A friend of a friend is coming for 6 days on the water,and is an insulin diabetic. Anyone have any storage/carry tips which I can relay to him? Thanks OTH

Contrary to popular belief, insulin does not need to be refrigerated short-term. Keep it in a handy location(I carry my husband's in my waist pack, along with his testing meter) and place out of the sun when in camp. We carry an extra insulin vial and some syringes duct-taped under the gunwale of the canoe as an emergency supply in case the primary one gets lost/damaged/compromised in some way. This HAS happened to us, so I highly recommend the precaution!

Test the blood sugar more often than usual when canoe-tripping. Carry snacks at all times, in a readily accessible pocket or pack. Keep HYDRATED!! Dehydration seems to affect the blood sugar more than you might think.

My insulin-dependent husband and I have been canoe-tripping together, just the two of us, for 30+ years and have had emergencies, but never anything we didn't handle successfully. You do need to take extra care though, since 911 isn't readily available. I carry a glucagon injection kit to use in case of a severe insulin reaction, and I know how to use it. This is a prescription item and can be gotten from your physician.

The companions need to know how to recognize a low blood sugar situation, and to suggest stopping for a test, a rest, and a snack if necessary. Sometimes the diabetic doesn't realize that they need this, particularly when they are doing an activity that is not their normal routine.

Hope this helps! Have fun!

Ditto to what Spartan2 said. Carry an extra set of everything. I always keep a set in a different canoe. Definitely check you sugar frequently. I have had a reaction while canoeing and I almost tipped us a number of times trying to get to shore. Don't let this happen! I try to keep my insulin cool in a dip bag. It still should not be allowed to get over 80, so why chance it. I also carry a tube of cake frosting. It can be absorbed through the cheek even if you are unconscious. It is small, light, and easy to carry. It also stays good for a long time. I would rather run a little high, than low on trips like this.

I have type 1 and ditto what was already said. I am usually on week or more long trips, so I choose to carry my insulin in a Frio pouch. They are great little wallet sized bags that have crystals inside that absorb water and keep the insulin at a cooler temperature. I just put it in the outside of a pack liner and it absorbs water.

I have everyone in my group carry GU packets. I put 2 in a snack sized zip lock for each person's fanny pack. It's nice to have some emergency GU in the tent since all the food is in the food pack hung up in a tree or hidden off the beaten path.

Test, test, test. And bring more than one glucose meter if it's going to be a longer trip. If one dies, there's a backup. Without a backup, you're screwed. That happened to me a couple years ago. I got some weird error message on my meter and it wouldn't work. The last day and a half, I just had to guess what my blood sugar was.

Yeah, definitely bring an extra meter. You don't think you will drop it or it will break or anything, but you can never be too careful. A buddy of mine dropped his down the icehole last year--the last place you would expect, but it happened.

Anyone use pumps?

I have an insulin pump.(Deltec Cozmo. It's waterproof) It's great to have except when it it really hot and humid--then it's hard to get the tape to stay put over the pump site. Need to watch the tubing too...I've gotten mine snagged in trees and bushes on portages. But the fine tuning capabilities are worth the hassle. I don't bring a spare pump, just syringes in case the pump would die.

How about using meters in freezing temps?

Has anyone ever found one that actually works when it's cold?

Is there even such thing?

I don't think there's one available to work in cold temps. I get an error code on my meter even when it's about 50 degrees.

I warm the meter in my hands. Once it is warmed up it will work as long as you are quick. Then again it does not get as cold here as it does by you.

I have found that all the above are very good tips. The most important thing (he might need to talk to his doctor about this to be safe) is his dosage. I have found that I can take about half of my usual dosage to stay on the safe side. As Marc stated I like to stay to the high side a bit. But being active for an entire day paddling and portaging, even if it is at a moderate pace, really has an effect on blood sugar levels and he needs to be aware of this. I usually solo so I may expend a bit more energy than those in a group (or maybe not), but it is one of the more important things to be aware of.

I have had Type 1 Diabetes for 39 years now. During my college years led kids (Diabetic and non-diabetic groups)on canoe trips in both the BWCA and Rivers in Upper Wisconsin and Minnesota. More recently have gone on family trips in the Superior National Forest.

Looks like great advice that has already been provided. I would recommend your buddy brings glucagon and trains one (or more) of your group how to inject it in the unlikely event that your friend became unresponsive from an extremely low blood sugar. Also, on both canoe trips and bike touring trips I ALWAYS set my watch alarm for 2 am and hang my watch in the tent (so it can be heard), then test my blood sugar to make sure I am not low/going low. I would strongly recommend your friend considers this. I have found it to be a wisely invested five minutes each night. Insulin requirements will likely decrease substantially on the trip, and sometimes the reduced insulin needs will extend for many hours after that last 300 rod portage. Oh, and make sure some sealed glucose product (like Gu that was previously mentioned) is kept easily accessible at the camp site AFTER the food pack is hung up. I remember one trip back in 80's when the group had to lower the foodpack in the middle of the night to get at the sweet food to treat a low blood sugar. On that trip we did not have sealed glucose products on hand, and the camp site had many recent signs of bear activity.

Have a great trip!

All I knew about it was a glass of grapefruit juice in the morning and food choices. That's fairly ignorant; especially miles from nowhere. Thank YoU All So Much . These tips will all be shared with our group of four and we will learn what to do in case. God Bless, oth

If you are traveling in a group also make sure everyone knows what to look for when your blood sugar getting low. My wife and friends know when I am low just by the way I talk. I make sure the people I go with know what to look for because they can usually can tell before me.

I am a type 1 diabetic as well-seems like a disproportionate number of us. Also a physician assistant and all of the advice above is wonderful. I definitely am a fan of redundancy!

Personally-my insulin demand drops to maybe 50% on BWCA trips. I too would rather run a little high than low.

Over the years of tripping, a major stressor for me has been the overnight hypoglycemic episode. I have always hung my food pack and never (knock on wood) had a bear issue. At this point I am really considering purchasing a bear vault-bear proof container. When its just my girlfriend and I it could hold everything for a 3-4 day trip. For longer trips or larger parties it could hold snacks and "quick-fixes" for those hypoglycemic episodes.

PS-I love the cake frosting idea!

tg

My brothers uses a reusable Frio cooler pack, you just immerse it in cool water (always available in the BWCA)and it keeps the temp for about 45 hours. It works great. They come in all sizes and are afordable. These are a must for anybody traveling away from home for extended outdoor trips. Here's the link http://www.diabetesandmore.com/detail.aspx?ID=232

Frio Characteristics
• Light and compact (between 29gms and 66gms) ( 1 to 2 ozs)
• Activated by water - no need for ice or fridges or even electricity
• Keeps insulin cool for over 45 hours for each immersion period
• You can keep on using it over and over again - either continuously or intermittently, the choice is yours!