How to Hike With Chronic Conditions

DIABETES

The risk: Hypoglycemia (low blood sugar) or unconsciousness brought on by exertion, eating too little, or taking too much insulin.
The fix: Sheri Colberg-Ochs, Ph.D., and author of The Diabetic Athlete’s Handbook, advises:

• Your body uses more glucose during prolonged physical activity, especially in temperatures below 50°F, so you might need to reduce insulin dosage to compensate.
• Keep insulin between 46˚F and 86˚F. Prevent freezing by carrying it in an inside pocket and stashing it in your sleeping bag at night; in hot weather, store it in a Dia-Pak with a cold gel pack ($23; medicool.com).

ASTHMA

The risk: An asthma attack triggered by exercise, altitude, wood smoke, pollen, dust, or cold temperatures.
The fix: Esther Langmack, MD, pulmonary specialist at National Jewish Hospital in Denver, advises:

• Spend at least 48 hours acclimating at your destination before beginning a high-altitude trip; adapting to elevation is more difficult for asthmatics.
• Consult your doctor about bringing an emergency steroid (such as Prednisone) on the trail–these prescription drugs reduce airway inflammation if you have an attack.

HEART DISEASE

The risk: A heart attack brought on by the stresses of altitude and strenuous hiking with a heavy pack.
The fix: Gerald Fletcher, MD, cardiovascular specialist at the Mayo Clinic in Jacksonville, Florida, advises:

• Improve baseline health with good nutrition and regular exercise. This treats the underlying disease and lowers the risk of on-trail complications.
• Ask your doctor about packing a vasodilator like nitroglycerin, which treats chest pain by widening blood vessels.
• Don’t overdo it. If you experience shortness of breath or pressure and pain in the chest, stop and rest.