Overlanding with Diabetes

[Desert Runner]

Maybe more Covid related but diabetics would appreciate the struggle. Fedex has had my insulin now for 3 days and delivery says pending. Impossible to get anyone on the phone. For obvious reasons, I need it now. This covid issue is messing with more people than anything could think of. Even if you don't get the virus.

Fed-Ex is in the scope of things, one of the least you would expect this type of problem with. The USPS......yah, To many are low motivated, and follow the creed of 'It will get there, when it gets there'. For the Fed-EX shipment, you should be able to track your delivery, on your own, and if in your area, at which substation it is at. If the delay is in system,......aka.....in transit to your city, could it be weather?, a accident (ground-truck?). Station managers will/should be monitoring delayed shipments. Calling the domestic help line (airbill/pkg tracking number) will help get the ball rolling from their side also. Of course, calling your medical supply company will put further pressure on the delivery service to remedy the problem.

I worked for a competitive overnight service company for over 35 years, and formal complaints are something Head quarters does look to see resolved. And if it is a driver induced local problem, the station manger should be fixing the problem. Sometimes mistakes can happen, it is the same mistake happening repeatedly, that is a valid concern. Belonging to a local neighborhood chat forum, we had this same problem with a Fed-Ex driver, first mis-delivering to the wrong house, and then,.....DELIVERING THE WHOLE STREETS SHIPMENTS TO JUST ONE HOUSE ON THE BLOCK, like Santa's bag being lost. Obviously this was abnormal, and individually a driver induced problem (personal issues) who is now gone we believe, as the problem went away.

I'm glad this OP was made, and too those who have responded, as it puts out in the open, the challenges we face for being able to get out and travel, enjoying that which limited our ability in the past. Not all of us can afford an electric fridge, and regulating, your drugs, a challenge in a ice cooler, can be difficult. It is good to see how OB members rise to the challenge.

 

[Mr. McPickle]

T2 here. Very cool thread, thanks for posting!

 

[Paula - Canadian Explorer]

My DH was diagnosed with LADA in early 2019 after his annual checkup (Latent Autoimmune Diabetes in Adults). He had about a week of Lantus SoloSTAR insulin shots to regulate his numbers, but has not had the need to take any - yet.
LADA is a slow-progressing form of autoimmune diabetes. Like the autoimmune disease type 1 diabetes, LADA occurs because the pancreas stops producing adequate insulin, most likely from some "insult" that slowly damages the insulin-producing cells in the pancreas. But unlike type 1 diabetes, with LADA, you often won't need insulin for several months up to years after you've been diagnosed. We believe the 'insult' was a terrible flu that he had in 2018.
DH currently monitors his numbers with the FreeStyle Libre. We are still in the early phases. It can take months or even years for DH's pancreas to stop producing the required insulin.

I believe in Canada the assistance is a bit different. When diagnosed, my DH was right away sent to a specialist whom he sees every 3 months. Albeit that he did not even finish his first pen of insulin (not required right now), we changed the diet at home, added more exercises, etc. Right now, he just changes the sensor to his Libre, which is readily available through our pharmacy.

We definitely had to make some changes to the overlanding food intake whenever we travel. We also keep the pen in the ARB fridge in case it is required when we're out and about. However, we have yet to figure out a way to carry it safely when we are on long hikes.

 

[diabetiktaco]

My DH was diagnosed with LADA in early 2019 after his annual checkup (Latent Autoimmune Diabetes in Adults). He had about a week of Lantus SoloSTAR insulin shots to regulate his numbers, but has not had the need to take any - yet.
LADA is a slow-progressing form of autoimmune diabetes. Like the autoimmune disease type 1 diabetes, LADA occurs because the pancreas stops producing adequate insulin, most likely from some "insult" that slowly damages the insulin-producing cells in the pancreas. But unlike type 1 diabetes, with LADA, you often won't need insulin for several months up to years after you've been diagnosed. We believe the 'insult' was a terrible flu that he had in 2018.
DH currently monitors his numbers with the FreeStyle Libre. We are still in the early phases. It can take months or even years for DH's pancreas to stop producing the required insulin.

I believe in Canada the assistance is a bit different. When diagnosed, my DH was right away sent to a specialist whom he sees every 3 months. Albeit that he did not even finish his first pen of insulin (not required right now), we changed the diet at home, added more exercises, etc. Right now, he just changes the sensor to his Libre, which is readily available through our pharmacy.

We definitely had to make some changes to the overlanding food intake whenever we travel. We also keep the pen in the ARB fridge in case it is required when we're out and about. However, we have yet to figure out a way to carry it safely when we are on long hikes.

Lantus is 24 hours slow acting insulin. If you are taking 2 a day (12 hours apart) you may need to take it. However, that's usually to regulate a nighttime spike, etc. W/ that said, if your taking Lantus once a day and going on a day hike there's no need to take it with you. It won't correct a high quick enough anyway. But if you did insist on taking it with you, it cant stay out of the fridge for more than 30 days.

 

[Paula - Canadian Explorer]

Lantus is 24 hours slow acting insulin. If you are taking 2 a day (12 hours apart) you may need to take it. However, that's usually to regulate a nighttime spike, etc. W/ that said, if your taking Lantus once a day and going on a day hike there's no need to take it with you. It won't correct a high quick enough anyway. But if you did insist on taking it with you, it cant stay out of the fridge for more than 30 days.

DH doesn’t take any right now (and yes, pen was used to regulate his extremely high numbers - not only at night) but Doc suggested that he keep it on his person all the time just in case, which he does when he goes to work. Docs calls this phase ‘honeymoon phase’ which will eventually end, we just do not know when (could be in a week, a month or a couple of years down the road), hence why he has to visit the doc every 3 months. Interesting what you said about the 30 days as our pharmacist advised that it needs to be in the fridge (we asked given our travels and long hikes). Later when the ‘honeymoon phase’ ends, they suggested that a device be attached to the body that slowly releases the required insulin. We have not been educated on this device as we’re not there yet.

But you know what, you just gave me an idea: going to ask the pharmacist again next time I’m at the pharmacy. Having DH carry his pen on long hikes is the freedom we seek to conquer, and if this is possible, wow! That would be great.

 

[diabetiktaco]

DH doesn’t take any right now (and yes, pen was used to regulate his extremely high numbers - not only at night) but Doc suggested that he keep it on his person all the time just in case, which he does when he goes to work. Docs calls this phase ‘honeymoon phase’ which will eventually end, we just do not know when (could be in a week, a month or a couple of years down the road), hence why he has to visit the doc every 3 months. Interesting what you said about the 30 days as our pharmacist advised that it needs to be in the fridge (we asked given our travels and long hikes). Later when the ‘honeymoon phase’ ends, they suggested that a device be attached to the body that slowly releases the required insulin. We have not been educated on this device as we’re not there yet.

But you know what, you just gave me an idea: going to ask the pharmacist again next time I’m at the pharmacy. Having DH carry his pen on long hikes is the freedom we seek to conquer, and if this is possible, wow! That would be great.

One main thing I've learned after 20 yrs of T1 Diabetes is that nobody knows more than the people who live with it. No amount of college can educate someone on what the reality is.

 

[Paula - Canadian Explorer]

One main thing I've learned after 20 yrs of T1 Diabetes is that nobody knows more than the people who live with it. No amount of college can educate someone on what the reality is.

So true!

 

[Blackey]

The insulin pens I use don’t require refrigeration I take one out when the last one is used up. I have a little pouch that I keep a pen of both my long acting lantus and my fast acting novalog in with the needles. Befiore a trip I’ll put a box of pens in the refrigerator in the Motorhome fill up the pouch with needles make sure my gms is good thru the trip and some or grab one of the sensor kits and some needles and throw them in the Motorhome. The pouch has everything I need for the trip. The other is just insurance I might even grab a hms kit for the trip if I think Theresa chance of the one in use becoming off ot other wise inoperable. I thought insul needed refrigerated but their are times when that’s not the case unless your above 80 room temperature then it might be wise to cool it then I would double zip lock bag it.and throw in the cooler or fridge when I eventually get one. I take two shots of Lantau daily morning and bedtime and three shots of novalog before meals the novalog is sliding scale where the lantus is same both times of the day day in day out. Check with your prim care doctor, or endocrinologist or the person following you diabetes and see what they say about refrigeration of your insulin they may say yes it’s required or may say if the ambient temp is less than x don’t bother refrigeration.

 

[Jim SoG]

I take Humilog pens for pre meals and I take Lantus twice a day (was once but they split it to cover another spike), anyway I was told that neither needs refrigeration for anything other than storage (till you use them), you can keep them out of fridge (out of heat as well) for 30 days........ Had 2 docs and a pharmacist tell them same thing.

So maybe that will ease some stress on our storage/cooling issues.

Jim

 

[diabetiktaco]

I take Humilog pens for pre meals and I take Lantus twice a day (was once but they split it to cover another spike), anyway I was told that neither needs refrigeration for anything other than storage (till you use them), you can keep them out of fridge (out of heat as well) for 30 days........ Had 2 docs and a pharmacist tell them same thing.

So maybe that will ease some stress on our storage/cooling issues.

Jim

Right, but it's hot from May through October even here in NJ. If you are away for an extended time you don't want to leave the extra out in the heat. Even the pen you are using that day it shouldn't be in extreme temps. If you are away for a week and it's reaching 90 degrees and remote that's not a chance you want to take to kill your insulin. It should stay cool and don't mess with it. Insulin to me is the same as oxygen. I need it to live and wouldn't take a chance.

 

[KILO19]

Type 1, 23 yrs and counting. Started with shots, then went to pump for like 18-20 yrs and now back using pens and shots. Had too much trouble with being thin and the pump getting blocked because of no body fat. Now that I've been using shots, i've gained 12 lbs consistent, and things are a lot better controlled because I know I'm getting the insulin and i'm not fighting all the alarms. I tell all the docs and people asking me why I went backwards, Pumps are great, but for right now, it just isn't for me. Maybe in the future.

I backpack, hike, camp, sorta "overland". and like mentioned above, humalog, novalog, doesn't require refrigeration because its designed to be in a pump all day, that being said, you don't want the temp swings. I have used a cooler and don't do anything special. I carry it in my backpack every day (man purse :( ) when i backpack I just keep it deep inside and away from direct sun.

Cant say this enough, like mentioned the best preventative action is educating people your with. Signs and symptoms of lows/highs and letting them know how you act or what you do in certain situations. People may have family members that are diabetic but they may act differently then you. Make sure there aware of that. Tell them where all your stuff is, sugar, glucagon, shots, meters etc...

Great post, and great to hear others side. "thumbs up"

 

[diabetiktaco]

Type 1, 23 yrs and counting. Started with shots, then went to pump for like 18-20 yrs and now back using pens and shots. Had too much trouble with being thin and the pump getting blocked because of no body fat. Now that I've been using shots, i've gained 12 lbs consistent, and things are a lot better controlled because I know I'm getting the insulin and i'm not fighting all the alarms. I tell all the docs and people asking me why I went backwards, Pumps are great, but for right now, it just isn't for me. Maybe in the future.

I backpack, hike, camp, sorta "overland". and like mentioned above, humalog, novalog, doesn't require refrigeration because its designed to be in a pump all day, that being said, you don't want the temp swings. I have used a cooler and don't do anything special. I carry it in my backpack every day (man purse :( ) when i backpack I just keep it deep inside and away from direct sun.

Cant say this enough, like mentioned the best preventative action is educating people your with. Signs and symptoms of lows/highs and letting them know how you act or what you do in certain situations. People may have family members that are diabetic but they may act differently then you. Make sure there aware of that. Tell them where all your stuff is, sugar, glucagon, shots, meters etc...

Great post, and great to hear others side. "thumbs up"

I was on the pump for 4 yrs. I don't know I'd ever go back to it. Way too many issues with it. The worst was when you'd change the site and your blood would go up to 400 within an hour. Take the site out and 50 gallons of blood comes pouring out. MDI (shots) is way better for me.

 

[Blackey]

I take room temperature as ok as I do not like hot temps above 80 or cold temps below 60

 

[Lanlubber In Remembrance]

Fed-Ex is in the scope of things, one of the least you would expect this type of problem with. The USPS......yah, To many are low motivated, and follow the creed of 'It will get there, when it gets there'. For the Fed-EX shipment, you should be able to track your delivery, on your own, and if in your area, at which substation it is at. If the delay is in system,......aka.....in transit to your city, could it be weather?, a accident (ground-truck?). Station managers will/should be monitoring delayed shipments. Calling the domestic help line (airbill/pkg tracking number) will help get the ball rolling from their side also. Of course, calling your medical supply company will put further pressure on the delivery service to remedy the problem.

I worked for a competitive overnight service company for over 35 years, and formal complaints are something Head quarters does look to see resolved. And if it is a driver induced local problem, the station manger should be fixing the problem. Sometimes mistakes can happen, it is the same mistake happening repeatedly, that is a valid concern. Belonging to a local neighborhood chat forum, we had this same problem with a Fed-Ex driver, first mis-delivering to the wrong house, and then,.....DELIVERING THE WHOLE STREETS SHIPMENTS TO JUST ONE HOUSE ON THE BLOCK, like Santa's bag being lost. Obviously this was abnormal, and individually a driver induced problem (personal issues) who is now gone we believe, as the problem went away.

I'm glad this OP was made, and too those who have responded, as it puts out in the open, the challenges we face for being able to get out and travel, enjoying that which limited our ability in the past. Not all of us can afford an electric fridge, and regulating, your drugs, a challenge in a ice cooler, can be difficult. It is good to see how OB members rise to the challenge.

When I travel I keep my insulin in the same kind of foam container that it came in. To keep it cool for long periods of time I use dry ice in small quantities wrapped in foil and no contact with the insulin. I have a frig-freezer now ($279 Amazon) but it hold all my food that needs refrigeration as well, so it is not expensive when you consider the cost of ice and a decent cooler. VA supplies my insulin and I've never had delivery problems with any of the delivery service people. I do keep a good supply of insulin on hand so that I never have to worry about running out before my next supply.

 

[Brentski]

Hey all! My 8 year old daughter was diagnosed 12/23/20 with Juvenile onset type 1. She is my little adventure girl and has been hiking and trail riding with me since she could walk. I'm really grateful to see this thread! I can't stand the idea of feeling this will be holding her back. I took a pelican 1060 micro case with the foam insert and was able to place her Lantus, Humalog pens, her tester and pen, then used the test strip containers (3 of them, they're like 35mm film containers) for needles lancets and test strips. It's a little bulky, but should keep her kit protected and dry for hiking, camping, and kayaking.

I think it would be awesome find something that keeps her supplies at room temperature.

 

[Blackey]

Try to get her on a glucose monitoring system like the freestyle librelink, or better yet the g6 setup no more finger sticks you can use a monitor they send with the first batch or your smart phone. I had a problem with the librelinks going bad/falling off my arms so I tried my belly area like g6 uses and it works great then I found a band aide type product that helps hold them on and it works great.

 

[old_man]

Try to get her on a glucose monitoring system like the freestyle librelink, or better yet the g6 setup no more finger sticks you can use a monitor they send with the first batch or your smart phone. I had a problem with the librelinks going bad/falling off my arms so I tried my belly area like g6 uses and it works great then I found a band aide type product that helps hold them on and it works great.

I use the Freestyle Libre as well. Horrible accuracy. Half the sensors had to be replaced.

 

[Brentski]

Try to get her on a glucose monitoring system like the freestyle librelink, or better yet the g6 setup no more finger sticks you can use a monitor they send with the first batch or your smart phone. I had a problem with the librelinks going bad/falling off my arms so I tried my belly area like g6 uses and it works great then I found a band aide type product that helps hold them on and it works great.

YES! Last week we got started on the DEXCOM G6, and to your point it has been a game changer! We also have a few cool overlay stickers to make them more secure. Every once in a while when we are high or low we double check with a finger stick, so we keep it handy. I've seen a product called a Freedom Band, which is a velcro arm band to keep the sensor/transmitter secure. Right now Max is wearing her G6 on her belly, but she is interested in wearing it on the back of her arm, and I think the band would keep it really secure when she's getting into the rough stuff.

 

[Blackey]

Yeah use the band with the arm. Were the readings similar when you checked them mine were close

 

[Brentski]

Yeah use the band with the arm. Were the readings similar when you checked them mine were close

It been pretty close, biggest variation we’ve seen so far is about 30 points lower than finger. We understand it reads a different tissue so the timing is a little different. We feel like it’s pretty trustworthy, but when we’re close to a high or low we double check with a finger stick. We are still checking at 2am so it has been a godsend to reach over and look at the receiver, instead of sneaking in for a blood drop.