It's been in the headlines a lot lately: Diabetes is on the rise in the United States, with the number of people diagnosed increasing nearly 40 percent over the past 10 years. While it is a serious condition, diabetes isn't reason to avoid the wilderness, as long as you know how to monitor and treat it.
- Practice on overnight and weekend trips before undertaking longer treks. Changes in physical activity, eating patterns, and climate affect how much insulin a diabetic needs, and how often. By starting slowly, he or she can accommodate the new requirements.
- Know how to recognize and treat diabetic emergencies. Problems can rapidly become life-threatening when a diabetic has insulin, but not enough sugar, in his system. When this happens, the person is unable to communicate normally and exhibits confusion and irritability. Other symptoms are hunger, sweating, loss of coordination, headache, tremors, slurred speech, dizziness, and possibly seizures. He or she needs sugar in its simplest form-candy or glucose tablets, for instance-right away. DO NOT give insulin.
- Learn how to use a glucometer, which measures the blood sugar level. Have the diabetic check his or her blood glucose often during the first few days of the trip. If readings are high, reduce the amount of carbohydrates consumed before increasing the insulin dose.
- Carry two times the insulin, glucagon, and sterile syringes you think you'll need. Divide the supplies and ask a hiking partner to carry half, in case one set is lost.
- When it's cold outside, insulin must be carried near the body to prevent freezing. Good spots to keep it are in an inner jacket pocket during the day and at the bottom of your sleeping bag at night.
- Protect insulin from overheating in hot climates. Keep it out of direct sunlight, and in the heat of summer, carry insulin in a "diabetic kit" gel-pack cooler (commercially available). Protect glass insulin vials by storing them in a hard case.
- Carry spare batteries for the glucometer.
- Pack nutrient-dense foods like nuts and dried fruits, which release sugar slowly into the body, for snacks. Check with your doctor to see if certain brands of energy bars can be tolerated.
Note: Adventure Foods (828-497-4113; www.adventurefoods.com) will pack trail food especially for diabetics.
For diabetic menu suggestions, check out Moveable Feast Online at www.backpacker.com/moveablefeast.