Being Diabetic on the Camino

This is a loose collection of diabetic resources on the Camino. I’ll address Type 2 diabetes at the end, since this form of diabetes is generally not insulin dependent (if you are, read the T1 part).

“A Warning”

Speak to your physician. Always do. Don’t ever take a page on the Internet as health advice. Seriously, not one. Not your health guru, not even someone with a .md domain name. Don’t do it!

Generally, it should be noted, that Spain is a very modern country. I repeat this a few times below, but you’re in one of the best health care systems in Europe and never further than a short cab ride away from a pharmacy. Read below about international prescriptions.

This isn’t a hike through the Sahel. But some advice, nevertheless…

Type 1

Your biggest worry is the combination of heat and insulin. Try not to walk in August, when it is the hottest, but I managed that part with three USB powered coolers until they were stolen from the albergue’s freezer overnight. I carried two 10’000 mAh battery packs for them, so them running out was never a real worry. I got new coolers the very same day from a pharmacy and was able to keep my insulin in my albergue's fridge until then.

99% of your hospitaleros and hospitaleras will be totally OK with storing it for you or letting you store it in their fridges.

Get a continuous blood glucose monitor like the Freestyle Libre 2 and pair it with your phone. If you’re in Europe, you can do this directly with an app like XDrip4iOS, US gets a little more complicated since Abbott sells different versions between continents. Talk to your Diabetologist about which one to get.

Freestyle Libre with MiaoMiao Transmitter. Might no longer be necessary if your version has hypo alarms

The Camino isn’t a hard walk, but it might be an unfamiliar stressor. Likewise, you won’t generally know what’s in the food you are being served, so be extra careful about hypos.

Have your physician write you two or three “International Prescriptions” for when you need Insulin. The health network in Spain is amazing, you’ll always have access to services, sometimes right next door or a short evening cab ride away. Spanish pharmacies honor these in almost all cases. You’ll probably never be more than a day or two without passing a pharmacy, just be proactive and have your coolers charged.

Make friends with as many bilingual Spanish speakers as you can. Spanish pharmacists are usually very well versed in English, but do it anyway just in case you need another way to communicate.

I had to fight a few hypos, so I carried some candy with me, but we’re used to that, no? :) Just keep in mind, that this is quite the sporty event, so plan accordingly and dose as you would after a day of any sport. Drink more than you usually would.

Type 2

The good news is, that this is probably the best thing you can do as a Type 2 diabetic. Exercise, walking, and fresh air are almost always indicated in this disease. However, heed the above and speak to your physician first, please.

If you suffer from peripheral neuropathies in your legs, do not go without speaking with your neurologist. You should also make sure, that your diabetes and blood pressure are controlled, and that you have enough medication to make it comfortably. If you are taking statins, you should be watching your intake. Also be careful in any blood pressure medication case, as many of the “orange juice” offerings might be mixed with grapefruit.

Bring a small blood pressure monitor, if you can fit it. Else you can have readings done in almost any town’s pharmacy. You’re not in the wilderness of the Sahel, you’re in suburbian Spain, access is always there.

Ask your physician to write you an international prescription for your medication as well and keep it on your body in a watertight zip loc bag, in case you lose your backpack.

Don’t overexert yourself. Plan a few more days, since you need to get used to the new normal in blood glucose (which will be low after a day walking) and higher demands on your heart and legs. Especially if you have a current managed HbA1c of higher than 9.0 make it small stages in the beginning.