Lately, I’ve been receiving a lot of emails from people with type 1 diabetes who want to study/work/live abroad. Their stories are different, their destinations are different, but at the core of each one is the same issue: How will I take care of my diabetes while I’m abroad? What advice do you have for me? Some just flat out say, I’m scared.
That being said, my replies are pretty much 1 part advice and 9 parts encouragement and reassurance. I say, You can do this. I know you can do this because I have done it–I am doing it currently–and I have type 1 diabetes, too. Here are a few things I’ve learned from experience and from listening to others, but as with most things (and definitely most type 1 diabetes things) plan to learn along the way. Plan to learn most things along the way.
Here is my response to one such email I received the other day. I’m in the process of fine-tuning an actual list that will be more organized than this one (actually, that’s a big maybe) so please, if you have any advice I should include, from your own experience or the experience of someone you know, I would love to hear it! Also, if you have any questions or topics you would like to see addressed, I would love to hear those, too.
[—] I have type 1, too, and stumbled upon your blog, Coffee and Insulin, tonight. I have to say I love it so so much. It was exactly what I needed to read, as I am leaving in two days to study abroad for a semester [—]. I can’t wait for the adventure but am very nervous about managing diabetes while I’m there. Any crucial travel advice you can give me??
Dear ____ ,
Thank you for reading my blog and for reaching out! [Your trip] is going to be so amazing, I’m so excited for you! First of all, of course you’re nervous. Studying abroad is a huge adventure in itself already, but with diabetes, it is even more so! But it is so totally do-able and I’m so glad you’re not letting your nerves and diabetes stop you from going.
As far as advice, here’s what I’ve learned through experience:
Of course, take all the precautions you would take in the states. Meaning always have juice or glucose tablets with you. (Little honey packets are also really good if you’re backpacking or traveling with limited space.) Meaning always have the supplies you need, and extras. Always have backups. Make sure your new friends/travel groups/whoever know you have diabetes and what to do if you’re really low and need help.
Learn how to get your needs across to people that don’t speak English, if you don’t already know. Know how to say things like “I have diabetes” and “I need sugar” in foreign languages. Also learn the word for ‘carbohydrate’! Wear a medical alert bracelet and have a card in your wallet that says you have diabetes/has the medical alert sign for diabetes on it.
Make sure you know how to get medicine/supplies if you need them. For long trips, I always take a 3-month supply of everything with me so that I have a safety net and I’m not stressed out as soon as I get there, wondering how I will take insulin the following week. Always pack more than you think you’ll need. Also bring copies of all of your medicine prescriptions, because airlines/countries are weird about us bringing mysterious vials of clear liquid and syringes without proper documentation. Know who to go to if you have questions and/or need help (study-abroad advisor, teacher, etc.) Know where the hospital or clinic is nearest to you. Know it’s name, and how to get there.
I’m not sure if this is relevant for your trip or not, but never put insulin in hotel refrigerators! I (and many people I know) have had entire batches of insulin freeze in those things. And that is an expensive nightmare.
Always keep all of your medicine and extra supplies in your carry-on when flying. Otherwise, again, the insulin can freeze, and also checked bags get lost all the time.
One tip I got from another type 1 diabetic woman who has done a lot of adventure traveling–backpacking, camping, hiking, etc– is to give a friend a juice box, travel-bottle of glucose tablets, and a little bag of back-up supplies. This may not seem necessary but the story she told has convinced me that it is a legitimate measure to take: This woman was hiking/camping with a friend in (if I remember correctly) Africa, and had all of her supplies and stuff in a backpack. She set the backpack down and walked away to take a picture, and next thing she knew a MOUNTAIN LION literally ran up, took her backpack in its mouth, and ran across the land with it. Can you imagine? So, yeah, maybe give your friend some backup stuff too, you know, in case a mountain lion steals your backpack.
Foreign cuisine can definitely throw blood sugars for a loop, since it’s not stuff we typically eat, thus we don’t know exactly how it will affect our blood sugar. That being said, try things anyway. Try the weird foods. The weirder the better, when you’re traveling. (Well, maybe not, but better stories to tell afterwards, at least.) Even the things that will make your BG high. You’re living abroad for one beautiful semester. Try things, take more insulin if you have to, figure it out as you go. Learn to adjust. You will adapt, and you will learn more about yourself and your diabetes because of it. I can guarantee you will have high blood sugars. You will have low blood sugars. But you would if you were in Wisconsin, too. We always will, at some point, so we might as well enjoy the French baguettes and the Italian pasta and the Spanish churros sometimes. Of course, use your best judgment, and of course, be careful. But don’t be so careful, so preoccupied by staying between 90 and 120 mg/dL that you miss all those amazing opportunities that travel offers. For me, a lot of those amazing opportunities are offered in the form of food. Enjoy it. Savor the empanadas, and then take your insulin shot.
Essentially, just do your best. Trust yourself. Trust that there are many things you will just have to figure out as you go. Trust that you can take care of yourself in South America, as you did in the US. Your blood sugar doesn’t know the difference between countries. You were the only one who could truly manage your diabetes in America, and you are the only one who can truly manage your diabetes in South America. It is up to you. Trust that you can do it, because you have done it bravely since you were diagnosed, and will you continue to do it bravely as you explore this big crazy world.
Best of luck to you!