A few days ago, I became a Wilderness First Responder. It was a 10 days long course with National Outdoor Leadership School (NOLS). Once during a lecture, our instructors asked, “How often do you see a person with diabetes come for a trek?”.
“Very often,” I instantly thought.
I have seen many trekkers with diabetes summit peaks and cross passes without any difficulties. I, myself, have led people trekking with diabetes on high altitude treks. But I have also seen them look puzzled and worried before the start of the trek. And I believe that nobody should have to carry the burden of confusion and uncertainty while coming for a trek.
So, let me take this opportunity to tell you about what diabetes can do in the wilderness setting and the easy steps to its management before and during the trek.
What is diabetes
WHO (World Health Organisation) says that about 422 million people worldwide have diabetes. Diabetes is a condition that affects the sugar metabolism of a person’s body. It occurs when one’s body cannot generate or effectively use its insulin, a hormone made by special cells called islets in Pancreas.
Insulin is the key that helps the glucose reach body cells. When you eat, the sugar level, that is the glucose in your body, rises. As your body gets this signal of risen glucose levels, your pancreas immediately releases insulin into your bloodstream. This insulin then travels to your body cells. There, they tell the body cells to open their gate for glucose. As the glucose enters, the body cells turn the glucose into energy. Some of this energy is then utilized immediately while the remaining is stored into your muscles and fats for later use.
There are two types
According to WHO, there are two main types of diabetes – Type 1 and Type 2
| Type 1
Here the body’s immune system attacks the insulin-producing islets in our pancreas. As a result, no insulin enters the bloodstream. The glucose in our body does not reach the body cells and instead, starts accumulating in our blood.
So, people with Type 1 diabetes need to administer insulin regularly.
| Type 2
In Type 2 diabetes, although the body does produce its own insulin, it is either not enough or has trouble serving as the key to open the gates of the body cells.
This more common type of diabetes does not require people to administer insulin regularly and can be controlled with medicines.
Diabetes and Treks
In trekking or in the wild, two more terms related to diabetes come up – Hyperglycemia and Hypoglycemia. These more common for Type 1 diabetes.
This indicates too much sugar in the blood and not enough insulin. This is generally considered as the only problem of diabetes.
| Symptoms: Dry mouth, increased thirst, weakness, headache, blurred vision and frequent urination
But there is another side of diabetes which is lesser-known and can be more common in the wilderness. Hypoglycemia, an acute condition, occurs when the body contains more insulin than the amount of sugar available.
| Symptoms: Sweating, pallor, irritability, hunger, lack of coordination and sleepiness.
Hypoglycemia is more common on a trek
It is important to understand that people with diabetes usually have a set diet in their routine lives.
But things change on a trek. Their diet changes on a trek.
Your activity level and diet changes on a trek. And Hypoglycemia is common when your body is adjusting to these changes
This means that the regular dose of insulin that one administers at home may need to be modified according to the change in the diet. While some people quickly adjust to the change in dose of insulin, others may take a few days.
During this process of adjusting, Hypoglycemia is a common phenomenon.
| Here’s why that happens.
The insulin administered may turn out to be more than the sugar intake for the day. Some other times, if a person vomits due to problems with digestion or acclimatization, the sugar level drops suddenly but the insulin that has been administered still works in the system.
The only way to deal with Hypoglycemia is by consuming sugar for the insulin that is present in the body.
How to do a High Altitude Trek with Diabetes
Don’t let Diabetes come between you and high altitude trekking. To do that effectively, come prepared and follow certain precautions on the trek.
Preparation before the trek
- Experience: It is important that you have some experience with heavy exercise and temperature extremes. This means that you need to prepare yourself physically by working out and pushing your body limits. It would also be helpful if you could reach the base camp a day or two earlier than expected to get used to the harsh weather. Start with smaller 1-2 days treks around your house to give you an idea of what to expect on longer treks.
- Medication: Carry twice the amount of medication required. Carry something that will make sure the insulin is kept temperature controlled i.e. it will keep it from freezing.
- Sufficient supplies: Carry sufficient supplies of everything that you may need on the trek. For example, insulin, syringes, glucometer, etc. It is also important to keep some spare batteries as they tend to die faster in colder environments. Carry sufficient glucose tabs or gel.
- Practice: Try changing your diet a little bit and practice adjusting your insulin administration starting a few days before coming on the trek.
- Plan: For a sick day, it is important to have a plan regarding your insulin adjustment, food and fluid intake.
Precautions to be taken on the trek
- Food and hydration: It is important to stay well-fed and hydrated at all times. Carry sufficient food supplies for the trails.
- Information: It is important to inform your trek leader and those who are in charge about your condition. Inform them about the immediate steps that you usually take in case of any emergency. Keep people around you updated about your medicine’s location in your bag so that it can be handed out to you in case of emergencies.
- Medication: Keep two separate sets of medication in two different places. If possible, keep one set with those in charge and one set with yourself.
- Blood sugar levels: If you feel the necessity, keep track of your blood sugar level and stay updated of the fluctuations.
At Indiahikes, all trek leaders are medically trained. They will take all the precautions required. All our Trek Leaders carry a fully-prepped medical kit as well as an oxygen cylinder in their backpacks throughout the trek. We are always prepared for any kind of emergencies at each campsite.
Which treks are good for first-timers with diabetes?
Trekking with diabetes is not as difficult as it sounds. At Indiahikes, we have seen many trekkers with diabetes completing a lot of our difficult treks smoothly without any difficulties.
If you are trekking with diabetes, especially doing a high altitude trek for the first time, start with an easy-moderate trek. A couple of my favourite treks are Dayara Bugyal and Deoriatal Chandrashila treks. Both of these treks, although easy-moderate, are a grand introduction to the Himalayas for any first time trekker. They offer magnificent forest trails and views of beautiful high rising peaks.
Once you gain confidence with a couple of treks, you can start doing more difficult treks like Har ki Dun – Ruinsara Tal, Gidara Bugyal and Hampta Pass.
To browse many more of such exciting treks, take a look at our upcoming treks page to decide on your next adventure. Happy trekking!