Cruising with Type 1 Diabetes

[ProbablyRachel]

I'm leaving on my first cruise (Allure, Sept 22nd) since being diagnosed with Type 1 Diabetes (Juvenile Diabetes for anyone still using old school terms). I was wondering if anyone has any cruise tips or advice in regard to:

 

1. Attempting to carbohydrate-count cruise food

2. Cruising with an insulin pump

 

Thanks in advance! I'm expecting the toughest part is actually getting on the plane to get to the port and I've flown with my insulin pump before so I'm prepared for that.

 

Thanks!

[mikechass]

I was diagnosed 5 months ago, just came back from Freedom. It was great. There are TONS of low carb options.

Also, if you take a minute to talk to the waiters when you sit down, they will work with you to keep your meals all under a certain number of carbs.

They have a sugar free dessert every meal

and sugar free ice creams too.

Still carbs in those of course but its an option for someone like me who is still getting used to no real sugar

I was allowed juice boxes with me on the planes, and once there if you are finding the wait difficult then ask for a chair.

I had priority boarding so we were in quick but they are VERY helpful at the pier as well.

There is a small fridge in the room, you can store your insulin in there. The only thing I can't know for sure is that when your off the ship if your meds need to be with ice? I would pack a thermal lunchbag, and get the room guys to freeze a few icepacks to keep things cool in the blazing summer months. Hope that helps. Anything else, let me know.

[novicetraveller]

I have no experience with the use of the pump, but as a T2 diabetic who is dependant on insulin, I have requested a sharps box. I don't know if this applies to you. If it does, make sure you request it.

[Doug R.]

I am a Type 2 who has been on the pump for over a year and have been on one cruise with it.

 

1. Not sure which brand you have, my company rents a loaner pump in case yours breathes its last in some foreign port. :eek: I think it was $50.
   
2. You are probably aware that the insulin used in pumps is good for up to a month at room temp, for a seven day cruise I take two vials and store them in the fridge.
   
3. I take twice as many infusion sets and reservoirs as I usually would use during that time period. I am sure you have muffed an insertion or two.
   
4. Batteries for the pump! They cost an arm and leg in some ports.
   
5. The ship will supply a sharps container, you can ask in advance or your steward can obtain one for you.
   
6. Don't forget a good supply of lancets and test strips.
   
7. Counting carbs when eating out is a challenge in any venue, including on board. I obtained a comprehensive guide that gives carb counts for virtually any food (even possum, raccoon, and muskrat. :D) I did pretty good but don't get discouraged if you have to do more correction boluses than normal.
   

Happy Cruising!

[jmf123]

The Animas brand of pump provides a loaner pump at no charge. They even send a pre-paid return box! And as Doug R mentioned, definitely take extra batteries. They (lithium) cost and arm and a leg on land! And you know this- but make sure to always have something with you in case of low blood sugar, particularly when off the ship. Glucose tablets are handy. Enjoy the Allure! :)

[Cruisfan]

As a diabetes educator of many years, I agree with Doug R above. I would recommend getting a copy of Calorie King, the calorie fat and carbohydrate counter. It gives zillions of food choices with portion sizes. Some of what you will do will be guessing but that often works based on past experience with food portions you normally eat, like pasta, 1/2 cup is 18 cho so looking at the portion you are served and comparing it to your 1/2 cup from home will get you pretty close.

Hope this helps,

Cruisfan

[FlightMedic555]

Coordinating how to take the meds, pump, diet, etc. is generally readily available from your physician, other cruisers with similar issues, etc. I would suggest you speak with your physician so that you have a good plan should you become hypoglycemic. That is really the only rapid onset of an emergency that could occur. IMHO I would make sure my cruising companion had ready access to a glucagon kit and know how and when to administer it. The same would hold true for whichevery glucose oral solution you would use.

[avonc]

Test lots more frequently. I find my basal rate goes down because of all of the extra exercise one gets during the day by just walking. Adjust your pump as you learn more as the week goes along. Even with lowering my basal, I can get away with eating lots more.

[Langley Cruisers]

Hi Rachel, Type 2 here so can help with the food concerns. You will find many low-carb options available to you, especially in the Windjammer buffet. You can fill up on the tremendous offerings at the salad bar, and add a little cooked chicken breast, ham, and kidney beans for protein. Lunch was actually the best meal for me because I knew exactly what I could have and left satisfied. :) Delicious.

 

Yes there are sugar-free desserts available but do be careful; they are not carb-free or even low-carb, so do not go overboard on those. At dinner, I decline the rice, pasta, breads, and potato in favor of one dessert (regular or sugar-free). Being a diabetic does not mean we refuse all sugar (that seems to be the "old school" way of thinking) - it means making healthy lifestyle choices and getting more exercise.

 

Have a great cruise. :)

.

[boewok]

As others have said, take twice as many supplies as you think you need. No one has mentioned a "small, cheap" glucose meter. They are impossible to find in the middle of the night! I bought one that uses the same strips as my usual one and uses the same batteries as my pump. I also take syringes in case I need to manually take insulin again. Not the best, but may keep me from being very sick. I am lucky enough to be on my third pump and take one of my old ones to use in emergency. I also take a list of pump settings in case I have to reprogram my current or old pump.

 

Enjoy your cruise. With some planning you can do well. Next month I will be on my 18th cruise with a pump and always come back with a good A1C and no weight gain.

 

Barb

[novicetraveller]

As others have said, take twice as many supplies as you think you need. No one has mentioned a "small, cheap" glucose meter. They are impossible to find in the middle of the night! I bought one that uses the same strips as my usual one and uses the same batteries as my pump. I also take syringes in case I need to manually take insulin again. Not the best, but may keep me from being very sick. I am lucky enough to be on my third pump and take one of my old ones to use in emergency. I also take a list of pump settings in case I have to reprogram my current or old pump.

 

Enjoy your cruise. With some planning you can do well. Next month I will be on my 18th cruise with a pump and always come back with a good A1C and no weight gain.

 

Barb

 

The one thing I would add is to carry with you some medical emergency card type thing to explain what medication and "typical" dosages you are on and any allergies.

[TNIris]

I emailed RCI (twice!) asking did they have any kind of nutritional information on the foods they serve so I could know carbs and fiber count of foods, and they said flat out no. Sigh.

 

I KNOW things like chicken and salad are low-carb, but I wanted to know specifically which sugar free deserts might be low-carb, and how many carbs they have.

 

Guess I may have to do the "3 bite" rule with deserts (read an article that said that a study was done and people said the first and last bites of desert were the best, so they recommend eating 3 bites and being done with it. Hmm, not sure I can do that, but I'm gonna give it a whirl!) ;)

 

I have a free app on my Iphone that is a Carb counter....I'm wondering if I set my phone to Airplane Mode if I can still use that app without using data. Does anyone know? I tried it today and the app still worked on airplane mode, but it would be terrible if I was racking up data at sea!!

Edited August 22, 2013 by TNIris
icon in wrong spot

[Motorman23]

I am a type 1 diabetic who was diagnosed at age12 and am currently 57yo so I have many years of experience. I have Medtronic pump and an associated bg sensor which provides trend analysis or bg readings. This is my 4th pump over the past 15 years so fortunately I have a spare to bring with me.

 

As others have suggested bring 2 times the amount of infusion sets and reservoirs and test strips. Bring an extra meter if you have one, if not call your provider and tell them you need another one, should be free. Bring extra batteries for everything. Bring extra insulin (I smashed a bottle on the floor of the bathroom once). Get a glucagon, hypoglycemia kit and train a family member on how to use it. Much cheaper then calling the medics on the ship. Regarding food, just eat sensibly and try to estimate your carbs on experience. They do provide some carb info but not for everything. Don't forget some snacks, I try to get some fruit or cookies from the WJ every night so I can deal with overnight hypoglycemia. That's about all I can think of, if anything else comes to mind I will post it.

 

Mike

 

 

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Edited August 22, 2013 by Motorman23

[imnocleaver]

We took our oldest son on a cruise not too long (within a year or so) after he was diagnosed with type 1. Although he wasn't on the pump, I agree with everyone else: bring twice as many supplies as you think you need. I would add to check your glucose levels twice as often as you think you need to!

 

As for the carb-counting, we brought the Calorie King bible, er, book, with us on the trip, but not to meals. We would reference it in the cabin if needed and took it with us while in port. Honestly, anything he ate during the day was always similar to what he ate at home, so he was familiar with how much insulin he needed. This was not intentional...preteen boys just seem to eat what they know. Once a teenager, this morphed into EAT EVERYTHING IN SIGHT. But I digress...

 

We ate dinner in the MDR, so we would look at the menu ahead of time and have him try to at least get some sort of idea what he planned to eat that night. That way, he had a ballpark of how much insulin he would need to take. He would then proceed to eat something completely different and we would take a wild guess at the carb count and wing it (this is where the testing twice as often comes in handy :D).

 

Now that I read this, it appears we might be an example of what not to do, but we had a great time, he gained a lot of confidence and we did not kill him in the process. In our book, that is a successful trip.

[elvismeggi]

I'm leaving on my first cruise (Allure, Sept 22nd) since being diagnosed with Type 1 Diabetes (Juvenile Diabetes for anyone still using old school terms). I was wondering if anyone has any cruise tips or advice in regard to:

 

1. Attempting to carbohydrate-count cruise food

2. Cruising with an insulin pump

 

Thanks in advance! I'm expecting the toughest part is actually getting on the plane to get to the port and I've flown with my insulin pump before so I'm prepared for that.

 

Thanks!

 

Hi 'ProbablyRachel',

you are not alone as a diabetic person during cruise:rolleyes:.

 

Meet our Allure 22nd Sept-roll call at : http://boards.cruisecritic.com/showthread.php?t=1696514&page=67

Greets Elvi

Edited August 23, 2013 by elvismeggi

[Buckerook]

Normally this does not apply, but if you are on a cruise longer than 30 days, you should take any extra insulin to the medical center on the ship and ask them to store it in their refrigerator. The room refrigerators are really only coolers and do not get insulin down to the proper storage temperature.

[ProbablyRachel]

Thanks everyone! I don't want to relegate myself to chicken and salads if I don't have to... I've got a couple of carb reference books that I'll bring along. Has anybody had luck guesstimating things like the roast beef sandwiches at Park Cafe or Sorrento's pizza? I love those.

 

I use the OmniPod and a Dexcom continuous glucose monitor. The upside is no tubing.. the downside is no loaner program. I've traveled before but never in such a disconnected way. I'll bring along my emergency Lantus with all of those extra supplies and request a sharps container.

 

Thanks again!

[ProbablyRachel]

As others have said, take twice as many supplies as you think you need. No one has mentioned a "small, cheap" glucose meter. They are impossible to find in the middle of the night! I bought one that uses the same strips as my usual one and uses the same batteries as my pump. I also take syringes in case I need to manually take insulin again. Not the best, but may keep me from being very sick. I am lucky enough to be on my third pump and take one of my old ones to use in emergency. I also take a list of pump settings in case I have to reprogram my current or old pump.

 

Enjoy your cruise. With some planning you can do well. Next month I will be on my 18th cruise with a pump and always come back with a good A1C and no weight gain.

 

Barb

Great thought on the pump settings! I'll bring a print-out with me.

[Motorman23]

Thanks everyone! (edited....) Sorrento's pizza? I love those.

 

Not sure about other folks with diabetes but I cant seem to bolus properly for pizza much. I spoke with my Endocrinologist who said it is because of the cheese and the fat content and it really has a high glycemic index which makes it absorb very slowly. The only way I can get even close is to use a dual wave bolus and run it over 1.5 hrs which brings its own issues. I just stay away from pizza as much as possible (but not completely :o).

 

Mike

[Lannybird12587]

My boyfriend has type 1 and we just got back from a 9 night aboard Explorer of the Seas. One of the best items he has ever bought was a belt that you can wear around your waist that you can put the insulin pump into. It was water proof and was VERY helpful for the pools and the beaches. Instead of disconnecting each time he wanted to go in and out of the water, he would just strap on this belt and he was ready to go! It was great. They sell them online if you are interested.

[Flick]

I have been diabetic for over two decades and have also done a LOT of cruises. Watch out for sugar-free desserts!!!! They usually use fruit instead of sugar and you get a lot of sugar from the fruit. I have found the regular desserts to be ok and if I have doubts I just don't eat all of it. I am insulin dependant and never have any issues. I use a scale of 1 unit per 10 carbs and I can tell you pizza is 70 carbs for 4 slices (medium size). My benchmark is 10 units and unfortunately that is the figure at McDonalds for a quarter pounder, fries and diet coke. Almost EVERYTHING ELSE is less than 10 units!!!!

[Finbar127]

My son is a T1 and uses the Animas Ping. Bolusing for pizza is a crapshoot but the combo or dual wave bolus certainly helps. When trying to figure out the carbs for something like pizza or the roast beef sandwich we just mentally break it down into its individual parts (breads, sauces, etc) and figure it that way.

 

Also this is another vote for Calorie King. They have a smartphone version but you need Internet access to conduct a search so you are better off with the book.

 

I also recommend bringing twice the amount of supplies. We usually put half in a carry on and half in a checked bag. It reduces the chance that you will lose all your supplies.

 

Definitely bring extra insulin. The ship's medical facility will not necessarily have the type you use. We found that out the hard way. Also RCCL will provide a small med fridge at no charge if you request it.

 

If you plan on bringing insulin ashore Google Frio. It is a gel based cooling pack that will keep your insulin from overheating in the blazing sun. We've used them for several years.

 

 

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Edited August 23, 2013 by Finbar127

[A2Mich]

My son is a T1 and uses the Animas Ping. Bolusing for pizza is a crapshoot but the combo or dual wave bolus certainly helps. When trying to figure out the carbs for something like pizza or the roast beef sandwich we just mentally break it down into its individual parts (breads, sauces, etc) and figure it that way.

 

Also this is another vote for Calorie King. They have a smartphone version but you need Internet access to conduct a search so you are better off with the book.

 

I also recommend bringing twice the amount of supplies. We usually put half in a carry on and half in a checked bag. It reduces the chance that you will lose all your supplies.

 

Definitely bring extra insulin. The ship's medical facility will not necessarily have the type you use. We found that out the hard way. Also RCCL will provide a small med fridge at no charge if you request it.

 

If you plan on bringing insulin ashore Google Frio. It is a gel based cooling pack that will keep your insulin from overheating in the blazing sun. We've used them for several years.

 

 

Sent from my iPhone using Tapatalk - now Free

 

I use an Animas IR1250. Pizza is about the most difficult bolus to figure out. I usually just do an combo bolus of about 40% immediately and the other 60% over about 6 to 8 hours and that seems to work well for me. But, everyone is different. Cruising for me is mostly a guesstimating and correction game, as you have NO IDEA what ingredients went into each dish. All you can do is to try the best you can, and not be too hard on yourself if your BG's aren't right. Will be very hard to do without having accurate nutritional info. Also agree that Calorie King is a great reference as well.

 

As for low BG's, a few people I have spoken with have recommended carrying either the Glucagon or as a cheaper alternative, a tube of instant cake frosting. The one advantage to these is that if your BG crashes and you are unresponsive, someone can squeeze a bit of this into your mouth and it will bring up your BG pretty quickly. Snacks are fine, but you have to be conscious and responsive to chew most of them, and glucose tablets can be a choking hazard if unresponsive.

[Donut23]

I'm a 2 so I know I'm different.

 

My biggest problem happens late at night. I take appropriate insulin amounts but am far more active than normal. For me, it seems to catch up at night and I crash.

 

We keep juice and some fruit in the cabin just in case. Keeps hubby happy. He can panic.

[2PARRS]

One time in the middle of a cruise my extra bottle of insulin "disappeared." :eek:It never did turn up again. The ship's doc was able to order up replacement insulin when we ported in Barbados. :) He said he wouldn't have been able to get it (pump usable kind) in a lot of Caribbean ports. Ever since then I lock my insulin in the safe. I filled out an "attaboy" card on the doc and turned it in. He had never even heard of one but was thrilled with the mention.