My 15 year old son has had diabetes for a year and a half. He has great control, never had ketones, has never been sick with stomach disorders or anything that would influence his levels. He is planning to go on the Boundary Water canoe trip, and now (with three weeks to go) his doctor is getting “cold feet” about the idea. My son plans to take a water filter along with other precautionary items. Any other suggestions?

There is absolutely no reason he can’t participate in the trip provided he has good education on what to do for diabetes urgent situations and emergencies. You should also have an adult on the trip educated on how to handle diabetes emergencies. He needs to have a protected way to carry his insulin and supplies on his person — they won’t do him too much good if they float away the first time the canoe tips.

It is important for kids to know that they can do any activity that other kids with diabetes do — provided they think twice about their diabetes prior to the activity.

MSB
Additional comments from Dr. John Schulga:

It sounds like your son has great control and is doing really well to look after his diabetes so carefully. If he has such a good grasp of diabetes, he seems well able to do what he would like and have fun. He should be allowed to go on his trip, but he needs to take a little bit more care of his diabetes and monitor it more carefully, as he will be more active and so this will affect his glucose readings.

You should ask your son’s doctor what is bothering him about your son going away. It is important to stress that anyone with diabetes has the right to a full life with as little restriction as possible. If he is keen to go canoeing, if you feel he is able to he should.

JS
Additional comments from Dr. Donough O’Brien:

Take a cell phone in a waterproof bag or make sure the organisers will have walkie-talkie contact. Essential numbers should be taped on phone.

DOB
Additional comments from Dr. Larry Deeb:

I have been to the Boundary Waters. I have taken kids with diabetes miles from civilization safely. One physician doesn’t keep you safe, you do! Plan! route the trip and leave it with the Ranger — then don’t vary from it. Ask the Ranger about the need to signal for help; he’ll explain how to do this

Take lots of strips
Test!
Watch for lows
Take along glucagon, glucose tablets, and gel
Have a good buddy and — have fun!

LD
Additional comments from Dr. Stuart Brink:

If he is in good control and understands what needs to be done to adjust insulin and food for such vigorous and continuous activity (including some middle of the night monitoring to prevent any severe hypo episodes), I see no reason he should not participate.

There needs to be extra supplies taken by someone other than himself as a backup, glucagon and most importantly, at least one or two others who know how to help him in a hypoglycemic emergency. There should also be a cell phone so that any other emergencies can be handled appropriately. Most likely, these will not be needed but better safe and prepared.

SB
Additional comments from Lois Schmidt Finney, diabetes dietitian:

Bring along plenty of supplies, including glucagon (and be sure someone knows how to use it), insulin and if on the insulin pump, supplies for giving injections in case something happens to the pump, batteries for the glucose monitor and pump, if used, and a back-up glucose monitor. Everything needs a back-up as for example, if your monitor falls out of the Duluth Pack, you need another way to get your blood glucose reading. Same for if your insulin bottle falls and breaks.

I have been up to the BWCA and you just bring along lots of extras, in case. It has saved my life. You will go through lots of water (bring a back-up water filter since one time ours hit the water and without the back-up we would have been in deep trouble), and be sure you have quick-acting carbs along. Also, blisters are inevitable, so bring plenty of stuff to take care of them, plus an extra pair of shoes to wear in camp. I assume you know the basics of BWCA — there are no luxuries and you hope the toilet paper never falls into the water!!

Enjoy it. I have always had a blast.

LSF