12 Months & 25 Countries with Type 1 Diabetes

When I was 25 years old I ditched life in the office to live out of a suitcase for a year. I lived in 12 new places spanning across Europe and South America over the course of 12 months with a program called Remote Year.

I settled into a new life every four weeks in Lisbon, Portugal; Rabat, Morocco; Sofia, Bulgari; Split, Croatia; Prague, Czech Republic; Valencia, Spain; Mexico City, Mexico; Bogota, Colombia; Medellin, Colombia; Lima, Peru; Cordoba, Argentina; and Buenos Aires, Argentina.

I hiked to Machu Picchu, went off the grid in the Bolivian Salt Flats, jumped out of a plane in Croatia, snow skied in Switzerland, crawled through caves in Colombia, fished for Piranha in the Amazon river, and rode camels in Morocco.

It was the adventure of a lifetime. A personal journey. A concentrated dose of experiences, cultures, challenges, and emotions. Jumping into such an extreme change is tough for anyone. But what about a Type 1 Diabetic?

Preparing for 12 Months Away

The moment I committed to travel, the planning began. When preparing for an extended amount of time away from home, there are countless things to consider. How will I get enough supplies? What if there is an emergency and I need a doctor? What if my pump fails? What if everything doesn’t fit in my bag?

This is how I prepared:

Start planning early.

I involved my care team in my planning months before my departure date. I booked an appointment with my endocrinologist. I called my health insurance company. I talked with my employer’s benefits team. I called Medtronic. It took 15 emails, 10 phone calls, four in-person appointments, a meeting, and nine weeks to secure 12 months worth of insulin, synthroid, pump supplies, and emergency back-ups like an extra pump and meter. It is not easy, but it is possible. Don’t take no for an answer! If you have the travel bug, always maximize your monthly supply & prescription medication allowance to create a stockpile to cover you.

Pack strategically.

To live out of a suitcase for a year, I packed one full-size piece of checked luggage, one carry-on, and a backpack. My dad had a field day configuring how to package supplies just right to maximize space. I always carried my insulin, synthroid, back-up pump, and two weeks worth of site changes in my backpack with the rest divided between my checked and carry-on bags. When my bags got lost for a few days on their way to Mexico City, I didn’t regret this!

• Note: a lot of airlines allow a free extra medical bag these days, at least in North America. If you are going to bring an extra bag dedicated to supplies, make sure to check the policy for other international airlines you anticipate flying with during your extended journey.

Stay cool at the airport.

My No. 1 rule at the airport is “ask for forgiveness, not permission.” Diabetics carry a lot of extra and unordinary stuff. I went through 20+ airports in different countries during my year on the road. Instead of drawing extra attention to myself, I put my bag through like everyone else. I rarely experienced issues with additional screening. When it does happen, smile and follow suit to avoid further issues. As a backup measure, I carried a doctor’s note explaining every medical-related item I travel with. (I never needed it).

Do your research, and get insurance!

Understand the medical environment in the countries you’re traveling to so that if you have an emergency, you can act fast. For example, in some countries you can buy insulin over the counter without a prescription. Try to understand how and where to get the best care quickly and affordably as a foreign visitor. I recommend investing in travel insurance for the duration of your extended trip, and having a full understanding of what it entails.

Living With T1D on the Road

As we say as Risely, sometimes diabetes is just going to diabetes! When you immerse into an extended travel experience all of the pillars that help stabilize your diabetes are disrupted. Your sleep, nutrition, stress, physical activity, and schedule are always in flux. That can make for an incredible personal growth journey, but a consistent uphill battle with T1D.

My tips for life on the road:

Create balancing anchors in your routine.

Maybe it’s 30 minutes of movement per day, a serving of vegetables at every meal, or 15 minutes of daily journaling - whatever helps you find balance in your regular life will help you on the road. You don’t need a gym membership to prioritize movement and you can lean into fun ways to cook with local produce.

Share your story with people you meet.

I told travel companions and people I met along the way about my T1D. I educated them about low blood sugars and how I administer insulin. There’s comfort in knowing that the people you are with know about your T1D. Just telling someone lightens our internal load and there’s comfort in knowing others can advocate on your behalf if needed.

Stay prepared.

It should go without saying, but bring twice as many low snacks as you think you might need. Always have local currency in case you need to grab a juice from a street vendor. Bring a site change, insulin, and syringes on the excursion. When doing something out of the ordinary, I always try to anticipate the worst case scenario and plan accordingly.

Reflect and make adjustments frequently.

In a constant state of change, it was difficult to manage my numbers. I had a lot of ups and downs and as soon as I nailed one routine, I was on to the next place to start all over again. Bring along your Diabetic Health Journal or whatever tracking system works best for you to analyze your patterns and adjust as needed. This will help you tackle pain points quicker so you can fully enjoy your adventure.

Keep it positive!

One night, a bouncer in Mexico tried to confiscate my meter and glucose tabs when I was entering a venue. I refused to let them take my things and found someone to help me translate to resolve the situation. Things will happen. Advocate for yourself. Remember that when you make a decision to leave home and travel, it is a once-in-a-lifetime opportunity to do, see, and eat things you may never have the chance to again. Always honor your body, but don’t let T1D stand in your way.

When I think back on my 12 months in 25 countries, I wasn’t a perfect T1D. My A1C increased a bit. I had a lot of highs and lows. I had a few situations where I was under-prepared or less responsible than I should have been. But I don’t think about that. I think about the people, the adventures, and the awe moments.

To every diabetic out there seeking adventure - go for it! You got this.

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