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Diabetes and the need for insulin

Discussion in 'Medical Problems' started by PabloElFlamenco, Jun 1, 2009.

  1. PabloElFlamenco

    PabloElFlamenco New Member

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    Hi, this is my first post and I greet you all. I'm planning possibly doing the camino franc?s and did my first training a few days ago, almost five hours with 9.5 kilos on my back.
    I'm a diabetic (type 2) and need to inject insuling morning and evening. This medicine (Novomix 30) may be kept at moderate room temperature for a week or so, but any longer periods the vials are to be kept between 2 and 8 celcius.
    Would there be any medical infrastructure, like "post in advance" to selected waypoints for safekeeping in a fridge?
    Otherwise, I'd have to carry medicine and renewable ice, meaning weight and other more or less inconvenient arrangements.
    Thanks your appreciated advice,
    Pablo (Belgium)
     
  2. PabloElFlamenco

    PabloElFlamenco New Member

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    Newbie camino franc?s with diabetes

    Hi, I've already posted something about the subject on the "medical" subcategory, but I thought I might get a more rapid response in this department.
    Has any member with diabetes done a sizeable trek and what could she/he tell me about it?
    I'm moderately well aware of the problems associated with diabetes, like hypo's and all, but maybe there are things I haven't yet imagined.
    Last week I (slightly stupidly) went off and walked some 22 km with almost 10 kilos on my back, and had my first lack-of-bloodsugar dizzyness after ... 35 minutes ... (took half a tablet of dextro-energy and ...bought a raisin croissant), to have a second attack of weakness at the very moment, after 2 hours of sturdy walking, I was stopping for a ravenous and delicious self-carried lunch.
    So I stand warned about hypo's.

    Basically, I think doing such a tremendously long trek should not be a major problem for a (moderate?) diabetic, but all warnings and experiences are more than welcome. Whilst I'm not in particularly good physical shape, last week's experience did reassure me, and I'm to some extent banking on my prior knowledge of marathon training (in a previous life, admittedly) to provide general guidelines.

    I've read the Roman legions had a 3-day walk, 1-day rest schedule which I like to let me be inspired by.

    There's so many questions! :)

    Pablo
     
  3. Leslie

    Leslie Administrator

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    As far as I am aware there is no post in advance service. The Camino routes have a reasonable infrastructure but they are quite informal.

    There are however many chemists along the way and I would think you would get to one ever day or two, you would have to check for the size of towns the route passes through.

    The room temperatures are not moderate during the summer in Spain, it is hot mostly and the albergues can be hot and stuffy at night.

    Hope some of this helps.
     
  4. Sil

    Sil New Member

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    Diabetes and the camino

    Try Frio wallets (to keep medication cool).
    This was reccommended by a diabetic pilgrim a couple of years ago:

    " I would personally recommend the Frio cooling wallets to any diabetic who needs to take their insulin with them. I would also be happy to answer any other questions that arise. Look at IDEA2000 - International Diabetic Expedition to Aconcagua in 2000 for more information about IDEA 2000, and the successes that we achieved, with great support from Frio!
    clare_todd@bah.com
    http://coolerconcept.com/pages/testamon2momtainclim.htm
    http://advancedspanishforpharmacist.weebly.com/diabetes-glossary.html

    If you would like a copy of an article written by a diabetic pilgrim, please mail me off forum at: sillydoll (at) gmail. com
     
  5. Darren from Dartmouth

    Darren from Dartmouth New Member

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    Hi Pablo,

    I am starting my pilgrimage in a few weeks. I am from Canada and the Canadian Diabetes Association has some good information on living with diabetes. Here is the link:
    Physical Activity and Diabetes

    Hope this is helpful, good luck on your journey.
    Darren
     
  6. PabloElFlamenco

    PabloElFlamenco New Member

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    Hi Darren. Thanks a lot for the link, it does contain useful information. I've already hinted that I'm training; basically I've been on a "10thousand" steps per day program for a few years already, but I'm upping that considerably now. Like yesterday, I walked 2 hours and 15 minutes, with only a water-carrying little backpack, without any problem other than the aching achilles tendon last week's foolish 22km+10 kilo outrage triggered. I'm doing a daily ice pack and wearing an anti-inflammatory patch. Luckily I still have near 3 months before I'm due to set off to St-Jean...

    My guess is that the hefty training program I feel is necessary before even thinking of doing such a trek, will as a matter of course reveal any "diabetic related" problems there may be. I always carry sugar on me, anyway.

    The only problem is how to keep the required medecine (insulin) between 2 and 8 degrees centigrade for some 5 consecutive weeks...I think I'll surely have to make do with carrying a styrofoam+ice pack combination whilst walking, then putting everything in a freezer (the ice for next day) and refrigerator (the insulin) infrastructure during the evening and night.

    Oh yes, Darren - I wish you a good pilgrimage. Franc?s?

    Pablo
     
  7. PabloElFlamenco

    PabloElFlamenco New Member

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    Sil, other than being a beautiful river and valley in Galicia, you're a darling (if you don't like that qualification too much, change it to fit! :)

    I'll have a close look at your links and if I have any further questions, I'll come back to you via email. I indeed think some kind of carrying pack will be the best solution. Buying insulin "en-route" would be an expensive and wasteful alternative: Novomix 30 is sold 5 vials a a time, (enough for 4 weeks or so), costing around €50 (even if Belgian social security would probably refund it to me, I can't condone using 1 vial and throwing the other 4 away because overheated).

    Kind regards,
    Pablo
     
    Last edited: Jun 3, 2009
  8. Sil

    Sil New Member

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    The name Silvia is Oihana in Basque. It means forest or woods in most cultures so I really like being likened to a beautiful river.
     
  9. PabloElFlamenco

    PabloElFlamenco New Member

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    Sil/Oihana, ok, you're a lady (most men would probably object to being described as a "darling", whereas -in English- it doesn't have, I believe, too many "funny" connotations, provided it be used to address a person of the female gender. Basque? RSA? Ok!

    I'd like you to know I've, as a result of your assistance, ordered a suitably sized "Frio" pack for my insulin. I found it being highly recommended also on some Dutch websites and by the "Flemish Diabetes Association" so, the problem is therewith SOLVED.

    I'm very grateful.

    Today I also went to buy some new shoes (Meindl Bernina). They fit like a (wide) glove and appear an incredible improvement to the 12 year old very heavy klunkers I was hitherto moving around in.

    And I announced my plans to my boss and he thinks it's great.

    How about that!

    I now have almost three months to train.

    Que le vaya bien, Sil.
    Pablo
     
  10. Sil

    Sil New Member

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    I admire you - some might have used the diabetes as an excuse! If you would like a copy of the diabetic peregrino's article, let me know.
    un abrazo,
    Sil
     
  11. PabloElFlamenco

    PabloElFlamenco New Member

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    Yes Sil, I would love a copy of that diabetic peregrino's article, just to read about HIS problems, especially if there's anything in there specific to diabetes.
    There's really no justification for admiration (of course I like it, but that's contrary to the spirit of being a pelgrim). I admit I stopped running after diabetes was diagnosed (in fact, no: it was diagnosed after I stopped running already!). But my form of diabetes is quite moderate, with blood sugar levels never beyond "220" (metric measurement). I know of diabetics who measure ... 400+ at times. Now THAT would worry me!
    Doing the camino has been a very vague idea of mine for many years, without ever getting to it. I did my youth on grass, caf?s and motorcycles, my middle age working and jogging (5 marathons) and the first peregrino's I ever saw were between L?on and Astorga when I stopped my Porsche because I needed to pee. Now I'll be 60 end of August and I can have a period off from work (there IS no work due to the crisis) and I said to myself: now or never. My wife gave me the green light. I'm sure the excercise will be very good for my diabetes. Just have to avoid making mistakes and always (always!) carry "fast" sugar (dextro energy).

    But I'm getting carried away...I'm a forum beast, at times.

    Un biqui?o,
    Pablo
    (P.S. Another reason for the camino: I speak Spanish and want to immerse)
     
  12. Jas

    Jas New Member

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    Diabetes and the Camino

    Hi Pablo,

    I have just completed the journey from St Jean to Satiago and returned home to England. (It was a brilliant experience!) I am writing an article about diabetes and the Camino I will be submitting to the English Confraternity magazine. I am waiting to have it reviewed by my diabetic consultant. You sound as though you are being thoughtful and I should say you will cope well.

    I kept my insulin cold with a Frio container as advised by others. It seemed to do the job well. To me the surprise is that I had to reduce the insulin I injected by more than 50%. It sounds as though you might have to reduce your dose too once you are walking. Carry emergency food. I found dried apricots and figs helpful but also nuts (almonds and cashews).
    • Test your blood sugar very regularly and adjust your insulin dose as needed.
    • Carry at least a day’s supply of food at all times for emergencies.
    • Make sure your food and test kit are easily available (or you might be tempted not to bother).
    • Consider going with someone who knows you well and recognises your sugar low symptoms.
    • Eat as regularly as possible.
    • Look after your insulin and carry a spare pen.
    • Drink plenty of water. (Of course this does not only apply to diabetics.)
    • Be very careful of your feet. Change your footwear (shoes and socks) as soon as the day’s walking is done.
    I suggest you try to do three successive days walking. That will give you a better idea of the effect of walking day after day. Rest days are a good idea but most people don't take them so you will find you are among a different group of people after every rest day.

    Come back to me if you have any oher questions. Otherwise enjoy the experience!

    James
     
    Last edited: Jun 5, 2009
  13. Leslie

    Leslie Administrator

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    Thanks Jas,

    I think this is great information, I have moved the thread to medical and made it sticky to stay at the top of this forum.
     
  14. PabloElFlamenco

    PabloElFlamenco New Member

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    Absolutely Leslie, Jas' advice is very welcome and excellent. Without having any direct first hand experience, his recommendations are plain common sense in a diabetes environment. There is no doubt in my mind the need for insulin should, indeed, drop considerably. How much is, of course, to be fathomed "empirically", as there is no way to calibrate that information in advance.

    To demonstrate this to non-diabetics (or those who have no idea what it is all about in actual practice), insulin injections are necessary compensation for the fact that the pancreas doesn't produce natural insulin. When the pancreas doesn't function properly, great masses of food sugars accumulate in the blood circuitry and effectively act as poison instead of, as is ordinarily the case in healthy people, "energy" (for the muscles).

    I can well imagine injecting my usual morning dose of insulin, starting to walk, and -within a reasonably short period of time- suffer from a "hypo". In one practice walk, this in fact happened after a mere 35 minutes. For the non-initiated (some rite! :D), a "hypo" is when there in not enough sugar in the blood: in my case I start sweating, feel "wobbly", I get confused, and ...ravenous hunger. The standard solution is to immediately eat some "fast" sugar, in the form of one "dextro energy" sugar tablet. It is better to stick to one tablet only, as injestion of more sugar quickly leads to the opposite situation, with soaring blood-sugar levels.

    It's pretty much a matter of ...equilibrium. Like everything in life.

    Anyway, thanks for this discussion. There ain't no taboo.

    Pablo
     
  15. Jas

    Jas New Member

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  16. PabloElFlamenco

    PabloElFlamenco New Member

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    Once again, thanks to all, Jas in particular for that link.
    I have, in the meantime, been doing my practice walks, in line with a schedule weaned from, I believe, somewhere on this forum. It's another month before I take off from Salamanca northwards via V?a de la Plata/Sanabr?s.

    Yesterday, I walked just short of four hours, I would guess about 19 km, with 4 kilos in my backpack. No problems except fatigue upon getting home... Blood sugar 94 (metric) which is a very good value (for reference: I should stay under 140 or so); I ate a moderate amount, maybe total 50 grams, of grilled peanuts + dried raisins en-route, and drank about 1.5 liters (only: weather was sometimes rainy and it was not very warm, maybe 21 celcius).

    I'm very careful with my feet. Wearing my over 1 kilo each Meindl klonkers (B-rated), with a heel pad to soften impacts there. I've been daily dabbing my feet with caphor alcohol, and before stepping, anoint my feet either with Gehwol foot cream or sprinkle them with mentholated talcum powder. I found that wearing two woman's nylon stockings (the mid-calf type :eek:) under my thick woollen socks does a perfect job in avoiding blisters, much better than the Nike thin running socks that would be the alternative to stockings. In spite of being thin, these running socks are much thicker than the 2 x 20 denier nylons. The drawback is, nylons do not have a very long life.

    All in all, I fully realize it will be very difficult doing an average of 20 km per day for 24 days (Salamanca to Santiago is approximately 480 kilometers). But such is the nature of the beast.

    Paul
     
  17. Hello everyone,
    I am writing this post to ask about a friend who I might ask to walk the Camino with me. He's a type 1 diabetic but his blood sugar stays fairly level if he gets exercise regularly. He doesn't have any problems with his feet (that I've heard of) and is in relatively good health. I know that a big concern of his would be the availability of emergency services as he has suffered from seizures during hypoglycemic episodes. Is it fairly possible to get transported to a hospital along most of the Camino? Are there better areas to walk than others so he can feel more secure about the availability of emergency services?

    Thank you for all your thought and advice.
    EK (USA)
     
  18. stevelm1

    stevelm1 The Happy Peregrino Donating Member

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    This link does not work for me. I have logged in and retied, but no joy. Has the article been taken down?
     
  19. Leslie

    Leslie Administrator

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    Hi @stevelm1

    the confraternity have updated their website without putting in place redirects.

    This happens a lot with site when they update, perhaps having a search round their site and you might find the page at another location.
     
  20. LAI3

    LAI3 -Luther, Minnesota, USA

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    For the diabetics who have walked, did you have an issue finding proper food when you needed it? I've read that breakfast sometimes is a piece of toast and coffee, followed by a pastry and coffee mid morning, and if you get too late in the aft, most everyone is on siesta and closed. Also wondering how easy it is to find a sandwich in the morning to bring along? Thanks for any help! -Luther (type I).
     
  21. Jas

    Jas New Member

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    Hi Luther,
    See my post of June 2009. I usually got up very early and walked for an hour before stopping at a convenient cafe for a coffee and whatever they could offer me to eat. At that point I would do my first injection. Often I could buy a sandwich (bocadillo) at that point for lunch. For me the salient, and surprising, point was the extent to which I had to reduce my insulin dose. I was making regular tests. I also carried food such as dried apricots, dried figs and nuts in case I felt low. However I am aware when my blood sugar level drops (I become sweaty and feel wobbly) and to date I have never needed assistance due to going too low. I realise that is not true of everyone. For me it was a brilliant experience in so many ways. If you are interested you can access my book on www.lulu.com/uat for more background information, or come back to me if you have any further questions.
     
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