Question for Type 1 Diabetics that travel to US.

[Irishoutlaw]

Hey Guys.

So another year has gone by as I was diagnosed in 2014 with type one diabetes. I have again traveled to the US to visit family. So here is the thing, my glucose management here in Ireland is always touch and I wake every morning with a reading of around 12ish. When I travel to the US my reading are always far lower ie around the 6-7 mark. Diet remains the same yet I take far less insulin and have far better control. Only difference is the food eaten there is American as apposed to European....

My question is do others experience the same situations.???? Also as a Type one I have been advised that exercise will not affect sugar control without the insulin however on a day trip to New York I forgot my insulin and after a day in the city eating and walking for 8 hours my glucose level was 9.1 when it would normally be well in excess of 20... Any ideas?

 

[slip]

Just wondering if when calculating carbs in the States you're not reading the nutrition labels correctly and so 'over' inject - they count the fibre as carbs so 100g of what ever here would be say 15g of carbs in the states the label might say 20g carbs (5g of which is fibre and not digested by the gut) - just an idea?

Of course you just maybe slightly more active across the pond, or the weather is better or...............?

 

[kitedoc]

Hi @Irishoutlaw, Perhaps holidays and visiting family is much less stressful than being at home, with work etc.?
Stress puts BSL up every time.
As for having less than expected BSL in NY with insulin not taken in the a.m.. ? Combination of exercise and perhaps being on a long acting insulin from say the night before. Some long acting insulins have longer duration of effect in some persons, say 30 + hours with Lantus and up to ? 50 hours with Tresiba.
The lessened stress and the exercise of the days before may have increased your insulin's sensitivity also.
Just some guesses. But enjoy the holiday !!!

 

[Dodo]

Hey Guys.

So another year has gone by as I was diagnosed in 2014 with type one diabetes. I have again traveled to the US to visit family. So here is the thing, my glucose management here in Ireland is always touch and I wake every morning with a reading of around 12ish. When I travel to the US my reading are always far lower ie around the 6-7 mark. Diet remains the same yet I take far less insulin and have far better control. Only difference is the food eaten there is American as apposed to European....

My question is do others experience the same situations.???? Also as a Type one I have been advised that exercise will not affect sugar control without the insulin however on a day trip to New York I forgot my insulin and after a day in the city eating and walking for 8 hours my glucose level was 9.1 when it would normally be well in excess of 20... Any ideas?

I've been to the US a few times and noticed my readings are more stable when I'm there. The only difference I can think of in my case is the fact that I always carry on taking my basal at the same time as I would if I were at home i.e. 6 pm when in New York and 3 pm in California. When I'm home I take it at 11 pm, so I wonder if taking it in the afternoon rather than at night last thing makes a difference with me.

 

[kitedoc]

I've been to the US a few times and noticed my readings are more stable when I'm there. The only difference I can think of in my case is the fact that I always carry on taking my basal at the same time as I would if I were at home i.e. 6 pm when in New York and 3 pm in California. When I'm home I take it at 11 pm, so I wonder if taking it in the afternoon rather than at night last thing makes a difference with me.

Hi @Dodo, A very insightful thought. Are you going to test your hypothesis?

 

[Dodo]

Hi @Dodo, A very insightful thought. Are you going to test your hypothesis?

Probably not as I have since adopted a low carb way of eating and now find my readings to be pretty stable. It is, of course, more convenient injecting my basal at night rather than mid afternoon but for a holiday I thought it better than risking an under or overdose. Some people have previously advised slowly altering their injection time a few weeks before going away and then repeating the exercise when they get back home. Seems a lot of bother for a few weeks holiday.

 

[Irishoutlaw]

Thanks for the reply guys. It really is a mystery but I will continue to investigate. I would agree that I am 100% more active when I visit as I am made to do a lot more walking due to shopping and visiting places and stress is cut right out. In regards to the food it is mostly home cooked potatoes and meats so similar to home really but just different affects. I start pump treatment in a few weeks and hopefully that will level things out.

On a side not I was testing out the Lifestyle Libre before and whilst I was away and had an over all 7.9mmol for last 90 days. Since returning I am struggling to keep it under 10. Hopefully the pump will help to level things out.

 

[kitedoc]

Probably not as I have since adopted a low carb way of eating and now find my readings to be pretty stable. It is, of course, more convenient injecting my basal at night rather than mid afternoon but for a holiday I thought it better than risking an under or overdose. Some people have previously advised slowly altering their injection time a few weeks before going away and then repeating the exercise when they get back home. Seems a lot of bother for a few weeks holiday.

The trick I learnt from a frequent travelling diabetic was to wear two watches. One watch is moved to the new time zone the other says on home time so that basal injections stay set and use bolus insulin for meals whenever they are offered. If there is a stay over for some days, a week or more, than slowing move the basal timing backwards (so that there is no possible gap in action) to a more convenient time.

 

[Deleted Account]

I found travelling much much easier with a pump than injections.
I changed the time on the pump and the basal sorted itself out without a need to worry about time differences.
Just had to remember to change the time back again when I got home.

I can never compare my BG management when I am away with when I am at home because so much changes. If I am away for pleasure, I am far more active and less stressed; if I am away for work, I am far less active and more stressed. And that's without considering what I eat because I get bore so easily my diet is constantly changing - if I eat the same breakfast two days running, I am bored!

 

[Dodo]

The trick I learnt from a frequent travelling diabetic was to wear two watches. One watch is moved to the new time zone the other says on home time so that basal injections stay set and use bolus insulin for meals whenever they are offered. If there is a stay over for some days, a week or more, than slowing move the basal timing backwards (so that there is no possible gap in action) to a more convenient time.

Good idea. Similar to when I was cruising back from New York, continued having my basal at 5 pm over a five day period but it was actually an hour later each day as we crossed the North Atlantic, so that by the time we reached Southampton I was back to my usual 11 pm.