Cruising with Type 1 Diabetes

Vacation Blood Sugar Stats:

• High: 264
• Low: 31
• 7-Day Average: 158 (Did not include first 3 days of trip)
• 14-Day Average: 138 (Includes all travel but also some pre-trip checks)

I was nervous about taking a cruise for the first time since being diagnosed with Type 1 diabetes and depending heavily on my medical devices. I consulted some forums and scoured the blogosphere for advice.

I quickly got over the traveling by airplane with diabetes and will be taking my first solo flight for work next month. In the past I have depended heavily on Brad to catch my carry on bags through security, so I’m on my own for this unless I end up at security at the same time as my colleague.

Guesstimation at its finest

What worried me the most about this cruise was the food. There’s a lot of food and no nutrition information. With traveling to and from and the 7-night cruise, I ended up SWAG-ing every single carbohydrate count for nine days. 

Guessing the carbs in my food was pretty tough, as well as figuring out timing. It was reasonably easy to figure out the fruit, especially since I could pick up a whole banana or kiwi or a standard cup of melon and breakfast wasn’t bad because I could do bacon and eggs and often opted for an English muffin over the sugar-laden muffins, waffles or whatever. Salad was also always a safe option at lunch and for an appetizer, but who wants to subsist on salad? I eventually figured out the bread for the paninis and guess and check proved helpful for the legendary roast beef at Park Cafe.

Portion sizes for served meals were incredibly reasonable, but desserts abounded. There was always a sugar-free dessert option and a sugar-free ice cream but I pick three bites of chocolate something any day over a sugar-free fruit tart with light whipped cream that still has carbs. If I’m going to bolus for it, I want to enjoy it.

The dessert cases in the cafes and snacks had a sugar-free option (gluten free available upon request, they don’t stick those all in the same case for a good reason). I was pleasantly surprised with the flavor, texture and effect on my blood sugar for the sugar-free cookies (chocolate chip, peanut and peanut butter). They had sugar-free mousse in the case and I tried the vanilla, two bites in I set my fork down. Not great. So I bypassed the other flavors, there was strawberry and I think peach or something that was orange.

The Low-Highs

The first few days of vacation I experienced a fair amount of lows. I would be fine then I would crash suddenly… into the 30s and 40s. That wasn’t fun and often resulted in over treating. Conversely, I would spike very high… yet crash again quickly after eating. So I had to figure it out better or vacation would be a nightmare. I reset my Dexcom parameters, changing the low alarm from 70 to 80 and the high alarm from 160 to 190. This really helped.

When Dexcom buzzed low at 80, we made our way somewhere for a snack and I could eat before going dramatically low. When it buzzed at 190, I rechecked in a few minutes and went from there.

The Gear

While waiting in the Baltimore airport for the final leg of our flight, the lady sitting across from me in the terminal said, “Can I ask you a question about your Dexcom?” and pointed to my leg. The surprise must have showed on my face when I said sure, because she said, “I wear one too, but only on my stomach. Do you find that wearing it on your leg is still accurate?”

“Yes,” I said. “They say it’s only approved to wear on your stomach, but I haven’t had any luck with accuracy there. My leg and my butt are actually the most accurate places I’ve worn it.” Our chat was very brief because she and the two friends she was traveling with agreed to be bumped to a later flight, that actually ended up leaving earlier than the original flight we were supposed to be on together, that was delayed.

I lost faith in the ship’s medical facility when the nurse asked what the thing on my leg was and I showed her my Dexcom and OmniPod, letting her know that it was an insulin pump. She asked when I was diagnosed and I answered two years ago. Her following comments about how I’m not overweight and don’t look diabetic made us realize that she thought I had type 2. (We weren’t in the medical center for me. And don’t worry everything ended up being okay.)

The crew members were very polite when they asked about my tech. The sports staff handling the zip line didn’t give me any trouble, but they did want to know what was on my leg and if it could fall off. They were okay with my explanation that it was a medical device and was actually implanted in my leg.

I got some questions when going back to the ship in Mexico about what my pod was, I said “insulin.” He asked if it came open, I said that no, it was sealed. Their concern is with smuggling drugs. The pod had more insulin in it when I got off the ship than when I went back on! I also got myself an extra wanding leaving Jamaica. But no issues. I did notice that the US is so much more organized with travel security as well.

Now that I’ve changed my Dexcom sensor, I have a nice, bright white oval on my leg… which I suppose is proof that I did get a tan, but even tan Rachel is really white!

Accommodations

Prior to leaving on our cruise I filled out a special needs form with my reservation number and requested accommodations in the form of a medical fridge for our room and a sharps container. I received a confirmation with advice to carry a prescription for the sharps, etc. with me when I travel to the port. *well duh*

When we arrived in our room, there wasn’t a sharps container and there wasn’t a medical fridge. I wasn’t thrilled but the room fridge was actually cold, so I stashed my insulin in there. Later when we talked with our stateroom attendant I told him that I had filled out the forms and needed a sharps container. When we returned to our room that evening this was on the bathroom counter:

It was small but for only two pod changes that week, it would do. I can imagine that someone on MDI could fill that up pretty quickly. I didn’t bother with the medical fridge, but I was disappointed that I went to the trouble of filling out the paperwork in advance and the accommodations hadn’t been made. We had left port by the time I got that request in, so if they had needed to requisition those supplies, I’d have been out of luck.

No one really looked twice when I tested my blood sugar, but I tried to do it discretely and I put my used strips in a bag that I closed at the end of the week and threw in the trash instead of having strips loose in the room’s trash can and possibly making a mess when the can was emptied.

It’s been strange adjusting to life back on solid ground this week because I hadn’t been on a ship since before diabetes. I’m much more in tune with my body from being cognizant of highs and lows, so sometimes the equilibrium adjustments feel like low blood sugar!