to 3 or possibly 4 cc’s taking double the amount of insulin typically required. I get the same issue when I wake at night from a “high CGM alarm”. My lack of activity makes insulin work horribly so I have to increase my insulin by 50% of what I would normally take. Snacking on a bag of sunflower seeds typically may take 1 or 2 units of insulin, while traveling for an extended time may take 3-4. That is just how things have worked out for me.
I know the frustration of being on a trip with high blood sugars. To be the guy on a guys trip who has to stop to use the bathroom every hour and face the ridicule of your friends coming back to the car. “ You’ve got to pee again Brandon, I thought the wives stayed home on this trip!!!”… yea you get some comments. I’ve been so excited about a trip, but spent the first day feeling so crummy because my excessive blood sugar had made me dehydrated to the point my stomach hurts and I can’t enjoy a nice sit down dinner when we get there (and eating is a huge part of my enjoyment of travel). I don’t want to whine or give a woe is me monologue, but that is just how life is sometimes. For those out there with this same frustration, I feel your pain. Keep a tight reign on that diet, pump that insulin up a bit (with Drs. Approval of course) and please, please, please don’t let it stop you from hitting the road. Life’s too short to have flawless blood sugars but never leave the front yard. Happy trails!!!