Wilderness Canoe Trips with Type 1 Diabetes
by Sharon Brodin
For those of us who are generally in good health, we tend to think of health on wilderness canoe trips as it relates to emergency situations. “What will we do if someone gets injured?”
But for those who live with ongoing health issues like diabetes, wilderness canoe tripping is a whole different ballgame.
I was on a 3-day Boundary Waters trip in September with my daughter and two other young women who are good friends of ours. One of them was Rachel Anderson, who has Type 1 diabetes. This was a first for both Rachel—her first overnight canoe trip—and for me—my first canoe trip with someone with this serious of a health concern.
When Rachel suggested I write a post for Bending Branches about canoe tripping with diabetes, I jumped at it. Here’s my interview with Rachel…
What were the unknowns for you going into a wilderness canoe trip as related to your health?
RACHEL: I had never done an overnight canoe trip before. Obviously we were way out in the wilderness where we wouldn’t have quick access to a hospital or ER if anything happened. Something I always have to take into consideration is: If something really dramatic happens, how can I contact emergency help?
Rachel Anderson was diagnosed with Type 1 diabetes when she was 10
Because of my diabetes I had to plan for a level of activity that was a lot higher than what I would do on a normal day. Increased activities meant I would probably need less medicine and a lot more backup snacks in case my blood sugar went low. So I brought Ziplocks full of dred fruit, granola bars and protein to snack on in case my blood sugar went low.
Because of the time of year and the cold, I had to think about keeping my medical equipment warm enough, because it’s not designed to function in really cold weather. I kept my diabetic meter close to me, and my other supplies either in an insulated pack or in my sleeping bag at night.
The other thing I had to take into consideration is my diet restrictions. I’m allergic to gluten, soy, nuts and dairy. A lot of typical camping food has those things in it. When we were planning our meals we had to look for brands free of those allergens.
What preparations did you make?
RACHEL: Because the battery life for my diabetic pump isn’t the best, I brought two different battery chargers. And I needed to use them twice on the trip, so I’m really glad I brought them.
Rachel’s most-satisfying accomplishment on this trip was portaging the canoe this entire 232-rod very hilly portage!
I gave my trip mates a mini-training session on what symptoms to look for if I was acting strange or became unconscious. I showed them how they could check my blood sugar for me and give me an emergency shot in case I was unconscious.
I also separated my diabetic supplies into different packs in case something happened to one of them. If one got lost or fell in the water, I had enough supplies in a separate pack so I wouldn’t be completely without.
Before a trip to Nepal a couple years ago, I called a diabetic educator and asked questions. I told her about the kind of trip I’d be on and what we’d be doing, and asked if there was anything I should be aware of or make preparations for. That was actually a life-saving phone call!
She told me if I was in the mountains and far away from emergency services and should get some kind of stomach bug or infection there, there would be a risk of something called ketoacidosis. It’s a serious diabetic complication where the body produces excess blood acids (ketones). She said if that happens when you’re in the mountains, you’re going to need to let your team know that they’ll have to helicopter you out.
That sounded really extreme to me, especially since I hadn’t had any kind of diabetic emergency in over 10 years. Nonetheless, the “worst case scenario” actually did happen, and I had to get helicoptered from the mountain to a hospital. If she hadn’t told me that, I wouldn’t have known what to do and my team wouldn’t have known what to do.
Relaxing at the campsite
What were your biggest concerns while out on the trip?
RACHEL: My biggest concern was that my blood sugar would go really low because of ongoing levels of high activity. I hadn’t done much canoeing before, and both with the canoeing and portaging, I didn’t know how my body would respond.
So I was little bit nervous about knowing how to adjust my medicine dosages every day. One day I had a lot of lows and we had to keep stopping. I was thinking of it a lot in advance but it didn’t really pan out the way I had hoped. It was very much trial and error.
Celebrating the end of our hardest portage
A smaller concern was wanting to be sure I wasn’t hungry the whole trip with the smaller meals and camp-style food, and not knowing how that would affect me. But it ended up fine. The meals were more than enough.
(NOTE from Sharon: Another interesting concern none of us thought of ahead of time was that Rachel had to have a small bag of food in the tent with us in case she had a diabetic crisis during the night. As you know, we’re never supposed to have food in our tents out there because of bears. But in this case, we had to choose which was the most important priority, and obviously it was Rachel. We didn’t have any bear issues!)
What's important for a group to know when canoe tripping with someone with diabetes?
RACHEL: I’ve had people not want me to go on trips with them because of my diabetes and diet restrictions. It changes things.
It’s important to let the group know they’ll have to have some flexibility with the schedule. You do your best to predict the balance of activity and insulin, but your body can do its own thing.
Rachel shows us some of the diabetes medical supplies that are always with her
We probably delayed an hour one day because of stopping multiple times for my low blood sugar. (NOTE: Rachel checked her blood sugar often. If it was too low for too long, she needed to take short breaks and eat something to try to raise it.)
When you’re doing big outdoor excursions, sometimes timing is really important for where you’re trying to go and for daylight. So you need to let your team know there needs to be a little bit of leeway in case you have a blood sugar incident. And you can’t feel terrible about asking your team to wait. You have to be willing to inconvenience the group or you’ll run into bigger problems.
Along with that, clearly communicate your diet restrictions with the food planners beforehand so it doesn’t create frustration or offense. Higher carb meals really impact diabetics, and that’s common trip food. On a trip like this I wasn’t only doing more activity than normal, I was eating some different foods than normal. It affected how much insulin I needed and how long the meals sustained me.
In retrospect I’d be less lenient with making such big diet changes. I’d bring more of my own food or see if the group was willing to do fewer carbs and more protein. For backup, I brought a lot of dried meat sticks and other proteins with me, and those were really helpful.
(NOTE from Sharon: As Rachel was going over her needs and possible scenarios with us, I was a little fearful because it was so foreign to me. I was really glad Emilie was along, our fourth trip mate. She’s a registered nurse, and was very comfortable with Rachel’s diabetic needs.)
A gorgeous September morning in the Boundary Waters
Is there a different between Type 1 and Type 2 diabetes in a situation like this?
RACHEL: In either situation, if you’re Type 1 or Type 2, talk to your doctor before you go.
For Type 2s, activity could really improve their body’s blood sugar levels. So they’d want to talk to their doctor about how to modify their medication dosage with high activity. It would be very different than with Type 1s.
For Type 2s, based on health history, medications they’re taking and their dosages, their doctor might make modifications for a high-activity trip like this. There could be even more variables with a Type 2 diabetic on a canoe trip than with a Type 1.
Did anything surprise you about this whole experience?
RACHEL: Because of the activity level and because of eating slightly different meals, the compensations I made with my insulin were either too dramatic or not dramatic enough. I didn’t need to be so extreme in the modifications with my medicine.
And my appetite surprised me. Because we were doing so much activity, I thought I’d be starving the whole trip. But the meals were more than enough, and I wasn’t even that hungry between meals. I’m a high-metabolism person and usually eat a lot of food. But I didn’t need massive amounts of food on this trip.
Stopping at a portage for lunch
What’s your encouragement to other diabetics?
RACHEL: Don’t let diabetes hold you back from doing adventuresome things! But before you do them, talk to a diabetic educator. They’ve worked with thousands of other diabetics and have seen scenarios you might not have thought of. That’s been very helpful for me in knowing how to prepare and what to expect.
If a worst-case scenario happens, have a plan. It’s good for you and also really helpful for your group so no one’s caught by surprise.
Tell us what you’ve learned about the importance of nutrition for diabetes.
RACHEL: Not all diabetics know this, but how much fat and protein you eat really impacts the stability of your blood sugar. I brought a little container of coconut oil along on our trip because I understand how eating enough fat with my meals stabilizes my blood sugar. I brought things to help balance and complete each meal that other people wouldn’t have thought of.
I’ve been a diabetic since I was 10, and I’m 27 now. It wasn’t until I started working with a nutritional therapist five years ago that I started seeing a huge improvement in how well I was able to regulate and stabilize my blood sugar through my diet. And my energy levels are so much better than they were before, too.
Rachel and me (Sharon), canoe and tent partners for the trip
Any last words?
RACHEL: I had a really, really good time on the canoe trip! It’s always cool to see you can do something like this. I was nervous going into it because of my health stuff, but doing it was so fun. It was awesome to push past the fear and just go for it!
Rachel is a certified Nutritional Therapist Practitioner with her own business, Healthy Is. To learn more about her and nutritional eating, check out her website or follow her on Instagram and Facebook.
Do you need help choosing a canoe paddle for your wilderness trips? Contact our friendly Customer Service team today: 715-755-3405 • [email protected]
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