After a week of seeing patients in clinic as part of my dietetic internship, spending some time in the mountains was just what I needed this weekend.
Clearly it’s always better to adventure with a buddy, but adventure buddies who are willing to spend hours trekking up hill with you are sometimes in short supply. If you can’t find someone to join you, should you just stay home? I say nay!
Some might consider hiking alone with type 1 diabetes a risky undertaking. Although hiking solo with a chronic illness comes with a set of extra risks, in my opinion nothing is out of the question if we take some extra precautions.
Here are a few of my t1d trekking tips:
1. Travel with treats
Bring twice as much glucose and food than you think you need. Hiking is good exercise and your BG may drop unexpectedly. Differing conditions such as heat/cold, altitude, wind, and terrain can all affect your blood glucose on the trail. For a day hike I try to bring at least 5 energy gels ( I like the honey stingers) in case I go low as I climb. I also bring a Cliff bar or two for some longer lasting energy if needed.
2. Bring lots of water
Getting dehydrated sucks, and getting dehydrated with t1d can be dangerous, so pack extra water. I usually try to bring a liter for every hour I plan to hike, sometimes more if I’m hiking in the hot sun. I usually fill a 3 or 4 liter bladder with ice and water and stick it in the hydration sleeve of my backpack before setting out. Bladders are great because they allow you to drink on the go, rather than stopping every time you need a sip. My go to is the CamelBak Crux reservoir, but there are plenty of other great hydration bladders to choose from, depending on how much you are willing to spend.
3. Have a remote hiking buddy
You may not always be able to find a friend to hike with you, but chances are there’s someone in your phone book who you can inform of your plans. Tell someone where you’re going, what trail you’re planning on taking, and approximately when you expect to be back. You can also stop by the visitor center if you’re hiking in a state or national park, and let someone there know where you are headed.
4. Carry an insulin Pen or Two
Even if you’re exercising you may still need insulin. Although I have a pump, I like to carry an insulin pen with fast acting insulin (I use Novalog) when I hike for back up. You never know when a pump site may get ripped out, so it’s a good idea to have back up. If I’m hiking somewhere sunny and hot, I try to store my insulin next to my big bottle or bladder filled with ice water. Insulin cooling cases such as the one made by FRIO are also a great option for keeping your insulin cool.
5. Fuel Properly Before and During Your Hike
I feel like I need to include this as I am a grad student studying nutritional science. Protein, carbs, and fat are good fuel for a day of physical activity. It is ill advised to head out on a solo hike with nothing or something insubstantial (say just vegetables) in your stomach. Make sure you’ve had a good meal, preferably one that includes carbohydrates, fat, and protein (your 3 macro nutrients). In my personal and professional opinion, it’s not a great idea to experiment with keto before a strenuous hike. My go to pre hike breakfasts include: a breakfast burrito with scrambled eggs and a whole grain tortilla or oatmeal with peanut butter and fresh fruit. If you’re going on a long hike, it’s a good idea to prepare a solid snack or two or lunch that includes both protein and carbohydrates. My go to snacks include: crackers and cheddar cheese, crackers and salami, an apple and mini peanut butter packets, or a cliff bar.
6. Consider Reducing your Insulin Needs
Speak to your endocrinologist about tips for reducing hypoglycemia during exercise. Some of the best advice I have gotten from my endocrinologist is to utilize the temporary basal feature before starting a workout or when you notice your blood sugar dropping to prevent lows. We all respond differently to exercise, but what has worked for me is to reduce my basal by 60% or even shut it off for an hour prior to beginning exercise.
7. Get Familiar with the Trail you are taking
Bring a map and know how to read it, and if you want to navigate the old school way bring a compass. My go to is using the AllTrails app which allows you to track where you are on the trail and to follow someone else’s tracks. It’s been very helpful when the trails are not well marked.
8. Stay on the Trail
That trail through the brush that you think is a shortcut may in fact be a couple mile detour, so don’t take it. This is just good advice for everyone. Do your best to stay on the trail, and you will reduce your risk of getting lost and injured and disturbing the local habitat.
9. Check your blood sugar
Keep an eye on your blood sugar throughout your hike. If you don’t have a cgm make sure you bring your test kit and test before during and after. If you do have a cgm, still bring your test kit for back up, and turn your high and low alerts on. I usually try to start a hike with a blood sugar anywhere from 120 to 170, and if possibly try to stay between 80 and 150 throughout the hike.
10. Have fun!
Getting too worked up and frustrated about your blood sugars is never fun. All we can do is try our best to be prepared and slow down, speed up, or take breaks when we need to. Try not to get to focused on the blood sugars and take some time to enjoy the outdoors!