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Old 05-02-2014, 19:02   #1
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Diabetes Long Term cruising

How do long term cruisers who are diabetic keep insulin on board ? How easy is it to replenish your stock pile , once in the Caribbeans . I use two types Novo Rapide and NPH, also need needles (I use the pens) , testers and assortment of other items.
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Old 05-02-2014, 19:08   #2
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pirate Re: Diabetes Long Term cruising

I would imagine the same way they did at home.. as for the drugs.. likely have a different name but they are quite modern down there..
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Old 05-02-2014, 19:56   #3
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Re: Diabetes Long Term cruising

Believe the pens will go quite a long time without refrigeration. I've kept them at room temperature in our house here in Hawaii for several months without a problem. Also sailed to Hawaii from SF with pens that were unrefreigerated for over two months. Hawaii doesn't get super warm, mid to high 80s in the daytime so don't know what the shelf life would be in warmer climates, however. Insulin survives without refrigeration but apparently loses its potency over time. It will not survive being frozen, IIRC.

Probably best to get your doctor to write you an open prescription with a backup information letter. Hopefully would get you through if you needed a quick replacement. Any decent Pharmacist will know what types of Insulin are compatible/comparable if they don't have the particular brand of insulin you are taking.

I've gone with refrigeration to keep my insulin cool. Probably will never go so far that I will need it to be refrigerated but it gave me an excuse to keep my beer cold.
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Old 05-02-2014, 20:43   #4
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Re: Diabetes Long Term cruising

Opened insulin is recommended to be stored at room temp below 86F , but unopened, not-in-use insulin should be stored in a refrigerator at a temperature of 36-46 F

The insulin vials are rated at 28 days at room temp once opened , the pens vary from 7 days to 30 days depending on what type of insulin.
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Old 07-02-2014, 08:41   #5
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Re: Diabetes Long Term cruising

As an aside, be sure to keep some insulin and syringes in your ditch bag, next to the Scotch.
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Old 07-02-2014, 08:57   #6
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Re: Diabetes Long Term cruising

Extra monitors have been the big issue for us. As others explained, insulin and other items are fairly robust, but take a good wave through an open hatch and the monitor is shorted out. Without the monitor (my wife is quite brittle) insulin is very difficult to use. We had a nervous situation once, which ended well.

Get several extras plus tapes, rotate them, but always keep the spares in a secure waterproof container (ditch bag).

Glucagon and phenergen are also required; no 911.
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Old 07-02-2014, 09:59   #7
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Re: Diabetes Long Term cruising

Thinwater sounds like they've got it down. I'd also recommend a few bottles of glucose tabs too.

It also depends on T1 vs T2 and how much dependance on insulin is there. (T1 it's pretty obvious...)

Meters are cheap in the US - they're usually free. Ask your endo for some. (My son is T1 - we can get a freebie every trip... 'course the strips cost $$$) --

So I'd have a few meters bagged with desiccant. Plenty of pens in the fridge. Some in your ditchbag.
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Old 09-02-2014, 20:21   #8
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Re: Diabetes Long Term cruising

Thank you for the responses.

However I cannot see why a T1 or T2 would require more or less test strips depending on what type of diabetes you have. A T2 might require more. I know in my case my resistance changes with the seasons, stress levels and activity.

Another issue is dehydration. I tend to dehydrate very quickly in heat, followed by drinking much water and then the unstoppable urination. At that time your electrolytes are shot going from hyper to hypo.

At this time you feel, like you went 12 rounds with an angry Tyson, while your hands are tied. If you are lucky your blood sugar should be relatively stable, but in my case I am now also Hypoglycemic and crashing hard, these conditions will happen in a span of 15 minutes.

Given that the sailboat might my need my attention at that very moment, it is imperative that I maintain complete control over my condition.

Yes testing is important, but very much so, when conditions are changing, you need to adapt before things get out of hand. You need to balance your activities to the caloric intake, insulin, peak effect time and when your sugars are being released (carbs, vs sugars) in your blood stream.

Unfortunately I have no way of testing electrolytes, but you will know it when it happens. Other conditions may arise depending on body type, physical condition and metabolic rate.
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Old 09-02-2014, 21:53   #9
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Re: Diabetes Long Term cruising

There's a huge difference between most t2 and t1. A t1 makes absolutely zero insulin. Ie. Will die within a day or two without the basal dose. Most (not all) t2 that is not the case. In any case, treatment and measurement is the key. And on a boat you need to ensure treatment. Be it strips/meter, metformin, or insulin.

Pack what you need for 6 mo. For t1 (and fully insulin dependent t2) a regimen with lantus as the basal and some sort of r as the bolus (humalog/novalog) is much more flexible than a nph/r regimen.

Ask your endo about it if you're on nph.. IMHO nph sucks. Pump or basal/bolus is almost always better... ask the endo.
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Old 10-02-2014, 05:24   #10
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Re: Diabetes Long Term cruising

Quote:
Originally Posted by tightgroup View Post
... Unfortunately I have no way of testing electrolytes ....
I don't know if this idea made it into the market place.

DSpace@MIT: A disposable, self-administered electrolyte test

http://dspace.mit.edu/bitstream/hand...pdf?sequence=1

Patent US20030201192 - Disposable, self-administered electrolyte test - Google Patents
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Old 10-02-2014, 09:29   #11
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Re: Diabetes Long Term cruising

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Originally Posted by jeepbluetj View Post
There's a huge difference between most t2 and t1. A t1 makes absolutely zero insulin. Ie. Will die within a day or two without the basal dose. Most (not all) t2 that is not the case. In any case, treatment and measurement is the key. And on a boat you need to ensure treatment. Be it strips/meter, metformin, or insulin.

Pack what you need for 6 mo. For t1 (and fully insulin dependent t2) a regimen with lantus as the basal and some sort of r as the bolus (humalog/novalog) is much more flexible than a nph/r regimen.

Ask your endo about it if you're on nph.. IMHO nph sucks. Pump or basal/bolus is almost always better... ask the endo.
Agreed with NPH sucks.. your always chasing the numbers.. I have no endo in Canada its a state system, which sucks more than the NPH. I go to a clinic get a test and a prescription good for 2 years. I manage the rest by myself..

If I screw it up badly I go to Emergency for a day or so.. So my fear is on a sailboat, I need to have my regime well organized..
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Old 10-02-2014, 09:30   #12
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Re: Diabetes Long Term cruising

Started to check this out, looks very interesting.. tks
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