Diabetes in Paradise


To most people, eight days in Hawaii sounds like a dream.  And while I’m not a sit-on-the-beach kind of person at all — in fact, I hate both the sun and salt water — I am currently one of those people.  My husband and I are on Kauai right now, and there are enough activities — from hiking the Na Pali Coast to kayaking the Wailua River — to keep me very well entertained.

But bringing diabetes to paradise is challenging. Most of my vacations tend to be in cities — or, if not urban areas, places where it’s warm enough that I’m not tempted to jump into every body of water that I come across. As such, it’s no problem wearing an insulin pump or a continuous glucometer — I tuck them under my clothes, keep my shirt on, and enjoy my travels.  Hawaii’s different — not only is there the fashion challenge of matching bathing suits with insertion sites (those I don’t care about too much) and coming up with clever ways to tuck a pump into a sundress, but there’s the basic issue of the water: oceans and diabetes gear are not a good match.

I have adhesive problems with my CGM when I’m at home lying in bed, so I realized there was really no point in trying to get my sensor to stick to my skin for an hour’s snorkeling, let alone a week by the water. (Plus the fact that I doubt the electronics would react well to salt water.) So that’s out the window — it’s back to finger sticks. And then there’s the question of the pump: I’m careful to disconnect it and close up the catheter with the little plastic cap that comes with every QuickSet — but how effective are those really when it comes to keeping water and bacteria off of my puncture wound? (Not so much, if my last site was any indication — hello, red, swollen skin.)  And, of course, there’s the insulin problem: take the pump off while you swim, and you’re risking a high blood sugar when you come back to shore. Some people I know deal with this situation by going “untethered” while on vacation — temporarily switching back to just shots. But it’s been a long time since I’ve been on Lantus, and switching back — especially when I’m getting so much exercise — scares me. So my pump is still on.

All this is worth it, of course — I’ve only been here three days and so far have had schools of fish follow me while I swam, and watched a pod of breaching humpback whales (whale-watching = very diabetically friendly). I’m also finding that spending much of the day outside moving around can do a good job of  counteracting one of the other main dangers in paradise: the fruity cocktail. (I mean, seriously, people — are you trying to kill me?) But even when I manage to say no to strawberry daquiris, I’m also having an unexpected reaction to spending so much time outside: a day in the sun (which I had today, despite my best sunblock efforts) makes my skin feel  hot in exactly the same way as a high blood sugar. So I’m sitting here on the couch, several hours after eating, completely convinced that my blood sugar is sky high. In reality, I’m just dehydrated. Maybe I should reconsider that daquiri after all.

Got any tips to share on how to vacation with diabetes (besides leaving at home)? Do tell.

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