Backpacking with Type 1

Hey all,

I am going backpacking in Peru (yay) for 5 days and 4 nights. I have never done this type of thing before. I am worried about how my blood sugar will react. And also just logistics of managing diabetes while on the trail. Anyone have experience handling their diabetes on trips like these? Tips you’d like to offer?


One more thing, any thoughts on the affects of high altitude on your blood sugar? I have also heard it can effect how your meter works!

Bring twice as many supplies than you think you’ll need, also quick energy sources like glucose tablets, dried fruits, and gel (as a last resort for me!) I’m currently living in Uruguay and have traveled to Peru (hiked the Inca trail), Bolivia, Thailand, Europe, etc. with my pump and supplies. I was diagnosed 6 weeks before the Thailand trip, which included a three day hike but I was on shots then. My recommendation is buy a Frio pack to keep your insulin cool. I have one and have used it hiking for days on end- it can even "recharge’ in a stream or bucket of water if no running water is available.

Test often! Especially when you start out. On both of my long hikes, we were walking for upwards of 6 hours per day and at every stop I would test, sometimes on the trail, too. I had to explain to everyone what I was doing and to the porters that were carrying some of our things that I was not a drug user! Let the tour operator or guide know well in advance if you need any special meals or other accommodations. My meter and pump were just fine at altitude, but I can’t guarantee anything. DO you know of others who have had problems? Maybe check with the manufacturers to see what they recommend.

Best of luck and have a wonderful time!!!

Hi Lisa; I was reading your response to backpacking with type 1, and was wondering how expensive it is to purchase diabetic pump supplies, ect in a different country other than america? I have thought about moving to a different country for a few years; but I would have no idea what I would have to do to make sure I get all my diabetes supplies,etc. Do you have to find a doctor in Uruguay to give you a prescription, like in the U.S., or are things done differently all over the world? Do you have health insurance in Uruguay, ect. ?

Hi Amy- I have been on long term travel insurance for the first six months that I’ve been here and am just going to get set up with a hospital insurance on Monday. I brought a suitcase full of pump supplies, insulin and testing equipment when I arrived here in March. Every country is going to be so different in regards to insurance… it’s hard to make any recommendations.

From my experience, if you are on injections, the insurance in Uruguay will cover nearly all of the expenses (with copays MUCH lower than many plans in the USA). I know of one man here with type 1 for 50 years that pays $4 US for 5 bottles of insulin per month. Pumps are another matter. There is a Medtronic distributor in Uruguay (and they were instrumental in the return of my Lot8 infusion sets) but I have not found an insurance company or private hospital plan here that will cover pump supplies.

Insurance companies here are choosy. Some of the best and most reputable insurance organizations in Uruguay will not cover preexisting conditions for 2 years- IF THEY ACCEPT YOU AT ALL. There is a public health care option but I don’t know of anyone who uses that. Everyone I know opts for a private health care- but even that is so much cheaper than our insurance in the USA. I’m self employed and had an individual plan in Minnesota before I moved here. I was paying $1100/month for insurance for me alone- plus giant co-pays and out of pocket maximums. Here, I pay approx $230/month insurance + $10 month for urgent care/ambulance service and (generally) smaller out of pocket expenses + approx $400/month for a box each of infusion sets and canulas. Still $460 less per month than what I was paying.

If you are interested in a specific country- google for blogs about that country and read as much as you can about personal experiences in that country. We have a blog about life in Uruguay (including more to come about our insurance visit on Monday) at

My husband corrected me that it was $1100 for three of us in MN, now it’s $200 for the same in Uruguay.

Thanks Lisa, for all this info! I appreciate it… I guess nothings impossible, even if you have Diabetes…so do you see a doctor in Uruguay in order to get prescriptions and pump supplies, etc? Yeah, I live in MN myself…but, I am sure if I were to work in a different country, the pay would be cut as well; but… your company is an American based company, right…
Thanks again, Amy

Amy, I’ve used a few methods, but I’ve only worked with medtronic-minimed for my insulin pump supplies. They have offices in many countries, including Russia, Germany, Israel, which I’ve used to buy supplies while living in the same and neighboring countries. I’ve also had them ship me emergency supplies and, once, an emergency pump, to places they have no offices, including northern China.

In most places, it’s actually MUCH easier to buy insulin. In the UAE and Oman and Saudi Arabia, it’s subsidized by the government and significantly cheaper. In fact this was my experience in Russia and China, also. And I never needed a prescription, I just went to a pharmacy and bought it.

Sometimes you can have difficulty depending on how remote you are and shipping costs in and out. Local insulin supplies might be very tight and reserved for locals — I’ve encountered this twice. What countries are you thinking about?

It can be much more reliable to maintain your relationship with your insurance and supplier as if you are still living in the US. I have used services that gave me a US mailing address, but actually forwarded directly to my address in the middle east. You can consider and look into services like that as well. When you start dealing with post in other countries, things can get strange and unreliable; again it all depends on where you’re going.

I’ve done expeditions with both insulin pumps and injections. Some more information on your background experience with similar activity levels would be helpful – have you ever done long runs or hiking?

You’ll find your basal levels will fall, possibly significantly. Your insulin sensitivity will be greater, so your ratio of bolus-to-drop-in-BG will increase, and your ratio of I:C will drop.

I have not experienced problems with changes in my insulin sensitivity because of altitude (over 15,000 feet), but everyone reacts differently to altitude so be cautious. However — your vials of insulin have air in them, so you can get a big pressure gradient between the vial and outside, and this can surprise you. Remember to use the valve that connects your reservoirs to your vial of insulin, to release the pressure gradient (connect it to the vial only so air can flow through the needle freely).

I saw the comment about using cold packs to protect your insulin. This myth is a legacy from pharmaceutical history. I’ve had insulin unprotected in 120 degree weather for days on end without ever a spoilage, and in fact I’ve lived this way a lot of the time. HOWEVER I have lost insulin to freezing. In my experience that’s much more of a danger. On expeditions, I’ve had to take all my insulin and remember to carry it in inside pockets, against my body, to protect it from cold. Same with glucometer, your glucometer can stop working from the cold.

Enough for now…