UKC

If you're diabetic it may seem as if multi-day walks in the wild are a step too far; but don't be deterred, says outdoor instructor and diabetic Ailsa Graham. Here she shares tips for managing the condition out on the trail.

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Thank you so much for writing this article. I am a diabetic and have been hill walking and backpacking for years. Currently I am doing the Cambrian way in long weekend sized chunks.

Lots of useful info in the article add still lots to learn about diabetic management but as you say it should not deter people.

Thanks again Ben

My wife did the Pyrenees haute route solo, the alpine GR5, and the haute route with type 1 diabetes.

I'll point her at this article to see if she has anything to add tips wise.

Regarding refrigeration in summer heat spells, one could get a phase change material pack to keep the insulin below 30°C and above 0°C. A PCM with a phase change temperature of say 15°C should keep it above freezing and below thirty a considerable amount of time in a wide range of conditions, depending on its mass and insulation of the case.

I believe PCM cases for carrying insulin already exist on the market?

The PCM can be freely "recharged" overnight just by letting it freeze outside or in a cold water stream – you just need to get it bellow its melting point for a long enough time, which should be doable with the 15‑20°C PCMs anywhere there is colder running water outside even in the summer.

Brilliant Article! I've been Diabetic coming up on 20 years, testing the condition is all kinds of environments climbing and walking. CGMs were an absolute game changer being able to anticipate Hypos and fight back with Jelly Babies. I'm currently experimenting more in the outdoors with a hybrid close loop systems- would love to connect with people and compare results.

Re keeping insulin cool, I've found the Frio pouches to be very effective. They work by evaporative cooling, so need to be exposed to a flow of air and be "recharged" every couple of days. Keeping them in a rucksack@s outside mesh pocket seems to do the former, and finding plenty of water isn't usually a problem in the UK.

The UIAA has put together some info on this in the past (with some contribution from UK volunteers), it gave my diabetic partner some helpful ideas:

https://www.liebertpub.com/doi/full/10.1089/ham.2018.0043

She seemed pretty happy with her Breezypack when we were in France back in June:

https://breezypacks.com/

I climbed the nose on el cap with a diabetic over 5 days. So much is possible. Although running out of food on the last day proved unwise.....