The Type 1 Traveller Ch6: Kit

A blog post for others with diabetes considering overseas travel

Sometimes the speed of the changes on this journey make my head spin. With the diabetes I have been through these phases and each one is different. It seems so short a time ago Mel and I were worried about keeping my insulin cool in the tropical heat. Now I step outside into minus 20 degrees Celsius and I need to think about where I keep my insulin so it doesn’t freeze.

I don’t know how to operate in minus 20. The cold feels like like blades going into your lungs. The moisture freezes in my nostrils and pulls at my beard. Then I am conscious of the insulin sitting in my bag and that within 20 or 30 minutes and it will be rock hard.

At least the heat is less of a worry now. All through China we have simply got into a hostel and put my years supply of insulin against the window to keep it cool. But now we have an added complication that we are constantly moving from minus 10 degrees Celsius outside into buildings that are kept at the high 20s. So it is a constant yo-yo of temperature.

But the supply levels are this funny little indicator of our journey. When we left Australia I stocked up on everything I thought I would need.
I completely emptied two Darwin pharmacies of their Lantus, Novo Rapide, needles and testing strips. They had to order the last in for me. So I placed it all out, counted it out, estimated and then packed it all in.

But I checked the other day and the insulin will do me to the end of the year but the needles run out in about 60 days. The testing strips in 90 or so. I am already using needles twice or more to stretch them out.
Out of interest in Beijing I wandered into a pharmacy and showed them one of my insulin pen needles. The lady smiled and went under the counter and produced 5 small packets of th exact needles I like.
How much? I asked. Her reply almost made me fall over. In Australia with our diabetic support system we simply walk into a chemist, sign a form and walk out with little boxes of hundreds of needles completely free. But someone always pays and now I know how much.
Turns out that each little disposable needle designed for single use costs 70 Australian cents. Those little boxes I walk out of the chemist with are worth $70….

The saying “you don’t miss your water until the well runs dry” rings in my ears. At home I use the needles once, I grab boxes whenever I walk past a chemist, I find stashes of unused needles in bags, under couches, in kitchen cupboards. Now I carefully open each one. I get excited when I open a new needle (in a diabetic kind of way…for non diabetics each use blunts the needle so after a few uses it feels like it is puncturing the skin like a fish hook) and I am carefully sticking to my estimates for their use. I am holding out until my parents come to visit us from Australia and they can bring me some more.

I have had a bad run of late with the whole diabetes thing. The food in Russia has changed dramatically once again and everything seems to be potato and bread. So now I have to re-learn what all these new things do to my sugar levels. I thought I had found a great brand of oats for breakfast only to realise they weren’t stocked anywhere else in Russia. Then one brand was great and another sent my sugars through the roof. One bread seemed great (all grains and eye) then the same looking one from another shop sent me through the roof once again.

Sitting down on a train for 50 hours is not my normal state of exercise affairs so again the sugars went wild. Add on top of that this lingering 4 day virus that got passed from Mel to me to Tully and it is more than a little confusing. I am regularly taking doses of Novo Rapide without food during the day just to bring my sugars down a little and every time I test my sugars I sit there waiting with one eye closed not wanting to look at the result. 

Today after I tested my sugars Tully said “That always seems to happen Dad”
I said “What does?”
And she said “When you test your sugars and it is high you frown….”

I try my best to keep my emotions under control with diabetes but children have a way of seeing through these things.

Some practical findings for other diabetics:

• I have found diabetic supplies in every country. There seems to be a small stock of BGMs, testing strips and lancets – but as I mentioned the cost may be astronomical. I have not asked about the cost of the other larger supplies like BG monitors.
• I have found insulin available over the counter (??) in Vietnam – though the use of insulin pens seems to be not that common. One chemist showed me vials of insulin. Another had Novo Rapide pen refills. Many didn’t stock it at all and pointed me towards a hospital.
• In the hospital in China (with Zoes broken arm) I happened to notice the very familiar Novo Rapide boxes sitting behind the counter of the pharmacy – so you could probably obtain them in an emergency. The doctors in China were brilliant so it would be a smooth procedure. Before I left Australia I had a Chinese doctor write out a letter in Chinese explaining who I was, the diabetes and asking them to provide supplies that I need. I didn’t have to use it though.
• The food In Russia has been really challenging. The variety of rices, grains, breads and oats is a little bewildering and somehow they all seem to impact sugar levels really differently. I am still trying to work this one out. Fresh fruit and vegetables are available but not really fresh….so getting low carb meal options is quite hard.
• The other requirements for hypos – juice, lollies etc are in abundant supply.
• As for travel with the supplies –  not one single customs agent or border security has even looked at my insulin or needles across 11 different countries – so that is one thing that is not a concern when travelling.