Our nine year old daughter has type 1 diabetes, and our family is planning a two year sailing trip (along the coast of Central America, through Panama, and ending up in the Caribbean islands) to begin in the next two years. Are there places in which it is easier/harder to acquire diabetes supplies? Are there countries that have better/worse facilities to treat diabetes should a problem arise? Are there countries to avoid? Are there other issues I am overlooking?

This sounds like an excellent adventure, but you should be aware of the specific diabetes risks in a pre-teen. Finding supplies is just one of the potential problems since the places you will visit will sometimes have erratic provisions. If someone back home will be responsible for overnight mailing supplies from home to different ports-of-call, this would avoid the supply problem. Taking most (if not all) of the year’s supply would avoid some of this problem as well, as long as there are no supplies lost or spoiled by temperature problems in the hot climate.

Costa Rica has excellent facilities. Some of the other places will be more variable unless you will be in large cities with large medical centers, hospitals and medical schools. Along the coasts, this may be problematic as well. Frequent blood glucose testing will be required so that optimum control is achieved while you are away for so long. The ISPAD website has names of ISPAD members in all of these countries. There are many others who also belong to their own country’s diabetes organizations and also to American Diabetes Association as well as the Juvenile Diabetes Research Foundation and International Diabetes Federation. The websites of these other groups may also be searched for some specific names at each site. Your daughter’s own diabetes team may be able to supply specific names and contact phones as well.

SB