Last week, I got back from a 12-night cruise and 2-night stay in Amsterdam. If you have never cruised before, you might be asking yourself “How hard is it cruising with diabetes?” This is not really an easy question to answer. I started to write this post and it got way too long so I have broken it up into a two-part series.
Cruising with diabetes had its ups and downs. One of the advantages of cruising with diabetes was just giving myself a mini “break” from the everyday stresses of diabetes. Recently work has been pretty busy and stressful. Combined with my disappointment from my latest A1C result, I was ready for a break. I had been working really hard to get my A1C below 7, basal testing a LOT back in March and April, working out and really watching what I was eating and trying hard to carb count and bolus correctly. So, when the result was 7.3, I was pretty discouraged. This trip gave me the perfect opportunity to let go of some of that anger and guilt I was feeling. No, I didn’t stop testing my blood sugar or changing my infusion sets or anything but I did relax a little bit about what I ate and drank and didn’t give myself too hard a time when I was high. Normally at home, I get so discouraged when I have “high” days. On this trip, I did have some high numbers but I would treat them and go on with my day and hope that things would even out. I think overall I did a decent job of balancing good diabetes control and having fun on vacation.
Another benefit of cruising was the food on the ship. The restaurant we ate at for breakfast and dinner was amazing. The food was so yummy. In addition to the delicious food at the restaurant, I also didn’t worry too much about getting low because food was available anytime. There was a buffet that was open all day long and room service was available 24/7. The negative to this was when we would dock in cities and go off on excursions. During the group excursions, we would never know when we were going to eat lunch or what they would even be serving us. They would serve us a predetermined menu and I would have no idea if I would even like it. I couldn’t begin to tell you what I ate in some cities but I do know that I had a vodka shot and glass of champagne in Russia ;-).
I did recognize crepes with some sort of meat inside among other things in St Petersburg. In Denmark, we had a buffet of food I didn’t recognize. I think some sort of meatball was included as well as a curried fish? Also, since I never knew when we were going to stop for a meal, I always had to make sure I had a snack with me. However, one stop we made at a castle in Denmark didn’t allow big bags, so I left my bag on the bus and just took my test kit with me, forgetting to grab my snack. My blood sugar was around 120 then so I started to get nervous about what I would do if I were to drop while we were in the castle. Luckily, my blood sugar stayed pretty perfect and then we were back on the bus.
Besides not knowing when I was going to eat or what I was going to eat, another difficulty in cruising with diabetes was trying to read food labels in a different language and different units than I’m used to in the States. The day we went to Berlin, we had a long train ride there and back, where we were given snacks. Trying to read the labels from the German food we were given was pretty difficult.
Despite the unknown foods and unknown schedule, I think overall I did an okay job with my diabetes. The mornings were always the best for me. I had the same meal every single morning, much like I do at home, but instead of eating two waffles and a string cheese, I would have an omelet and 2 chocolate croissants. The great thing about this was that I didn’t have the post breakfast 100-point spike in my blood sugar like I normally do with my waffles! It did take me a couple of days to figure out how many carbs the chocolate croissants had and how much insulin I needed but then I got it down to a perfect science (I estimated around 20 carbs per croissant) and my blood sugar did great in the morning hours. It wasn’t until lunch that things got screwy. Lunches were either out during an excursion or on the cruise ship eating at the buffet. I never ate the same thing twice and as I said above, I often had no idea what I was even eating. I would eventually come down from my highs at lunch and would be good around dinnertime but then dinner was sort of hit or miss. Some meals I would be high afterwards and others, I did a good job of bolusing. The restaurant we ate at every night would always serve different entrees and most nights there would be 6 courses (appetizer, bread, soup, salad, entrée and dessert). At first, I ordered all of it but then as the cruise wore on and fears of gaining 10 pounds started to become a reality, I narrowed down my choices to maybe 3 courses at most. Eating dinner would take around an hour and a half, which is why I think, despite eating way more carbs than I probably should, I was able to control my blood sugar OK with some pre-bolus action.
Looking over my numbers it’s pretty clear that days we did excursions, where we mainly sat on a bus stopping at different destinations to take photos, and days on the cruise ship, where it was easy to drink and graze on food all day long, were my higher days. Days that my husband and I went off on our own, my blood sugar did great, most likely due to all of the walking. The one exception was when we were in Tallinn. We went off on our own and it was about a twenty-minute walk from our cruise ship to the Old Town area, where we explored. When we got into the Old Town, I started to feel very weird. I brushed it off that maybe it was just because I was so exhausted after the long days in St. Petersburg the two days prior but then I got a little worried at how off I felt so I decided to test my blood sugar even though my CGM said I was perfect at 110. And it was a good thing I stopped to test, my blood sugar was 56!! I ate a snack and we kept walking around but then I got low again so I stopped and ate again and we continued on. I kept getting low until we finally stopped for lunch, where I ordered French fries and my low blood sugar was no longer a problem.
A nice thing about cruising with diabetes was not being annoyed by my Continuous Glucose Meter (CGM) alert. It’s funny when I think back to the cruise, I was remembering how my CGM alert didn’t go off too much and how nice that was because I get so sick of hearing it. I have my sensor limits at 80-170 from 6AM to 11PM and then 80-200 from 11PM to 6AM. I have my high repeat every 3 hours and my low repeat at 20 minutes. On a normal day at home, I get alerted to high blood sugar pretty much everyday, as my breakfast meal always seems to raise my blood sugar by 100 points. I also tend to be high around 2AM (thanks to a late night snacking habit that I can’t seem to break-eating before bed around 11PM) so my CGM likes to go off in the middle of the night as well. So it wasn’t until I looked at my CGM reports online that I discovered that my CGM actually went off a LOT during my trip. I averaged about 9 alerts per day, of which around 2 were overnight. I’m not sure why I blocked out these alerts when thinking back to the trip other than I was having such a great time that I didn’t let it bother me as much as I do at home.
The food was a plus to cruising, while the unknown schedule, unknown food, and unreadable labels were negatives to cruising with diabetes. It was nice to “relax” a little bit from trying to be the perfect diabetic. It’s funny how when I wasn’t worrying too much, my blood sugar did stay in pretty good control, at least as good as they are when I’m back home, worrying non-stop about them.
Check back tomorrow as I finish up my two-part series on cruising with diabetes :).