Traveling to Belgium and Eating/Diet Abroad

Type 1 and LADA
1

Hi Everyone,

Wanted to ask for some experience about eating while traveling abroad, and also to bounce what my wife thinks is a really stupid idea off of everyone. I’ll start with the details (and my details), and then suggest my stupid idea :slight_smile:

I’m traveling for work to Belgium at the end of March. I travel frequently for work, and I generally get by by packing nuts, low-carb protein bars, and then ordering salad meat and green veggies at restaurants. This works fine when traveling to D.C. or Bozeman, Montana, because I’ve eaten all the food and don’t feel like I’m missing out. Here’s the thing: I’ve never been to Brussels before, and I hear the restaurants are amazing (cafe culture, etc.). I’m also going to have a very generous per diem allowance, so I won’t even have to spend my own money on eating. Sounds great, right? Well…

I haven’t yet gotten to meet with an endocrinologist, and I’m controlling my BG with diet, exercise, and Metformin. I won’t be able to see an Endo before I leave at the end of March, and I’ll be gone for two weeks. I do not have a prescription for bolus insulin, so my normal travel routine is to stick to my every day at home routine: less than 50g of carbs per day on days I don’t exercise intently; 75g of carbs on days I do exercise intensely; no non-fiber carbs for breakfast. That keeps my BG comfortably in the 70-126 mg/dL range, and I have no issues with food or BG or complications other than constant, uncontrollable weight loss (which is why I’m seeing an endo and likely starting low-dose insulin ASAP).

So here is my conundrum:

  • I really want to eat good (i.e., normal) food while I’m in Belgium, at least in moderation!

So here is what my wife thinks is a terrible idea:

  • My best thought is, eat what I normally do for two meals a day while in Brussels (i.e., low-carb high protein), and the third meal have a “normal human being” meal in a restaurant as I want to order it from the menu. Deal with the BG spike as being unavoidable.

My wife points out that I won’t have insulin to correct with, and I’ve been preaching about “needing to stick to 70-126 mg/dL range” for months now, so she sees this idea of mine as both terrible and completely at odds with my entire treatment goal (minimize complications by minimizing BG). Is she just right about this, and should I just suck it up and eat the same boring low-carb foods in Brussels that I eat every day at home?

Or, given that I’m not likely to spike to 500 and go into instant-DKA (I still produce endogenous insulin in sufficient quantities to have generally stable BG), is it reasonable to relax the standards a bit in the cause of living the good life in a way I’m not likely to get to (maybe ever again)? Is this the proverbial slippery slope, at the bottom of which lies lower limb amputations and blindness? Am I doomed to eat low-carb forever??? (or at least until I get insulin prescribed)?

Anyhow, genuinely not an attempt at whining, but rather looking for experience: is it worth it to “relax the standards” on occasion (a week or so, in my case) in order to fully experience life? Am I likely to do major harm to my body by running a higher BG than normal for a week or two?

2

I lived in Brussels for 2 years (long before I was diagnosed). I was always amazed at the variety and healthy options when eating out… with the possible exception of the wonderful Belgian beer :beers:

My family and I walked more there than we typically do back here inChcago. Have a great trip and enjoy yourself!!

3

The happy Belgians give you a bowl of Pommes frites and some mayonnaise with every meal. Yum. Be careful.

4

i would say if you have enough insulin still being made for you, that some long walks after your meal would be on the cards. i think your idea is a good one, as long as your regular human meals are not just the chips with mayo. which you should try at least once while youre there.

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5

One nice meal a day won’t kill you (immediately :wink:). I would take my nice meal at lunch - the meal will be smaller and you’ll have more time to walk it off.

On a side note - it’s one thing to aim for 70-126; it’s another to expect to always stay in that range. Most of us on insulin regularly cross both boundaries regularly. It’s in the nature of having to think like a pancreas instead of having one that’s doing its job.

Have a good trip.

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6

David, such a great trip coming for you!

I know Brussels well, and have family there. Lovely place when it’s not raining (it rains all the time unfortunately), great cafes, great food, great people although sometimes a little stressed.

Some thoughts:

  • imho it would be a real shame if you don’t try the food
  • based on my own experience, the slippery slope is always slipperier than you think

But - why not take insulin with you? Can’t you get an insulin prescription from your regular doctor before the trip? What is wrong with doing some bolus insulin just for these meals?

Another option: if you are not able/ready to go for insulin - what about increasing your metformin prescription, and using glipizide on top every day you partake? The caveat is - you can get low on glipizide, so you need to test appropriately, and make sure you have sugar with you.

Hope you find a way to eat well there! Don’t forget to visit my good friend when you are there - I am linking to picture of him below:

http://www.oddcities.com/wp-content/uploads/2014/02/Manneken_Pis_crop.jpg

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7

That’s what I would do.

So, why don’t you just get some insulin prescribed? You may not even need to bolus before meals, just correct later if need be.

Extremely unlikely. IMO, you’d do far more damage to your body and mind by not enjoying the trip to the fullest, including some delicious food. If I were you, I’d get some insulin and start researching restaurants in Brussels.

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8

Traveling for work always involves - work. High BG’s for me result in cranky attitudes and brain fog. Get proactive with Meds before you go - conversation with your GP about the trip should do it…you’ve pretty much decided to enjoy a little cheat here and there - try to avoid the real gooey stuff and up your professional game - perhaps more trips will follow! P.S. Bring your wonderful wife on the trip next time :kissing_heart:

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9

Yes, I say it’s completely OK! :slight_smile: You will still be making efforts and even if your results for that week are not exactly what you are used to, they shouldn’t bring either immediate (DKA) or long-term damage.

I lived in Brussels for a summer the first year I was diagnosed with T1D (though I was on insulin instantly and by the time I went to Belgium was also already on a pump, so my management was obviously different) and enjoyed the cuisine tremendously. I probably ate waffles only once (the biggest carb challenge for me), from a place where some local acquaintances told me they served “the best”, but on the other hand, a paper cone of Belgian fries + some mayo-based sauces were consumed fairly regularly. The good news is that there are a lot of less carb-heavy meals to try: various types of mussels, carbonade flammande (a type of beef stew) , waterzooi (a rich chicken soup), a rabbit stew whose name I don’t remember, and – my favorite discovery – witloof (endive heads wrapped in good ham and then fixed up as an au gratin). So there are lots of things to enjoy that are not complete carb bombs and if you time meals to be followed by nice long walks around town, you should be OK.

Now, if you are a beer lover (I wasn’t at the time, but now Belgian quads are my favorite!), the challenges might be more numerous…

Make smart choices and best of luck!

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10

You just gave me some great ideas! Fortunately, I’m an incurable exerciser, so burning off some BG shouldn’t be a problem :slight_smile: I also don’t drink beer or other alcohol, so that shouldn’t be a problem (although I know I’ll be missing some of the world’s best beer and wine). The stews sound fantastic, and not like anything I’m likely to come across at home!

I think what I may do is this: have one day where I have waffles (for dinner) followed by a run; one day where I have the fries; and the rest just eat as close to “my normal” low-carb while ordering more or less what I want. Getting more excited for this trip by the day!

Thanks everyone for the suggestions. I think if I had bolus insulin that would make the most sense, but my GP isn’t comfortable prescribing it to me, which is why I’m seeing an endo. She’s never had a diabetic patient like myself before, and she wants me to consult someone that knows what they’re doing (and I respect and trust her, so I’m good with that).

11

Lucky you! I love the food in Belgium. You can eat just as low-carb and healthy as at home. Of course there are high-glycemic treats there that are hard to resist. I would consider getting an Afrezza prescription for those instances where you do want to try them. It’s served me brilliantly in those instances where I’ve gone off plan.

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12

I would go and enjoy the food, no question. I live with severe and, in one case, life-threatening food allergies for which I can never “cheat” without risking an immediate trip to the hospital (or worse). It’s very hard for me to eat out anywhere because I react even to invisible cross-contamination. I’m currently on a week-long work trip and have not eaten anything aside from food I’ve prepared. I would give almost anything to be able to eat at restaurants, buffets, or social events (usually I do not find it so hard, but watching my colleagues eat without a second thought has made me aware how different things are for me). Diabetes is not a deadly food allergy, and eating foods that may not be the best for blood sugar control every once in a while is not going to result in complications. It sounds like you have a good plan in place for preventing spikes as much as possible, so I would say go for it and enjoy! (You may want to eat a test meal before leaving, just to ensure that you can get your blood sugar back down with your plan of action. It would not be good to go on your trip expecting that you’ll be able to control your blood sugar only to end up at 400 after eating and unable to get back down into range, which could create a medical emergency since you have no insulin.)

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13

I’m Type 1 and not familiar enough with Type 2 to help with specific strategy. However, my general advice is watch out for unexpected mega-carbs. For me, high BG causes short term problems like bad attitude, grumpiness and trouble sleeping.

I had a trip this summer in northern IT, Alps and Germany and never successfully “cracked the code” of carb guessing for restaurant meals or even local beer for that matter. I was hiking 6-10 hours a day and went into it thinking I could “walk off” lingering high BG but that did not always work. I came away from it a little mentally beat up over my seemingly constant insulin corrections and basal adjustments and overall lack of ability to successfully adjust to restaurant meals. I suspect that sugar was a randomly used secret ingredient in some of the meals including places you’d never expect to find it (like “plain” fresh yogurt).

Not trying to be the dark cloud, just wanted to say be careful. Make sure you have a reliable strategy to bring high BG down.

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14

We spent 10 days in Louisiana last Xmas. We decided to have one great meal a day. We had the same experience as @John58: a really hard time estimating and dealing with rich restaurant food, and a lot of work compensating for it afterwards.

Louisiana food is similar to Belgian food in the sense that it is really rich, with a lot of butter in every dish - often true in Belgium too - although, interestingly, the famous “French fries,” really from Belgium, used to be made with horse fat. I remember, on vacation there when I was a kid, my father buying me “cornets” of them made of newspaper to hold them with, from street sellers who used 55 gal drums to cook. That was a long time ago, in the late 1960s:-)

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15

I agree with @John58 - "have a reliable strategy to bring high BG down"
If you do, then you can enjoy that much more of your trip and the food, and have less worry about restaurant “mystery carbs” which are always unpredictable.
It can be harder to keep up lots of exercise when on the road, so having some insulin handy seems like a straightforward solution.

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16

while I agree with this, since you are not currently taking insulin and your trip is imminent, I would be hesitant to start taking it now, esp since you’ll be by yourself.

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17

After thinking about it, I agree with @MarieB, even though I suggested insulin. But I don’t think @David49 is considering it anyway since his GP won’t prescribe it.

18

Yes, Belgium is known for fine dining and you should definitely be able to treat yourself while you are there. On my six visits to Belgium I have always made a point of enjoying at least one beef tartar dinner, something I can’t do here in North America without risking being hospitalized for food poisoning. Beef tartar is a an open face sandwich, usually a slice of rye bread, a raw beef hamburger, capers, raw onion and a raw egg, with a dash of tobacco sauce. The difference of course is that while North American butchers in order to maximize profits include the guts, entrails and - definitely - cowpoop -in their ground beef, a European butcher doing that would risk serious jail time. As for the evening meal, I’ve never had a post dinner bg that could not be lowered by a few quick strolls around the block. Good luck and enjoy your combined business/pleasure trip to Belgium!

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19

Actually, a proper steak tartare (to give it its correct name) should not be made with ground beef. It should be made using steak that has been finely diced using a sharp knife. That way the only raw meat you are eating is steak

Here’s a good recipe

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20

A raw egg is raw meat. There is one on top of the pile of uncooked beef. Just because the French do it does not mean it is automatically a good idea. I like a medium rare steak. But not cooking it at all is de trop.