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7
KEEP ON KEEPING ON
Living With Diabetes
Can life ever be “normal” again after that initial shock of hearing the doctor’s diagnosis, “You have diabetes mellitus.”
No one can promise that life will be easy with diabetes. When Martha was first diagnosed at the age of nine, she cried. She thought surely she would have to spend the rest of her life in bed, with a nurse jabbing her with a needle every few hours. She felt cheated; she felt sure that she had lost her freedom of choice. Life was over!
When Carole first learned that her husband Larry, had diabetes, it came as quite a shock to her. She remembered back to her childhood and thought of the only diabetic she had ever really known. That was an old lady who, as far as Carole knew, ate nothing but baby food…and saved all the baby food jars to clutter her tiny little house. Were all diabetics strange—did they all have odd habits—as Carole’s childhood memories suggested?
My father-in-law had a favorite expression that he often used when the going got tough. He would say, “Keep on keeping on!” Don’t give up. Accept life’s difficulties and challenges. Go on with life—good advice for all of us, diabetic or not.
As time went by, Martha adjusted to life as a diabetic. By the time she was 17, she came to believe that living with diabetes can be as close to normal as living with asthma or an irregular heartbeat. An emotionally healthy person just learns to live with it.
And Carole discovered that she and Larry didn’t really have to make so many drastic changes. Oh, yes, they had to make some changes in what they ate, in their exercise program, in their overall lifestyle. It took “a little adapting”. But 21 years later, Carole can say, “I’ve learned that being a diabetic isn’t a terribly inconvenient thing. You can learn to live with it quite easily. And in many ways, it has beneficial aspects to the rest of the family.”
No one can promise that there will never be any awkward or embarrassing moments in the life of a diabetic. They will almost certainly occur. Martha has often been caught in public restrooms while testing her urine, or had to inject her insulin while riding in a car in busy traffic. But, she says, “I’ve decided to look for the humor in these situations.” But what about the insulin reactions, the problems, the difficult times? Larry believes that experiencing difficulty is probably one of the best things that can happen to a diabetic because it makes one more determined to try to avoid a repeat of the situation. Does life have to be a burden to the person with diabetes? “No,” says Larry. The lifestyle it requires “really can be a blessing to the diabetic and to his entire family.”
As Carole said, learning that a person has diabetes does “take a little adapting”. And the new diabetic is almost sure to have many questions about what he can or cannot do:
“I enjoy swimming and badminton. Do I have to give them up now?”
“What about dating and marriage? Can I ever have a baby?”
“Now I’ll never be able to travel to some of the places I used to dream of going, will I?”
Can I go back to my old joy, or do I have to stop working or change my work?”
These and so many other questions may be major worries to the diabetic until he comes to the point where he accepts his diabetes and understands his own body’s responses to it.
After a few years of neglecting her condition and feeling more and more guilty about it, Martha finally came to one important conclusion. Although she couldn’t change her body, she could change her attitude. She decided that she had two choices: One option was to become increasingly more depressed and dangerous to herself. The other choice was to take an interest in her own health.
Fortunately, Martha chose to become healthy and disciplined. Now she rejoices that she has learned one important truth about life: “That which does not kill me makes me stronger.”
Martha has already had to find answers to many of the questions faced by a diabetic. Throughout life, she will have to find the answers to other questions that she has not yet encountered.
Let us look now at how being a diabetic affects a person’s day-to-day life.
If you are a diabetic, what can you do? And what should you do—or not do?
Wearing I.D. Tags
Everyone with insulin-dependent diabetes—from the very young to the very old—should wear a medical identification tag at all times. In case of an accident, insulin reaction or diabetic coma, such I.D. will alert people that you are a diabetic. Because the symptoms of an insulin reaction may be mistaken for drunkenness, wearing some I.D. will help ensure that you get the correct treatment.
Your I.D. may be a special bracelet or necklace which says “I am a diabetic.” For small children, it may be easier to use an ankle bracelet. Parents sometimes sew special I.D. labels into the undershirts or other clothing of a diabetic baby or small child.
In addition, a card in your wallet or purse—or in a child’s school bag—will tell people what to do in case of an emergency. It may also tell what type and amount of insulin you normally take.
Diabetes organizations or societies often provide such identification cards for all of their members. Some of these organizations provide insulin, syringes, testing equipment and other diabetes supplies at discounted prices, but require members to show their I.D. cards whenever they purchase such supplies.
Unfortunately, many diabetes societies do not produce I.D. bracelets or necklaces. An employee of one diabetes association said that people wouldn’t wear them anyway—“We Asians don’t want to disclose if we are ill.” However, such I.D. bracelets, necklaces and cards are available from Medic Alert in Turlock, California (USA), and from some other health organizations (see Helpful Addresses on pp. 335 to 337).
Work
Even though you have diabetes, you can still choose almost any kind of work you wish. There may be a few restrictions, such as in the area of public transport. An insulin-dependent diabetic may not become an airline pilot, and in some places he is not allowed to drive a public bus or taxi.
A few other jobs are not really advisable for a diabetic because of the potential danger to his own life. He probably should not become a policeman or a fireman. He may not be able to work in the armed forces. Neither should he become a deep-sea diver or work at great heights.
Many diabetics do not want to tell anyone about their diabetes because they fear prejudice and discrimination. They’re especially afraid that they won’t be able to get a job if anyone knows that they have diabetes. The American Diabetes Association, however, believes that any person with diabetes, whether insulin-dependent or non-insulin-dependent, should be eligible for any employment for which he or she is otherwise qualified.
The important thing is to choose a job which you know you can do, and then do it well. If an employer is concerned about your diabetes, you can prove that diabetes is not a problem by having a good attendance record and doing well at your assigned work.
If you have any questions about whether or not you as a diabetic could or should do a particular job, discuss the matter with your doctor or diabetes specialist. Jobs that require irregular work hours or a lot of traveling may be more disruptive to a diabetic’s schedule and control. Yet diabetics who have reasonably good control of their diabetes may even hold jobs in entertainment or in sports, or other jobs which require a lot of travel.
Social Life
What about dating and social life if you are a diabetic? Diabetes does not need to take all the fun out of life. Sharing good times with your friends can help you enjoy life and help you feel better about yourself.
Feeling good about yourself is sometimes a difficult goal for a diabetic to reach because of some of the emotional conflicts involved. Some people think that being one of the crowd—doing what everyone else is doing—is really important. Whether they have diabetes or not, they are afraid that no one will like them if they are different. And so they act like everyone else, even if it is not the wisest choice.
If you are a diabetic, following the crown may mean eating what everyone else is eating, drinking what others are drinking—even if it is against your doctor’s advice. Unfortunately, that often leads to very poor diabetes control.
You may feel like a cheater for going off your diet, especially if poor diabetes control causes you to like to your parents or doctor about your blood or urine test results. And when that happens, you probably won’t feel very good about yourself at all!
For the best social life, learn what your own body can handle. Work with your doctor to determine how to make adjustments in your medication when needed. Get to know what foods and drinks are best for you, and don’t be afraid to request them. Go out with your friends and enjoy being with them.
Eating Out
Eating is a favorite activity in Asia. Many working people in the cities probably eat out more often than they eat at home. For easy entertaining, they often take friends or business associates to a restaurant. When they get tired of cooking—or there is no one at home to do the cooking—they go out to eat. For social occasions they enjoy going to a restaurant or other food center. And just to taste something new and different, they go out to eat.
Should you stay at home and miss all the good food if you have diabetes? Not at all! If you have learned your meal planning and food exchanges well, you should have little difficulty finding good foods to eat wherever you go. Here are a few simple suggestions for eating out:
*Practice at home to find out the correct serving sizes for yourself. Then at the restaurant you will be able to recognize how big a serving you should take.
*Eat on time, or learn to cope with delays. Some diabetics delay their insulin injection until they know that the food is about to be served. Then they don’t have the worry of an insulin reaction while waiting for their meal. At a large buffet dinner put on by his company, Robert casually walked by the food serving table as he entered the restaurant. He decided what foods he was going to eat and what size servings he would take. Quickly he calculated how much insulin he would need for that amount of food. He sat down at a table with a group of friends, pulled up his shirt slightly, injected the insulin, and a while later he enjoyed his meal.
*If you take your insulin before leaving home, but you think there might be a delay in getting some food, eat a little before you leave home. Once you are out, you could request a drink that has enough sugar to prevent an insulin reaction. Or excuse yourself to go to the toilet, and take a quick snack from your purse or pocket while you are out of the room—or take along enough that you can offer some to everyone in your group.
*If you find that you have ordered more food than you really ought to eat, many restaurants and food centers nowadays will pack up any extra food for you to take home. Keep it in the refrigerator, and you’ll have a free meal for the next day!
*Be careful of those 10-course wedding dinners! They can cause even the healthiest people to overeat. Learn how to pace yourself, and eat only small servings. To make the time pass without eating more than you should, eat slowly, chew your food extra well, and talk more.
Entertaining at Home
If you are entertaining guests at your home, don’t be embarrassed to serve healthful meals. Just make your meals look attractive and taste delicious.
If you wish to serve snacks, offer a pretty arrangement of bite-sized pieces or raw carrot, celery, cucumber, and other vegetables.
For drinks, some juices such as tomato, V-8 or other sugarless drinks may be nice. My daughter recently came back from a friend’s home with a refreshing drink recipe. She simply squeezes a few drops of fresh lemon or lime juice into cold water, then serves it with a thin slice of the lemon or lime on the rim of each glass. No sugar, no calories, no problem with drinking as much or as little as you want.
When it is time for dessert, fresh fruits are an excellent choice. Remember, however, that even fruit has carbohydrate which will eventually raise your blood sugar level.
Most diabetic societies or associations, as well as many large hospitals, have recipe books especially for diabetics. If you serve your family’s favorites, your guests will likely be pleased too.
Dating
If you are single, you may wish to go out on dates with someone you like. Don’t let diabetes stop you.
Should you tell your date about your diabetes? That is your own decision. It may be easier to tell than not to tell! If you need to eat your food at a certain time to avoid a reaction, knowing about your diabetes will help your date to understand why you are so concerned about time. And it is better for you to choose the time you want to tell rather than letting an insulin reaction or other embarrassing situation announce it for you.
When you go out on a date, you may need to take a snack along in case your blood sugar starts to get a bit low. When you feel that you need to eat something, go ahead and take your snack. Just make sure you always take along enough to share with your date.
If you feel that you ought to take a walk after eating, don’t be afraid to suggest it.
Although you may not have talked about your diabetes on your first date or two, if you begin dating one person quite regularly, it is probably best to discuss your diabetes with that special person. Your diabetes is a part of you that your partner will need to know about because your diabetes will affect both of you.
Robert didn’t have any real trouble with dating, but he had decided that he would not marry any girl who had diabetes in her family. Robert himself had been a diabetic since he was small, and he had learned to live with his diabetes. But he also lived with the knowledge that both his mother and his father had passed on to him the hereditary tendency toward diabetes—each of them had one diabetic parent. When diabetes is on both sides of the family, there is a much higher risk of the children becoming diabetic. And Robert did not want to give his future children that extra risk. So he decided to find out before he began to fall in love!
Marriage
If you are considering marriage, you should definitely discuss your diabetes with your partner. With our without diabetes, marriage is a challenge and will have its difficult moments. Both you and your partner have your views and opinions, your habits, and your ways of doing things that may cause stress in your relationship. Diabetes is one more challenge in marriage, but it is one which you and your partner can work on together.
Both you and your spouse should try to learn as much about diabetes as possible. A partner who knows all about your illness can be more understanding and helpful, and can help you through difficult times.
Sometimes it will be a challenge for your mate to know whether or not to remind you that you haven’t taken your medicine, or to caution you not to eat too much when you are eating out. If your partner says something, you may consider it as nagging. On the other hand, you may blame your mate for not saying anything if you have any problems with your diabetes control.
Diabetes will not be easy for you; neither will it be easy for the person you marry. Yet love, understanding, and communication can help both of you through the rough times.
Sexual Matters
Sex is a normal part of any love relationship in a marriage. And for someone with diabetes, it is usually possible to have normal sexual relations and for the woman diabetic to have children of her own. Let us look briefly at some of the matters related to a person’s sex and sexual relationships.
In a woman with good diabetes control, menstrual periods are not likely to be affected by diabetes. With poor diabetes control, however, the menstrual cycle may be irregular or absent, and she should see her doctor.
At any age, a woman may find that menstruation causes her blood glucose level to either increase or decrease. Because of this changeability, it may be necessary for her to test her blood more frequently and change her insulin dosage during that time of the month.
In any marriage there are times when one partner or the other does not feel like having sex. Any illness or emotional upset can temporarily interfere with sexual function. The same is true in diabetes. Gently, calmly discussing problems and frustrations, however, will make such problems easier to solve.
For the man, diabetes may cause difficulty in having an erection. This is especially true if his diabetes is not controlled well. If a person fails to maintain good diabetes control over a long period of time, the nerves of the body may eventually become damaged—a condition known as diabetic neuropathy. One of the problems men may have with this nerve damage is impotence, which is discussed in greater detail in the chapter on diabetic complications.
Women do not have the same problem of impotence. However, diabetic women do tend to have more vaginal infections because a high blood sugar level allows fungi and bacteria to grow more easily. Such infections are likely to decrease the woman’s desire for sex.
If problems with sexual relationships do arise, they may or may not be related to your diabetes. The best advice is to discuss the problem with each other, and with your physician. Occasionally it may be necessary to seek the help of a professional counselor.
Diabetes does not cause sterility in either the man or the woman. Therefore, if pregnancy is not desired, it will be necessary for the diabetic to take precautions to prevent pregnancy—just as any nondiabetic would have to do.
The diabetic can use most of the usual methods of birth control. However, it is important to discuss your diabetes with your doctor because certain types of birth control pills can upset diabetes control.
The intrauterine device (IUD) may be used if other methods are not feasible. Because of the diabetic’s greater risk of infection, however, some doctors do not recommend the IUD for anyone with diabetes.
The condom, although not always 100 percent effective in preventing pregnancy, is one type of birth control that diabetics can use. The condom will not interfere with diabetes in any way.
Sterilization is the most reliable method of birth control, but it should also be considered permanent. If there are already as many children as the parents desire, or if a future pregnancy might endanger the life of a woman, sterilization is likely a wise decision.
The tubal ligation for a woman and the vasectomy for a man are both surgical procedures which are relatively simple. It is important, however, that the doctor performing the sterilization procedure know in advance if the person requesting it has diabetes. Good diabetes control must be maintained before, during, and after the operation.
Pregnancy
If you have diabetes, should you try to have children? Isn’t there a risk that your baby will also have diabetes? Yes, but that risk is not high enough to advise against pregnancy. The risk depends to some extent on what type of diabetes you have, and on whether only one parent or both parents have diabetes.
If either you or your husband has insulin-dependent diabetes, your child has only one chance in a hundred of becoming an insulin-dependent diabetic. That is only four times greater than for children of nondiabetic parents. If both you and your husband have insulin-dependent diabetes, then there is a much greater risk—about one in 10—of your child being diabetic too.
If you have type II diabetes (non-insulin-dependent), your child will have a 20 percent chance of getting type II diabetes sometime between the ages of 40 and 60. When both mother and father have type II diabetes, their children will have about a 70 percent chance of becoming diabetic later in life. In reality, the chances of your child becoming a diabetic are actually quite small.
In most cases, a woman with diabetes may safely have children if she begins preparing for pregnancy well in advance. There are just a few health conditions, however, which make pregnancy unadvisable:
*If any woman—diabetic or not—has a serious heart problem, the physician will likely advise her not to bear children because of her own safety.
*A diabetic woman with kidney disease should be cautious and should discuss her desire for children with a diabetes specialist.
*A woman with retinopathy—a diabetes complication affecting the eyes—may have a much greater problem with her eyes during pregnancy. It is not advisable for her to become pregnant during an active stage of retinopathy.
If you have diabetes but you have no heart, kidney or eye problems, and have no other health problems which make pregnancy unadvisable, you can plan on having children when you are ready. You must plan carefully, beginning at least six months before you hope to become pregnant. To avoid problems during and after pregnancy, you should follow these guidelines:
*Keep your blood sugar levels well controlled for several months before becoming pregnant. Many women do not realize they are pregnant for the first several weeks. During those first few weeks of pregnancy, the baby’s organs are being formed, and that is the time when deformities and birth defects are most likely to occur. Poor diabetes control will give a greater chance of birth, abnormalities, but with good control, the risk of birth defects is about the same as for nondiabetic pregnancies.
*Talk with your physician about your diabetes and your desire to have a baby.
Pregnancy is a stressful time for the mother’s body, with much greater demands being placed on her entire system. Because of this, it may take much more effort for you to control your blood sugar level during pregnancy. Yet it is extremely important that you do make every effort to keep your blood glucose within the normal range.
*Stop smoking and drinking alcohol. Both smoking and drinking may cause miscarriage or may cause the baby to be smaller than normal. Also avoid using drugs.
Poor control of diabetes can be dangerous to the baby and to you. In addition to the deformities possible if the mother has poor blood sugar control during the early weeks of pregnancy, there may also be problems with excess fluid in the birth sac and respiratory distress of the baby at birth. The baby may also have jaundice, a yellowing of the skin, soon after birth. However, most of these diabetes-related complications can be prevented by good diabetes control throughout the pregnancy.
Diabetics often have big babies. There may be nothing you can do about that, and it generally is not a cause for serious concern. However, if the baby is quite large, it may be necessary for the doctor to deliver the baby by a Caesarean operation (often called a C-section). The doctor may also advise delivery a week or two before the due date if the baby is very large. Although women in some countries and cultures prefer to have their babies delivered at home, a diabetic woman should always go to the hospital for her delivery.
For the best health of you and your baby, follow these guidelines during pregnancy:
*Carefully follow the meal plan that your physician, nurse, or dietitian designs for you.
*Check your blood sugar level at least four times a day—before each meal and at bedtime. Check it more often if necessary for keeping good control.
*Take your medicines and your meals at the right times and in the right amounts.
*Work closely with your doctor and other diabetes team members to adjust your insulin doses, meals, and activities to keep your blood sugar within a normal range. A diabetic woman may have to increase her insulin dosage every week or two during pregnancy. Some women will be taking two or three times their usual dosage of insulin by the end of the pregnancy. Do not change your insulin dosage without the advice of your physician or diabetic nurse.
*See your doctor frequently. Promptly contact your physician about any problems that may arise during pregnancy.
*Follow a good exercise program during pregnancy, based on advice from your doctor. Exercise will help you keep your diabetes in control. Walking, swimming and aerobics are some of the exercises which pregnant women can usually do.
Remember that good planning and good medical care are essential for a safe pregnancy and a healthy baby.
Smoking
Smoking is unhealthy for everyone. It can cause emphysema, bronchitis and lung cancer, and it more than doubles the risk of having a heart attack. When a person inhales cigarette smoke, the nicotine in the smoke causes the blood vessels to temporarily become narrower. It makes the heart beat faster and raises the blood pressure. Smoking also appears to contribute to the accumulation of the more permanent fatty “plaque” on the lining of the blood vessels, a condition known as atherosclerosis, or hardening of the arteries.
If you have diabetes, smoking is especially dangerous. Diabetics already have a high risk of blood vessel disease, but smoking increases that risk even more. The narrowing of the arteries reduces the blood flow to all parts of the body, increasing the risk of kidney disease and the eye complication called diabetic retinopathy. Smoking can also result in circulation problems which may eventually lead to amputation of a foot or leg.
Drinking Alcohol
Although many people boast that drinking alcohol does not affect them, alcohol can be dangerous to someone with diabetes. The American Diabetes Association advises diabetics never to drink more than two alcoholic drinks in a day, and not more than once or twice a week.
There are several good reasons why you should avoid alcohol if you have diabetes. When the stomach is empty, most of the alcohol a person drinks is absorbed directly from the stomach into the bloodstream. Normally, if the blood glucose level drops too low, the liver converts some of its stored glycogen to glucose and releases it into the blood. Alcohol, however, is given priority handling. This means that the liver will take care of processing the alcohol first, then care for the low blood glucose level later. The result: hypoglycemia—very low blood sugar level—and danger! Therefore, if you do drink some alcohol, you should always drink with a meal, never on an empty stomach.
Another danger of using alcohol is that one cannot accurately predict how soon a hypoglycemic reaction might occur. It may come very quickly if the diabetic has not had any food before drinking. On the other hand, there may be a delayed reaction, and hypoglycemia may not occur until as long as 36 hours after drinking!
Alcohol by itself contains calories. When combined with a sweetened mixer, even more calories are added. If you are trying to control your diet, you definitely need to take these calories into consideration. Because alcohol is digested like a fat in the body, it should be treated as fat exchanges in diet planning.
In poorly controlled diabetes, alcohol can also raise the blood sugar level. Besides that, diabetics taking oral diabetes medications may feel sick because alcohol sometimes blocks the medication’s ability to work properly.
A person who has been drinking does not always think as clearly as usual. After drinking, he may forget to take his insulin, or he may forget to eat. At a party, he may forget all about his diabetes and eat a lot of snacks.
Even worse, if a diabetic has been drinking and then becomes unconscious, other people will probably think he is just drunk when in reality he may be experiencing hypoglycemia, or insulin reaction. At home, if a diabetic drinks too much before he goes to sleep, he is also in danger of a reaction. “That’s why alcohol in such a scary thing with diabetes!” exclaims Steven Lee. “If a person gets really drunk, he will sleep through a reaction and die.”
Remember, no one has to drink. There are some good alternatives to alcohol. Mineral water, natural water, or even diet soft drinks are good non-alcoholic choices. You don’t have to apologize for not drinking!
Using Other Drugs
If illegal drugs are harmful to the ordinary person, they are even more so for the diabetic. Besides causing problems with the law and with your personal life, using drugs such as marijuana, cocaine and heroin can cause real trouble with glucose control.
These drugs increase a person’s appetite. Marijuana makes a person hungry for sweets, while cocaine causes the liver to release extra sugar into the bloodstream. Drugs also make a person less aware of reality. In general, drugs make it more difficult to manage diabetes, and may make blood glucose levels go wild.
If you do use drugs and then an insulin reaction causes you to act strangely, other people are likely to think that the drugs were the cause of your unusual behavior. They may not even think of hypoglycemia as the real problem, and you may not get the help you need. Drugs just are not worth the risk.
Traveling With Diabetes
If you have diabetes, you do not have to stay home for the rest of your life.
If your diabetes is well-controlled, and if you plan carefully, follow your physician’s advice, and take a few extra precautions, you can go almost anywhere your heart desires. If your diabetes is difficult to control, however, it would be wise to travel in more developed areas with a climate similar to what you are used to, and where you can easily follow your usual food habits and get good medical care.
Whether traveling by car, boat, plane, train or bus, advance planning is very important. Well in advance, you may want to make a list of what to take on your trip so that you don’t forget anything in the last-minute rush of packing and leaving home. Your medicines, syringes, testing materials, and all the other necessities of living with diabetes are absolute essentials.
If you travel by air, it is best to handcarry a special bag with your insulin or oral medicines, and other diabetes supplies. Do not pack your supplies in your checked baggage—if it gets lost or damaged, you could be in big trouble! By handcarrying your insulin kit, even if your luggage gets lost, at least you will still have your medicines.
Besides, insulin does not keep well at very high or very low temperatures. The baggage compartment of an airplane is too cold. In a car, the trunk often gets too hot. A good guideline to follow in carrying your insulin on a trip is: if the temperature is comfortable for you, it is a safe temperature for your insulin. In very hot or very cold weather, you may wish to carry your insulin in an insulated container until you get to a place where you can refrigerate it.
A word of caution about refrigerating your insulin away from home: When you finally (leave the hotel, friend’s house, or wherever you have been staying, don’t forget to take your insulin from the refrigerator! You’ve probably heard the saying, “Out of sight, out of mind.” It is too easy to leave something behind if you can’t see it. That’s why I often keep a note on top of my suitcase or taped to the door to remind me to take something from the refrigerator before I leave.
Many doctors recommend that you take an extra one-week’s supply of insulin and other supplies, just in case you break a bottle, in case you need more because of the change in food and exercise, or in case you decide to stay longer than expected. Also, if you travel outside your home country, you may not be able to find the same type of insulin that you usually take.
It is also wise to carry along a doctor’s prescription for your type of insulin and syringes. That way, it should be easier for you to get more if you need. In addition, if you will be going through Security or Customs checks during your trip, a prescription and a note from your doctor explaining why you have syringes and medicines may make things easier for you.
Take extra food and sweets along so that you don’t get caught short. On a trip, you may be walking and exercising more than you normally do, so you should plan ahead for this. For an airplane trip, unless you are very familiar with a particular airline and the meals available on it, you may want to pack along enough fruit, sandwiches, and other food for the time you will be on the plane.
It is best to travel with another person if possible, yet I know several diabetics whose jobs require them to do a lot of traveling alone. If you do travel with a friend or relative, you may wish to give that person a small kit of insulin and diabetes supplies in case something happens to yours. And make sure the person knows how to care for you in a diabetic emergency.
Whenever, wherever, and however you travel, it is especially advisable to wear and/or carry something which identifies you as a diabetic and tells what to do for you in an emergency.
If you need immunizations before traveling outside your own country, check with your doctor. Get the immunizations at least one month before beginning your trip, just in case they make you ill or throw your diabetes out of control for a short time.
If you are crossing time zones during your travel, you will need to make some adjustments in your insulin dosages.
Whether you travel by car, plane or other means of transport, be sure to get some exercise every hour. In the car, you can stop and walk around. In the plane, you can walk up and down the aisles. Without some exercise, your blood glucose level is likely to sneak up higher than it should be. Throughout the trip, be sure to keep drinking plenty of water and other non-alcoholic drinks. On long trips, especially by plane, the extra water—at least one large glass each hour—will help you feel fresher and help to avoid some of the jet lag you might otherwise experience.
Diarrhea is unpleasant for anyone, but for a diabetic it can be dangerous. Diarrhea throws both fluids and unabsorbed glucose out of the body, making it difficult to balance the remaining glucose and insulin in your system. Be especially careful if you are traveling to places where food or water might be contaminated. Bottled water and drinks are usually safe. So are boiling hot soups and hot drinks. Ice cubes are not!
Before leaving on your trip, find out where to get emergency medical help at your destination. Find out if there is a local diabetes society which can recommend doctors well-experienced in diabetes care. Your local embassy or consulate may also be able to provide names of qualified doctors.
If you are traveling to an area where you do not know the language, at least learn how to say “I have diabetes,” “I need sugar or orange juice please,” and “I need a doctor.” Also carry a diabetic I.D. card translated into the local languages in case you have a reaction and are unable to communicate.
Plan your trip well, then go off and enjoy yourself!
Nancy flies from Bangkok to Singapore, Jakarta, Manila, Tokyo, Los Angeles and many other destinations.
Until his recent transfer overseas, Larry—insulin-dependent and over 50—was on a similar travel circuit. Although most of his travel was for business, Larry didn’t mind driving for several hours to run a marathon in Malaysia.
Steven Lee is even more daring. His favorite sport is hiking and backpacking into the high mountains—alone! I’ll tell you more about that later, when we talk about exercise.
Live Life to the Fullest
Today, more and more diabetics are refusing to let diabetes be an obstacle standing in the way of what they want to accomplish. Many are learning that with good discipline and good planning, life can become more meaningful. They develop skills and find talents they might never have discovered otherwise.
As the famous philosopher, poet and scientist Goethe once said, “From disease I have learned much which life could never have taught me in any other way.” So get your diabetes under your control, and go out and live life to the fullest!