Type 2 Travelling with Diabetes

bigphillystyle said:

Hello everyone. I was diagnosed with T2 Diabetes in July of this year. It's been a struggle in terms of educating myself through GP and hospital consultations, books, online media etc. but I finally feel like I'm getting to grips with most of it, at least. My Hba1c at last count was 54 from 73 when I was first diagnosed, so I feel at least I must be doing something right (even though it doesn't always feel like it).

Cutting to the chase, though, I just want to know how everyone copes with travelling long distances with their diabetes. In September, I went up to Bristol for my son-in-law's kid's birthday. My wife and I travelled up there by train and I stocked up adequately on food and water and such, and aside from feeling quite uneasy about travelling through London, I managed the whole trip with no mishaps either way (in terms of hypos or hypers). For the return journey, however, my daughter in law offered my wife and I a lift part of the way we were going, thus being able to bypass London altogether. In theory, at least in my mind, I felt this would probably be better for me, in practice it wasn't. I again had adequate supplies, left Bristol on a slightly higher sugar reading than I'd normally care for (13.7mmol), and tried to ration myself throughout the day. I suppose the inactivity of being sat in a car rather being active through the London train route made me feel that much worse, it was extremely hot that day, I hardly lowered my sugars until we got home, and, of course not being able to go to the loo until almost every other service station made for a very un-enjoyable journey home.

Click to expand...

Hi, and welcome! Been a T2 for over 2 years now, and so far, so good. Without knowing your meds I can't say much, but as you mention hypers and hypo's, high bloodsugars while travelling and needing the loo a lot, you probably are running a little high all the time. Are you using insulin? Have you read any of Dr. Jason Fung's books, maybe had a look at dietdoctor.com? Because better control would make travelling so much easier. Diet could crush your symptoms, possibly get T2 into remission even, and make life in general that much better, so maybe something to look into? And remember, hot weather tends to throw us off. During the heatwave I was all over the place, while I'm usually steady between 4.5 and 6.0. Nothing much we can do about it, alas.

Good luck!
Jo

Have you read the advice on www.diabetes.co.uk about travelling?
This website has an amazing diabetes reference library as well as very informative forum members.
Go to the Home page and then select "Living with Diabetes" where you will see all sorts of things such as Driving, Employment, Fitness and Travel.
I recommend you check it out ... and the other great information available.

Hi @bigphillystyle,
I can certainly feel more stressed if I am a passenger in a care rather than driving it.
Stress pushes my BSL, as does inactivity (compared at least to my day to day at home routine).
And I have to up my insulin more for when the another driver is driving than if i am.
On long train trips the lack of toilet facilities seems bizarre. No periodic rests in station for a ''rest break"?
However not being aware of the times and distances involved I just raise it as a question for all those that have toileting needs all or some of the time??

@bigphillystyle
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

Yes, it is difficult to maintain a diabetes level while traveling. Here you can get a proper detail about Type 2 Diabetes. Proper supplements and a little caution may aid you to enjoy the trip.

bigphillystyle said:

Hello Jo. I'm on 2 500mg Metformin and 1 85mg Gliclazide at breakfast and the same at dinner. Sometimes my meds help, other times they hardly touch the BG levels until later on.

I haven't read those books, but that is definitely something I'll look into. Thank you for the recommendation.

You saying about the heatwave, my God, that was terrible. I was all over the show when I was first diagnosed.

Click to expand...

Have you changed what you eat at all?
A lot of us have got off all medication by changing our way of eating which can make travelling a lot easier to cope with without the worries of hypers and especially hypos.

bigphillystyle said:

Hello Jo. I'm on 2 500mg Metformin and 1 85mg Gliclazide at breakfast and the same at dinner. Sometimes my meds help, other times they hardly touch the BG levels until later on.

I haven't read those books, but that is definitely something I'll look into. Thank you for the recommendation.

You saying about the heatwave, my God, that was terrible. I was all over the show when I was first diagnosed.

Click to expand...

As an unmedicated T2 I'm not supposed to get hypo's, but I sure got hit with some this summer. (38 degrees was insane!). So if at the time you were still new to T2, the weather must've been quite the additional shock to the system.

As @daisy1's info states, practically all carbs turn to glucose once ingested, and as T2's we're not very good at processing that back out again, so cutting carbs can make a world of difference. More than the meds can, actually. (Metformin doesn't do much of anything for ingested carbs/glucose, mainly just tells your liver to dump less sugar in the morning and negates hungerfeelings some, supressing appetite. Gliclazide can lower glucose, but it does depend a bit on how many carbs you're eating.). You could change your diet, but that could mean the gliclazide will give you hypo's, so do be careful and test, test, and test some more. Plus keep hypo-treatments handy (cookies, jelly babies, DextroEnergy). Carb heavy foods are bread, rice, potatoes, pasta, corn, cereals and fruit, save for berries, avocado and a couple of cherry tomatoes. If you ditch those, that'd make quite a difference and might impact your HbA1c even further. Things that have very few, if any carbs, are meat, fish, above-ground veggies, double cream, full fat greek yoghurt, cheese, butter, nuts, olives.... For me, meals look like this: 3 eggs with bacon, cheese and maybe some mushrooms or cherry tomatoes. Sausages even? (If they're high-meat content). Maybe a green salad with a can of tuna, mayo, capers, olives and avocado, or a salad with goat's cheese and a nice vinaigrette. In the evenings a good chunk of meat or fish, and broccoli- or cauliflower rice with bacon and cheese (bacon and chese are my staples. ). For treats I have cheese, pork scratchings, olives, or extra dark chocolate (Lindt 85%<3 ). Might be something in there for you? In any case, I've found it easier to travel and actually do spontaneous stuff once I got my bloodsugars under proper control. No unpleasant surprises like needing the loo every 10 minutes or my heart racing and sweating buckets due to hypers. (HbA1c is currently 34, haven't been over 42 in 2 years). That took care of a lot of complications as well.

Just, again, if you do decide to change your diet, keep an eye on your bloodsugars, and better yet, talk to your doc beforehand. They're not always up to speed with the latest in T2 treatments (I know my GP wasn't at the time, and neither were either of my dieticians and my endo...), but it's worked for quite a few people here, so who knows, the doc could be in the know, AND that helps if your meds need adjusting...

Good luck!
Jo