Diabetes 2, pen & pills, no daily checkups

[PILGRIMSPLAZA]

I got an invitation to walk to Galicia and my diabetes specialist just promised to support me all the way by phone so there should be no problem at all! Untill now I thought I couldn't do it...
On this Forum there are already a few dozen posts on diabetes and diabetic and I PM'd with a few members but I'm still looking for a pilgrim with diabetes type 2, using a pen (not a pump) once per day, consulting the specialist only some 4 times per year, being 'stable', having hardly any hypos!
My main concern is how to adjust the daily doses of pills and insuline (Metformine, Gliclazide and slow working Lantus) to loosing a lot of weight. Now I'm a little over 100 K, 69 of age and male. Normally I only measure blood sugar levels a few days before the next checkup each trimester.
Anyone?

 

[Marilyn Canada]

I walked the Camino Frances in 2008.....juggling 3 daily injections of rapid acting insulin (Novo-Rapid) and 1 daily injection of long acting inulin (Levemir) and metformin tablets.....and other medications as well.....my meds and supplies weighed over 7 lbs in my backpack!!

With the Rapid insulin...my main concern was low B/S....so to prevent it...as well as eating fruits and veggies...for once I got to eat lot's of Nestle Chocolate!!!!

My B/S levels are very sensitive to exercise.....not everyone's is....based on my experience I would suggest you take lots of glucose testing supplies...and to test your sugars several times each day .... I was testing 8+ times a day at first.....you will see your B/S levels change.....I once joked that the cure for my diabetes was to walk 25 klms a day...everyday....

Your training walks should give you an idea of how your B/S levels are changing, with the increased exercise levels. Depending on how sensitive your body B/S levels are to exercise...you will likely find that you can cut back your Lantus with walking 25 klms a day.....but keep taking the Metformin ... I'm not sure about the Gliclazide, if it causes low B/S levels...then you could likely consider lowering the dosage.....BUT....discuss all this with your specialist.....

Lot's of testing will give you and your specialist the info you need to make any adjustments....buy a good lightweight glucose meter and take lot's of supplies with you...

Hope this helps and buen Camino,
Marilyn

 

[PILGRIMSPLAZA]

I walked the Camino Frances in 2008.....

... and we did some intensive posting and PM'ing then, remember Marilyn? I wonder how you are doing today? Thank you for your new reaction; I'll discuss it with my specialist. A new question came up: how easy or difficult is it on the Camino to weigh one's weight? In the meantime my original question remains: anyone out there with diabetes 2, pen & pills and no daily checkups?

 

[methodist.pilgrim.98]

I have walked four times just on insulin via a pen.

I have walked twice on tablets + pen.

I have now walked twice on a pump.

Everyone of us has a different Metabolism.

I think you are looking for an answer that we may not be able to provide. Even if someone was on your regime and had written down the number of every tablet they had taken and how much insulin they had injected, it might be of no use to you. Indeed, it could be dangerous because your needs might be very different. If you followed their plan you could find you're blood sugar levels running far too high or too low.

The standard advice is reduce your insulin by 50% and if that is making you hypo then cut it to 40% and so on. In 1998 and 2004 I was taking an average of 30 units of fast acting insulin for breakfast and had to reduce it to 5 units. I halved my long lasting insulin. I still hypo'd. Frequently. I just drank pure coke and then ate some biscuits.

My sugar levels bounced dreadfully but for the length of the Camino that was a price worth paying to do it.

When I got home I was back to being stable after a couple of weeks and regained the weight I'd lost on the walk though it took several months.

You are going to have find out by trial and error. I appreciate you are not used to doing lots of blood tests, but if you want to go on the Camino that is what you will have to do. Make sure you carry plenty of strips.

I think you only have a problem if you do not recognise the hypo warning signs. If they are clear, don't ignore them. Drink a couple of mouthfuls of coke (or any high sugar drink), eat a couple of biscuits and carry on. If the hypo doesn't clear then you need more coke+carb.

Marylin is right. Start walking locally. Do blood tests before, during and after your walk. Record the results and talk to your specialist on how to interpret them. Do blood tests the day after because the effects of exercise can be with you for up to 24 hours later. As you go build up the weight in your backpack.

If you have a companion as long as they know what to do if you have a bad hypo then you are going to be ok. Your specialist can be reached for advice via a mobile phone, a luxury I didn't have till 2009, so I think you will have to take a deep breath, recognise that the Camino will be taking you out of your well regulated control, and just go for it.

I will add that I have never been able to gain good control of my diabetes, even doing everything by the book. I have never lived in the comfort zone of good control and not having to do many blood tests. Going on the Camino makes me anxious, but it is not terrifying.

If I am right you are very well controlled, with a stable weight and a good regime. If you are fearful that the Camino is going to take you out of that zone, then you are right. To a stable diabetic the Camino provides a huge challenge and potential problems. Overcoming them and realising that you can alter your lifestyle for a few short weeks is deeply satisfying.

For all of us who are diabetics the issue is clear. Do I want to undertake the Camino badly enough that I will live with the bouncing sugar levels, the inconvience of hypos, the extra daily blood tests, the loss of weight and all the other things that are not part of your daily life?

We can only decide for ourselves.

There is only way you can find the answers to your concerns and that is to go. Make sure you have good travel insurance that covers your diabetes and go for it.

 

[pal]

I am female, 61, and Type 2 Diabetic. I just finished the Camino from SJPDP to Finesterre. I take Metformin morning and night and inject Lantus in the evening. By the time I got to Puenta la Reina, I found my b/s was dropping in the night (woke up sweating and took glucose tablets) and I had to lower the amount of Lantus I was injecting. I checked my b/s every morning and every night before I injected Lantus. Even with the amount of carbs I was eating (bread for breakfast, bocadilla for lunch, bread and potatoes at dinner), I maintained better b/s levels than when at home and went from 208 to 181 pounds in the process. I saw only one scale in a restaurant in Trabadelo though I didn't actively look for a scale. Now if only I can keep the weight off!

 

[PILGRIMSPLAZA]

I think you are looking for an answer that we may not be able to provide.

What a coïncidence! That's what they tell me in the cell phone shop after trying to master my new smartphone; obviously I'm not smart enough :? But seriously: thank you [and Pal] very much for your very interesting remarks. I've sent them to my specialist, so we have a lot to talk about :idea:

 

[PILGRIMSPLAZA]

Now if only I can keep the weight off!

Thank you, pal, you too give me hope; we're not alone

 

[methodist.pilgrim.98]

Ah, but the point is, lots of people have mastered the new telephone - and you will in time. What I meant was you might be the first person to walk the Camino with diabetes 2, pen & pills, and no need to do a daily blood sugar check.

I am really hoping you will go and then come and tell the next person who has your circumstances how you coped.

Even in the long history of the Camino there is still the first person to do this thing.

You will have to do several daily blood tests, but that is because you are outside of your normal lifestyle.

I have said before that when I was taking tablets as well as insulin I found I still had to take them, but perhaps you might need a tablet with a lower doseage. Your specialist will advise on that. I know that in England they do have a tablet with a lesser dose of metformin, so that may also be a possibility as well as reducing the long lasting insulin.

I echo pal's comment that you will have to up your carb intake, but the food on the Camino does that anyway. The Camino is the only place in my life where I can double the amount of my carb intake and yet still lost weight. Crazy, eh?

 

[Marilyn Canada]

Great replies and the wisdom of personal experiences of those of us with Diabetes who have walked the Camino....I agree with everyone's comments and experienced most of them on my Camino....the night time lows were my least favorite...

I found the looseness that developed in the waistband of my pants was a good measure of my weight reduction as I walked...I never saw a scale....but then I was not really looking for one...

I really do not think it is possible (certainly not adviseable) for a person with diabetes especially one who takes insulin, long acting or rapid acting....to safely walk the Camino without testing their blood sugar levels several times a day...no matter how stable they might be in your normal day to day life...they will be significantly lower walking the Camino .....unless of course your normal life includes daily 25 klm walks!!

My advice is to start testing your blood sugar levels now .....as you do your "regular" Camino training .....test before and then after you walk....you may even find that you have to test during your walks....and use this info to make any necessary adjustments to your food intake and to your medications...that way....when you are on the Camino, you will have "trained" for your diabetes management and will know what to do.......

And be sure to always carry some form of fast acting glucose....and also have it within easy reach when you are sleeping....

 

[PILGRIMSPLAZA]

...the first person to walk the Camino with diabetes 2, pen & pills, and no need to do a daily blood sugar check...

... if not the first, then surely the best advised! I realized that it can't be done without daily checkups, but that's what I dislike most; bodies are not for stabbing...
Thank you for caring and sharing!

 

[PILGRIMSPLAZA]

My advice is to start testing your blood sugar levels now .....as you do your "regular" Camino training .....test before and then after you walk....you may even find that you have to test during your walks....and use this info to make any necessary adjustments to your food intake and to your medications...

This is certainly a point to be discussed with my specialist; thank you, Marilyn! My major problem at the moment, however, is to find the best place for my two darling cats: Reiki and Basje; I can't put them in a pension for 3 months [or actually a little longer for recovery in Galicia?] so it might take some time before the Camino comes within reach and I could hit the Road...
[mailing these pics to myself made them smaller]

 

[David Mapletoft]

I got an invitation to walk to Galicia and my diabetes specialist just promised to support me all the way by phone so there should be no problem at all! Untill now I thought I couldn't do it...
On this Forum there are already a few dozen posts on diabetes and diabetic and I PM'd with a few members but I'm still looking for a pilgrim with diabetes type 2, using a pen (not a pump) once per day, consulting the specialist only some 4 times per year, being 'stable', having hardly any hypos!
My main concern is how to adjust the daily doses of pills and insuline (Metformine, Gliclazide and slow working Lantus) to loosing a lot of weight. Now I'm a little over 100 K, 69 of age and male. Normally I only measure blood sugar levels a few days before the next checkup each trimester.
Anyone?

I am a diabetes educator currently in Condom on my way to Santiago. Happy to assist if required.