Back Country Hunting with Type 1 Diabetes

[NebraskaStickHunter]

Any fellow roksliders out there with tips and strategies for backpack hunting as an insulin dependent individual. My brother and I are both diabetic and are going to Colorado in September 2018 to try this whole elk thing that people rave on about . Any advice would be great so the experience is better than struggling with it. Thanks

 

[Scoot]

I'm a type 1 diabetic and I've done a number of backcountry hunts. For me, I need to cut way back on insulin. I need about 1/2 or less of my usual dose of my long-acting insulin and I need less of the meal-time insulin too. I also carry a glucagon pen with me on these trips and strongly recommend you do the same. The combo of elevation and essentially working out 12 hours/day results in me needing a lot less insulin.

I try to hunt with a partner whenever I can. I make sure I always have multiple snacks to treat hypoglycemia (which I get a fair bit on these trips) and I make darn sure everyone I hunt with knows how to make use of the glucagon pen. I also did a lot more testing than usual on my first few trips, so I could stay on top of my sugar levels before they became a problem. It's a big pain in the ass, kinda like diabetes is in general, but you really don't want to have the kinds of problems you can have from hypoglycemia seven miles from the nearest vehicle.

I'm not trying to be negative or pessimistic for you- just trying to urge you to really stay on top of things and to go and have a blast! Talk with your doctor before you go. One of my docs was pretty discouraging towards the idea of me going and I simply told him "I'm going no matter what you tell me, so please help me figure out the best way to take care of myself while I'm there." That was after I had already done a couple of these trips and my new doc wasn't as supportive of the idea of my next trip as my first doc. I wouldn't have been that cavalier with my first doc, but I knew I could do the trip and wasn't going to let him talk me out of it.

FYI- if you do a search you'll find a bunch of info and experiences that have been covered on this topic. Most of it is from type 2 diabetics, but some is from type 1. Different individuals have different experiences and info, so it may be worth a search.

Go, have fun, report back here with pics and a great story! Good luck!!!
Scott

 

[adamm88]

No experice elk hunting but as a t1d i want to follow this thread as well, ill throw out some suggestions as well.

Look up todd mead, i know hes a t1d and elk hunts and backpack hunts in the adirondaks for deer.

I would think having somone with you thats not diabetic would be a good idea and somone at home that knows where you are. The garmen in reach(or whatever there called) that tracks all your movements and somone call follow you from home in a must. You need to think about keeping all your suplys at the right temp, my first year deer hunting after finding i was a t1d my glucometer Got too cold and it wouldnt work, i had to put on on my chest tucked into my coat to make sure it worked. Make sure you have a way to keep you insulin at the right temp, you dont want it to freeze or fry 7 miles back in. Plenty of ways to raise your blood sugar, i carried with a small bottle of gatorade with me(which i never used), next year im going to get powder to save on weight.

Some other suggestions would be to try and just camp a few days to try out your systems, talk to your endocrinologist , i would imagine going higher in altitude you will need to adjust your basil rate(i would assume atleast).

Again iv never been elk hunting or even west of the Mississippi but i have a goal of the next few years to do either a backpack deer hunt or elk(wishful thinking). Be smart, hunt hard, have fun, t1d is more of a lifestyle than anything else, if you put your mind to do something and plan there really isnt much you cant do.


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[Scoot]

Good point about the temps, Adam. I was going to mention that, but forgot. For me, the cold temps caused problems. I was smart enough to keep my insulin in my sleeping bag with me at night, but forgot to do that with my glucometer. It would get too cold to work in the AM if I didn't keep it in my sleeping bag with me.

I've not used an inreach because I've been with a buddy. However, if I was going to do a solo hunt I'd definitely have one (or comparable) with me.

 

[NebraskaStickHunter]

Thanks for the info so far. There is 4 of us going so 2 with t1d and 2 without. We keep pretty good control of our sugars, I have had it for 6 years (was 25 when I figured it out), so we run our A1C's in the 6-7 zone which keeps the hypoglycemic episodes to a minimum. When I had it down to a 4.7 it was a little harder to keep away for the lows because I was always close to it but was in a much more controlled environment ( I taught elementary school for 6 years). But the dosage for long lasting is good info because that was my concern of how insulin usage changed as you increase exercise all day long along with elevation.

 

[boom]

good for you..GO!

i dont know crap about it..if i were hunting with you; bare minimum, give me that abbreviated version on what I might need to do if things go sideways.

have a great time..go get one!

 

[Shraggs]

Rokslide:

I am a type 1 diabetic, adult onset 20 years ago. I have successfully and safely completed 5 backpack trips to Colorado. But haven't killed with my bow yet...

I also work in this field - I am a diabetes specialist for a large company that makes diabetes products.

Great advice so far, and you are welcome to PM me if you would like to talk by phone. If your doing something like a backpack hunt where you will have 35+ pounds makes a big difference. So will how many miles you walk a day and how high you are. If you were a type 2 that got put on insulin that mitigates the challenge of a true type one - meaning your body makes zero insulin.

That said, my advice is to start now in preparing for the changes you will experience.

I assume you are on multiple daily injections of both a once a day long acting and a rapid acting with meals. If not, that is step one and carb counting based on the carbs you eat. I'm sure you know this...

Second, I'm sure you going to start conditioning for such a hunt, if a flat lander like me best to start no later than January and build up to it.

AND that is the challenge for a type 1. Rigorous exercise an hour or so daily is more potent the any insulin on the planet. And any activity in the body is powered by sugar or glucose, or carbs. Absent carbs the body will turn to fat stores and convert them to sugar. Anyway exercise the type to train for can send to very fast hypoglycemic events.

When I stated this years ago I was not able to make it thru a work out without hitting the treadmill floor!, until I learned I need to go into a work out with blood sugars in excess of 500. In one hour they would be around 100. Again no insulin can process that amount of sugar in an hour. This is with a basal or long acting still on board.

I painstakingly ate and not dosed, and measured and recorded the true effects of both simple carbs (fruits, candy, cookies) and complex starches (potatoes, cereals, breads) on my body glucose. Same with dosing. Until I had a library mentally of knowing how my body will deal with food and medicine. Meats, fats and green things will never raise your sugar if you didn't know.

Then I went thru the same process of learning how much to eat given my physical exercise and effort to know when to not dose.

Great for a workout, but when your active most of the day, that becomes more challenging. Hence they great advice about packing more food than a non diabetic. Also, at altitude your heart will beat faster, maybe much faster. Go from 70 bpm to 120 + and a hypoglycemia will hit by surprise.

For these reasons and experiences on my first, I was not able to successfully hunt the way I hoped. I simply had to pack to much weight in food and eat constantly to be safe.

I switched to a pump. First, I don't sell them and I'm not advocating - you can be successful on shots for sure. And every persons diabetes is different in how they process both carbs and medicine.

Today I'm able to go into a work out at 200, right after I eat and not dose. Take my pump off and work out for an hour or so and be 90-100. On the mountain hiking all day, I can take a normal amount of food, plus my emergency food (snickers) and turn my pump off the majority of the active period. Night time sleeping with elevated heart rate for a few days I have learned to set my basal rate at 50% of normal and I'm fine and safe. This is hard to do with shots.

Over the years I have also learned that carbs are very different. Processed stuff is more sugar like and gives sharper spikes in sugar levels versus complex natural carbs like yams. So I have moved towards the pelao philosophy. That alone has improved daily life too.

Last, one of my customers who works with professional athletes, said to me.... don't you dare try to stay at 100 every hour, you need to run 140-160. Very good advice. Oh an A1C of 7% is is between 166 and 178 depending on the lab methodology your doctor uses.

Very best, I'm so happy for you! I wish I could get friends I know off their damn couch and into the woods or mountains who have conceded their life to diabetes. Nothing beats living, and active to improve this disease.

I might even take a trip to Sitka to hunt this next year, very confident in my management. Except those bears....

John

 

[topher89]

Wife is type 1 and doesn't hunt but we get out a lot. I think my first piece of advice is get out a few times before your hunting trip. My wife says she requires a different amount of insulin out in the backcountry compared to home. After years of trips, she knows what to dose and doesn't have to guess. If you can get out on some longer scouting trips, you can start to get a good idea of what your needs will be.

Overpack on food and get lots of quick sugar. Have a plan of who is getting out of the tent to get the bear bag if you need something during the night. We often have an unopened gatorade nearby in case she needs something during the night.

Get out and start trying!

 

[Mtnman84]

My hunting partner is type 1 and it definitely has some limitations but he has spent a lot of time in the backcountry and harvested some great animals he’s not on rockslide but you can check out his Instagram. I believe his handle is Briabetes the biggest problem he has is balancing his blood sugar during long hikes being packing in or packing out. He will usually try and keep his blood sugar in the 200 to 250 range. The only problem with that is he can get really dehydrated and cramp really bad after about 3 to 4 hours of hard hiking it’s always a balancing act but get out there and enjoy it it’s very possible

 

[Flatgo]

Awesome my wife has t1d and she goes hunting with me, but I haven’t backpack hunted with her. But here are a few tips we’ve learned. Low carb high protein fat diet seems to help give her more sustained energy but she still takes juice or glucose tabs for bringing sugars up while hiking. She usually does a temporary on her pump. A cgm like a dexcom is really helpful I would suggest if you don’t have one get it before you go really helpful knowing if you’re trending down and can counter act it earlier. Hiking mountains does different things to her sugars and drops them a lot faster than other exercise and may drop it at night afterwards so take glucagon. Last I would suggest taking a trip in the summer and see how you do you’ll learn a lot and it’s better to see how blood sugar acts when you don’t have a tag. Good luck have fun and it’s awesome to see people not letting t1d hold them back you’ll have more challenges but it don’t let it stop you

 

[Riverwalker]

Don't just take it as a given that your blood sugar will go down because of the exertion of backpack hunting. Some type!'s find it goes up. As a type1 myself the best advice I can give is to find out how your body reacts in simulated trips before you go on your hunt. Simulate all aspects of your hunt including the food you will be eating. Use your tester to see what adjustments you need to make. Slightly elevated blood sugar for a short term is better than a low blood sugar crash.

 

[Scoot]

I agree with riverwalker except elevation is darn tough to simulate if you come from lower elevation. Somewhat elevated blood sugars are not a big deal at all in the short-term though and much better than hypoglycemic episodes. That's something smart to keep in mind.

 

[Brandon@RBO]

I've had type 1 now about 17yrs., and I am an avid outdoorsman who loves to hunt. I would highly recommend taking a day trip and seeing how your body reacts to the activity level you get from hiking. Like the previous posts.....cold temps will cause your tester to not work, and you'll definitely want to test more frequently as lows can sneak up on you fast...always bring extra snacks!! I usually will bring dried mangos and a couple small apple juices with me just in case. It was harder to manage when I was injecting insulin, but I switched to a pump about 4yrs ago and it is a lot easier to regulate when your activity level changes. If you use a pump, just use a temporary basal rate that is 25-40% less....if you're injecting adjust your carb to insulin ratio about the same....then see how your levels did after a day on the mountain? Always better to prepare than assume since all our bodies react slightly different with exercise and foods!! I have learned that Diabetes is a very manageable disease, that when done correctly, does not limit you....so get out there!! Best of Luck on the Hunt


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[IdahoElk]

Make sure to bring candy bars with you,my friend is a type 1 and injected too much insulin and within minutes things got serious real quick.Thankfully I found a candy bar buried in my pack that I could give him because by then he was flat on his back about to go into shock 5 miles in with no cell coverage.

 

[Mike7]

Sone good info above. I've seen recommendations for athletes performing vigorous exercise short term (like a basketball game) to start with a 50-90% reduction in their usual regular meal time insulin prior to the activity and then monitor from there and make adjustments as necessary.

But backpack hunting is more like a triathlon, and now there are a lot of Type 1 diabetics who have done or do triathlons and posted their advice after years of training, monitoring, and honing their insulin regimens. So that is another source for ideas.

 

[ElkNut1]

You guys are awesome! Thanks a ton for sharing all your experiences! My 12 year old grandson was diagnosed with Type 1-D 2 months ago & my Son & I wondered how elk hunting may affect his abilities to go along with us. Very encouraging to read about something not talked about at other hunting sites, thanks a ton guys!

ElkNut/Paul

 

[uzikaduzi]

Rokslide:

I am a type 1 diabetic, adult onset 20 years ago. I have successfully and safely completed 5 backpack trips to Colorado. But haven't killed with my bow yet...

I also work in this field - I am a diabetes specialist for a large company that makes diabetes products.

Great advice so far, and you are welcome to PM me if you would like to talk by phone. If your doing something like a backpack hunt where you will have 35+ pounds makes a big difference. So will how many miles you walk a day and how high you are. If you were a type 2 that got put on insulin that mitigates the challenge of a true type one - meaning your body makes zero insulin.

That said, my advice is to start now in preparing for the changes you will experience.

I assume you are on multiple daily injections of both a once a day long acting and a rapid acting with meals. If not, that is step one and carb counting based on the carbs you eat. I'm sure you know this...

Second, I'm sure you going to start conditioning for such a hunt, if a flat lander like me best to start no later than January and build up to it.

AND that is the challenge for a type 1. Rigorous exercise an hour or so daily is more potent the any insulin on the planet. And any activity in the body is powered by sugar or glucose, or carbs. Absent carbs the body will turn to fat stores and convert them to sugar. Anyway exercise the type to train for can send to very fast hypoglycemic events.

When I stated this years ago I was not able to make it thru a work out without hitting the treadmill floor!, until I learned I need to go into a work out with blood sugars in excess of 500. In one hour they would be around 100. Again no insulin can process that amount of sugar in an hour. This is with a basal or long acting still on board.

I painstakingly ate and not dosed, and measured and recorded the true effects of both simple carbs (fruits, candy, cookies) and complex starches (potatoes, cereals, breads) on my body glucose. Same with dosing. Until I had a library mentally of knowing how my body will deal with food and medicine. Meats, fats and green things will never raise your sugar if you didn't know.

Then I went thru the same process of learning how much to eat given my physical exercise and effort to know when to not dose.

Great for a workout, but when your active most of the day, that becomes more challenging. Hence they great advice about packing more food than a non diabetic. Also, at altitude your heart will beat faster, maybe much faster. Go from 70 bpm to 120 + and a hypoglycemia will hit by surprise.

For these reasons and experiences on my first, I was not able to successfully hunt the way I hoped. I simply had to pack to much weight in food and eat constantly to be safe.

I switched to a pump. First, I don't sell them and I'm not advocating - you can be successful on shots for sure. And every persons diabetes is different in how they process both carbs and medicine.

Today I'm able to go into a work out at 200, right after I eat and not dose. Take my pump off and work out for an hour or so and be 90-100. On the mountain hiking all day, I can take a normal amount of food, plus my emergency food (snickers) and turn my pump off the majority of the active period. Night time sleeping with elevated heart rate for a few days I have learned to set my basal rate at 50% of normal and I'm fine and safe. This is hard to do with shots.

Over the years I have also learned that carbs are very different. Processed stuff is more sugar like and gives sharper spikes in sugar levels versus complex natural carbs like yams. So I have moved towards the pelao philosophy. That alone has improved daily life too.

Last, one of my customers who works with professional athletes, said to me.... don't you dare try to stay at 100 every hour, you need to run 140-160. Very good advice. Oh an A1C of 7% is is between 166 and 178 depending on the lab methodology your doctor uses.

Very best, I'm so happy for you! I wish I could get friends I know off their damn couch and into the woods or mountains who have conceded their life to diabetes. Nothing beats living, and active to improve this disease.

I might even take a trip to Sitka to hunt this next year, very confident in my management. Except those bears....

John

there is a lot of good advice here but also some very dangerous advice... exercising with a blood sugar in excess of 250 is a good way to put yourself into ketoacidosis. when the body burns fat, it converts them to ketones and then burns them... this is not bad in and of itself and most people enter a state of ketosis at least every night when they sleep and have to enter this state to lose weight but specifically this happens in people without diabetes when they deplete their glucose and glycogen levels either through exercise or just through fasting, but for us diabetic our body is also doing this when our sugar is high (which is why you urinate more frequently and why undiagnosed diabetes/ high blood sugar causes rapid weight loss) increasing exurshion can and does increase your insulin sensitivity but since you are already in a state of ketosis when your blood sugar is high (and low ironically) it will continue to convert fat into ketones for energy without enough insulin to allow your muscles to access that sugar so your ketone load continues to go up until you literally acidify your blood.

i'm sure as a T1diabetic you've felt the extreme mild forms of this such as increased urination, dry mouth, sweat smelling breath and urine, blurred vision, excess thrust... maybe you've felt the more moderate symptoms which are abdominal pain, nausea, vomiting, weakness, fatique, shortness o breath... any of these symptoms would be an issue backpack hunting but the extreme symptoms would be deadly which are confusion and eventually coma. to make this situation worse, working out can trigger a liver dump of glycogen (which is just a more complex version of glucose) and actually raise your blood sugar instead of lower it.

the only macro nutrient that can convert to glucose that are not carbohydrates is protein in the process of gluconeogenesis. which happens in similar times that your body would be creating and burning ketones which could make it worse still.

greater exurshion is going to increase your insulin sensitivity and exurshion is going to increase the rate at which you burn glucose and glycogen so it will be more important to get into the best shape you can before going backpack hunting both to be able to product how your body will behave when exposed to greater exurshion levels and your insulin needs during those exurshion levels because it is not a one size fits all approach. If you don't have them, an insulin pump and a continuous glucose monitor can be great tools to expand your ability to prevent issues on a backpack hunt. instead of being limited to just eating more, you can quickly suspend your basil rate or cut it back by a percentage if you catch your sugar dropping early enough or anticipate it based on previous exercise experience (by using your correction rate backwards... if running 3 miles tends to drop your sugar 40 mg/dl and you take 1 unit of novolog to correct from 140 to 100, you need to decrease your basil rate by 1 unit before or during that type of exercise) on the other side, you can see in realtime if your sugar is climbing and address that too. obviously you'll need to be more prepared with foods to treat low blood sugar too like has been sugested, but i would not take the advise of purposely starting out with higher blood sugar or aiming to maintain higher blood sugar. there are studies showing that post meal blood sugar spikes of 150 (which i'd bet Shaggs and NebraskaStickHunter as well as myself think of as not that high or uncommon) effect arteries' ability to to respond to the heart's demand more more blood flow (which could have been exacerbating Shaggs experience with altitude) and over the long term greatly increase your risk of vascular problems. in fairness, it's also true that studies show that T1diabetics tend to see an increase in dealth rates below an A1C of 7 which is in the range that Shaggs quotes and that is most certainly from increased low blood sugar events; however, i'd imagine with the popularity of continuous glucose monitors, we'll see that trend change.

to recap my advice:

1) start working out now and do what you can to mimic the type of loads you'll experience
2) if you don't have a pump, get one... I really like animas for how rugged it is and it's waterproof rating is much better than anyone, but i've had good luck with medtronic and the tandem pump I have now (with the tandem it's rechargeable and you'd need some type of portable phone charger to to take with you as opposed to AA batteries with the animas and medtronic pumps)
3) if you don't have a CGM, get one... with the dexcom, i can wear it for 3 weeks (even though they only recommend 1 week) with the addition of IV Prep tape... i could go longer but my skin gets itchy after 3 weeks and despite them receiving fda approval after the medtronic version to make dosing decisions based on it's readings, it's always been incredibly more accurate that the medtronic in my experience.
4) try not to go alone... having a buddy to go with can have someone else look out for trouble signs and with the dexcom g5 CGM, you can pair it to multiple devices to track blood sugar so they could monitor your blood sugar and receive alarms on their phone in Bluetooth range.
5) bring some good simple sugar options to raise your blood sugar if need be... i like sour patch kids, partly because i like them, but also because 8 of them have 18 grams of carbs and they are just about 100calories per ounce which is a general good minimum threshold for food to pack to keep weight down.
6) make sure you have your basil rate, bolus, and the rate you correct at perfect... I'd be happy to share how to do it, but it's likely better coming from your endocrinologist.
7) unlike the common advice of avoiding over packing, take at least 2-3x's the diabetic supplies you think you'll need and try to break up how you store them... i have had pump supplies fail or become damaged and I've broken insulin vials. i prefill insulin cartridges and put them in snack sized ziplocks and keep them in a mid layer pocket. you can get hot temps that are too hot for insulin and cold temps which are too cold for insulin in CO in september... keeping them close to your body will keep them as close to the range they need to stay in as you can realistically achieve backpacking.
8) bring alcohol wipes and or hand sanitizer... i can be pretty laxidasical about sanitizing injection/cannula/finger prick sites at home where i shower daily, wash my hands multiple times a day, and can easily visit a doctor or hospital quickly if something comes up, but spending a week+ without a shower and doing these things is a recipe for disaster and if you have a pump and CGM or take my advice and get one, the cannula and CGM sensor don't stick well to dirty skin.
9) don't let it stop you from going.

 

[mrennich]

I have been getting more curious of back country hunting more and more. Been dealing with T1D for 23 years and just turned 29 I feel I have a strong handle on it but being you never know what can happen. I was always curious if guys used the pump or injections and even bothered with a continuous glucose meter. I always have a bottle of juice and some sort of candy or granola bar with me so I’m on the right track. I was wondering about asking about this subject but I gained a lot of knowledge now.

 

[gabenzeke]

I'm a T1 and was excited to come across this thread. I've now got two western trips umder my belt and am happy to try to answer any specific questions based on my experience. I'm on an insulin pump, which makes things quite a bit easier than MDI. one thing that I think is important is a garmin inreach. When you register, it lets you enter specific medical information about yourself for first responders. That, and is definitely advise that you don't go it alone. The middle of nowhere is not a place you want to have a severe low and go unconscious or have a seizure. I always make sure my partner understands the use of glucagon and have them keep it in their pack. I test a lot in the mountains as I've found I tend to lose a bit of tight control at first when at altitude for some reason, but that's probably not universal. The one thing I haven't found a solution for is keeping sugar handy at night in case I get low while also being bear safe. I've just taken the risks and kept candy in the tent. Probably would figure something else out in grizzly country though. Cool to see other T1's getting after It! Don't let the big D slow you down!

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[gabenzeke]

I have been getting more curious of back country hunting more and more. Been dealing with T1D for 23 years and just turned 29 I feel I have a strong handle on it but being you never know what can happen. I was always curious if guys used the pump or injections and even bothered with a continuous glucose meter. I always have a bottle of juice and some sort of candy or granola bar with me so I’m on the right track. I was wondering about asking about this subject but I gained a lot of knowledge now.

I'm under tight control (a1c is usually around 5.8 to 6 even). I personally have opted out of CGM even though I own one simply because it's more stuff to bring and worry about charging. With all the diabetes crap, batteries kind of become a big consideration. I'm also on a pump. I think it makes things easier to manage. I've had diabetes for 24 years now, so similar amount of time. Any questions, I'm happy to help however I can or share whatever info I've got!

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