Meet Jeremy Larsen, world traveller that has been to over 30 countries. While this would usually be a simple thing to do, in Jeremy’s case it comes with a twist. Since he was 9 years old, he has had Type 1 Diabetes.
Today he shares with us his stories and advice in hopes it will inspire other Type 1 Diabetics to overcome their fear of the unknown and send them on the road to their dream destinations.
Since my father, brother and very close friend have Type 1 diabetes, I decided to focus on the subject of diabetes travel and uncover the questions we all ask ourselves before going out on the road; is it safe and possible, and if so how do we do so?
I have to say I have rarely read answers to my questions that were so practical, entertaining and inspiring. So without further a due, I leave the following information in his hands. If you have any other questions that weren’t answered here don’t hesitate to comment on the article.
To start this off, what inspired you to become a full-time world traveler?
I started taking short and then longer and longer road trips with friends as a teenager, and then spent a month backpacking through Scandinavia, then moved to Japan and started going on months-long voyages all around the world… and got hooked somewhere along the way. I’ve loved every second and there’s still so much I haven’t seen; the world is full of promising and beckoning destinations.
Traveling is the most rewarding way to spend ones time. It’s a constant challenge and a mesmerizing learning experience. Anyone who is naturally curious and open to new things, who bridles at stasis and predictability in their lives, will be constantly inspired and energized by travel. It’s addictively rewarding.
I’m lucky because I even love the mechanics of travel – buying train tickets and finding my seat when there’s no English, checking into a guesthouse on some quiet back street, or just looking at maps and letting my mind wander. I’ve never been disappointed by any destination. It’s not about needing luxury and entertainment for myself; it’s enough just to know what a place is like. To see its people and breathe its air and feel the thrill of movement and change.
I travel not to “get away from it all”; I travel to get *to* it all.
Did your diabetic condition make this choice to travel long term more difficult? If so, do you have any advice for other diabetics that haven’t traveled yet?
Mostly, I believe that having Type 1 diabetes since I was nine has only enhanced my enjoyment of and ability to travel. Many of the challenges that diabetes presents require focus and dedication and resilience – the same traits necessary for travel, especially long-term trips to unusual places where you’re on your own as far as tourist infrastructure.
There are some practical things that traveling diabetics need to deal with of course. Most are related to carrying and procuring supplies – insulin, test strips, et cetera. It’s not always clear what the local pharmacy scene is going to be but I’ve never been to any place where diabetes supplies were unavailable or even difficult to get.
Most diabetics who ask me for advice are merely fearful of the unknown. They think they’ll lose their insulin and be unable to get more, or pass out in some foreign street and be ignored by shrugging locals. It’s a natural inclination, especially for those with diabetes, but I always tell people to just GO.
Diabetically and otherwise, travel tests you. The thing is, you will always rise to the challenge. There isn’t any alternative. If you’re stuck in the middle of Cambodia and running out of insulin like I have been, you’ll find a way to handle the situation. Even if you presently have no idea how, you will. You have to hit the road to find out how. It’s exciting!
How do you carry your insulin during long trips? How do you keep it cold and in proper condition?
It depends on where I’m going. In hotter places like Thailand in the summer I’ll carry my insulin pens in one or two foil packs, sometimes together with an ice pack in a plastic baggie. (Actually the inside of your backpack can remain surprisingly cool in the heat, especially if you put insulin deep down wrapped in a few layers of clothes.) I always put my stuff in refrigerators or coolers at hotels and guesthouses overnight when possible.
On my recent three-month road trip around America I was able to keep insulin in a cooler in the back floorboards and fill it up with ice every day or two. On a trip to northern Norway in February, the outside air was cool enough that I didn’t have to worry about it! Every trip and each destination is different.
Surprisingly to me, I’ve never actually had insulin go bad or get damaged, even when it got too warm. Many people have recommended Frio packs to me, and I’ve always wanted to try them but haven’t so far.
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Are there any situations where you would say your life was in danger? How can these types of situations be avoided?
I’ve never felt that I was in any situation that dire; the couple of times I’ve had to go to hospitals in foreign countries weren’t because of diabetes. If my life were ever in danger I can’t imagine it would be diabetes-related. I check my blood sugar often and am pretty careful about eating strange food – I certainly do so but know to pay closer attention to sugar levels afterwards.
I’m not an adventure traveler per se – you won’t find me scaling Mt. Everest or paddling solo across the Pacific Ocean – so diabetes on the road is pretty much like diabetes at home and the advice is the same: know your BG, take into account your recent sleep, exercise, food (and alcohol). Anticipate good readings but be prepared for surprises.
And always carry low blood sugar snacks! If you read my various destination guides for diabetics you’ll see that every corner of the world has plenty of places to stock up on juices and cookies or whatever you like. I never leave my room even for two seconds without a day bag. It contains my insulin, blood sugar meter, and more low blood sugar snacks than I could need.
I have also recently begun wearing a medical alert necklace when traveling. It says “Type 1 diabetes” on it in English which medical personnel, should it come to that, anywhere in the world ought to be able to understand.
When you travel in developing countries is it difficult to explain to people that you are diabetic? Or do most people understand relatively quickly?
It rarely comes up but when it has it’s been easy. Often, as in pharmacies I visited in Serbia and Albania, a smile and a slow, clear use of simple English is fine. If not, pointing to a shelf of test strips or showing my own Humalog pen always gets the job done.
One time that things got tense was crossing into Vietnam at an obscure border checkpoint by motorcycle. The guards were suspicious of my bags full of needles and mysterious-looking insulin pens. I stayed friendly and patient, but my “injection” mime performance wasn’t helping. Finally I flipped through my guidebook and luckily found the Vietnamese word for “diabetes”. I showed it to them (rather than trying to pronounce it). So they all started laughing and nodding and waving me on into their country. (I put a downloadable doctor’s travel note template on my website to help others in situations like this.)
People in every location have diabetes and other medical issues. So it’s not like a traveling diabetic is some weird alien with an unknown condition. There’s diabetic infrastructure everywhere. English is usually enough, though I give the local words for “diabetes” and related terms in my destination guides, just in case.
What are some of your favourite countries to travel with diabetes? Any surprising ones that were actually much more receptive and/or where the food was more easily calculable?
I love Southeast Asia because it’s so easy to buy insulin there. You just walk into a pharmacy and point to what you want, and they have generally had what I need or something close enough. Then again, that area has a lot of food based on noodles and rice which can cause high blood sugars. Yet with enough experience and patience you can learn to calculate effective doses for it.
I once needed supplies when I was in Zagreb, Croatia, and the pharmacist I talked to explained how I needed to first visit a doctor and get a prescription and go through all this hassle. It was Christmas Eve and I didn’t want to do all that, and didn’t want to spend that extra money. So I kind of made sad eyes and she finally said she would sell me the stuff without the hassle as a special one-time thing. The same thing happened in Bodø, Norway (after a pharmacist down in Trondheim was unable to help). I realized that medical professionals want to help and will do whatever they can. And even if these pharmacists weren’t able to help me as they did, I could have just gone to doctors like they said. There’s always a way.
As a resident of Japan I was quite nervous on the road trip in my native America because I knew the medical system there is more rigid and much less helpful. Fortunately I didn’t have to buy any insulin there. I had plenty of strips for my One Drop meter for the duration of the trip. Fortunately America, like just about everywhere I’ve been, has easy-to-understand nutrition info on its food packaging.
Are there any countries you wouldn’t recommend traveling with Diabetes?
The motto of my website, http://www.70-130.com, is “You Can Go Anywhere With Diabetes” and I stand behind it.
No matter your age, health condition or career path, it’s possible to adopt a longterm travel lifestyle. Learn how here.
Other than your blog, are there any other major resources that every diabetic that wants to travel should know about?
Yes, people should join the “diabetes online community”, or #DOC, on Twitter. It’s not a formalized group, it’s just the fact that various diabetics and those close to diabetics talk about diabetes in their lives. On my Twitter account @70_130 I tweet about T1D as it relates to travel, but the other diabetics I follow might talk about anything. It’s nice to know that your experiences with diabetes are in fact shared by lots of others. Most people in the #DOC say that it’s a very supportive and illuminating group and I completely agree.
Is there an age at which a Type 1 Diabetic should travel? I’m asking for my little brother who just turned 18 (and has type 1 diabetes).
I see no reason for a diabetic of any age to restrain themselves from travel. Diabetes on the road isn’t too much different from diabetes at home. You just have to stay positive, always be aware of your blood sugar, and be prepared for the unexpected. When I was 19 I went on a two-week road trip around the United States with two friends. Of course there were lows and highs but I had the insulin and strips I needed and made it through fine just by being careful. I still look back on the trip fondly and would hate to have opted not to go just because of little ol’ diabetes!
Anything else to recommend on traveling with diabetes Type 1?
There are practical things you can do to prepare, like stocking up on more than the insulin and testing supplies you’ll need. Other things you should do include asking your doctor for any tips specific to you, learning local words for “diabetes” and maybe writing them down on a card in your wallet, and splitting up your supplies into two separate bags in case something happens to one.
But my biggest recommendation is about your mental preparation: stay inspired and don’t fear the unknown. Sign up for my free diabetes travel newsletter where I discuss my experiences traveling with diabetes and give you ideas of where and how to travel yourself. And most of all, rather than imagining all the horrible things that MIGHT go wrong, get over that fear. Go right up to it – in your exotic destination of choice – and stare it down. You’ll find that your diabetic training has prepared you very well. Now you’re specially equipped to get the most out of travel.
You can go anywhere with diabetes!
If you enjoyed this piece and want to learn more about diabetes travel head to 70-130.com, one of the most comprehensive blogs out there for diabetic people who want make travel a lifestyle rather than a vacation. I respect what Jeremy is doing, and therefore was not paid or compensated for this article.
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