“Plan Ahead and Prepare” – The Golden Rule for Life in the Backcountry

(Shout out to Dexcom for sponsoring our big adventure and gifting us the Dexcom G6!)

There’s no “sugar coating” it - Type 1 diabetes (T1D) adds an additional layer of complexity to outdoor adventures. When you’re multiple days into an expedition, completely out of cell service, and dozens of miles away from the nearest road – you’ve got to be fully prepared for nothing short of a bear eating your insulin pump while your stock pile of low supplies simultaneously rushes down a class IV rapid – OK, probably a little dramatic, but being properly prepared in the backcountry can mean the difference between an epic, life-changing adventure and a disastrous search and rescue mission waiting to happen. 

Fortunately, the world of diabetes tech has come a LONG way in creating tools that make time spent in the backcountry significantly easier and safer for folks living with diabetes. Arguably the most important tool from that toolkit is the continuous glucose monitor or CGM. Michael and I both wear the Dexcom G6 CGM System.

The reality of T1D in the outdoors is that inclement weather and precarious trail conditions have ZERO interest in accommodating out of range blood glucose levels. Additionally, the last thing you want to do is hop on the dreaded “blood glucose (BG) rollercoaster” when you’re faced with a finite amount of daylight and have miles to cover before reaching your next campsite. CGM systems work wonders in alleviating this potential headache. As opposed to Blood Glucose Meters, which only provide glucose readings for a single moment in time, CGM systems continuously provide glucose levels throughout the day and night. This information creates a dynamic blood glucose (BG) profile that not only shows the real-time direction in which glucose levels are heading, but also the rate in which the glucose levels are changing. In a nutshell, this additional information is tremendously helpful in aiding in treatment decisions on the trail and avoiding the “BG rollercoaster” all together.

It’s important to note that not all CGMs are created equal. After trying out various systems over the years, here are some of the top reasons Michael and I choose to wear the Dexcom G6 System in the backcountry:

·      Accuracy – a CGM is completely worthless (and arguably extremely dangerous) if the data it is providing is inaccurate. In our experience, the Dexcom system has provided the most consistent, accurate blood glucose data time and time again (sensor after sensor). 

·      The system requires zero fingersticks and no calibrations are needed.* This is an added bonus in cold weather environments, when the last thing you want to do is take off your gloves to provide a blood glucose calibration.

·      The system integrates into our smart phones AND comes with a receiver. Michael and I bring out both our phones and the receiver in case there is a technical malfunction or battery issue with one or the other.

·      The system’s sensors are approved for a 10-day wear - ample time for a proper backcountry expedition.

Michael and I had the opportunity to put the Dexcom G6 System to the full backcountry test this past April during two PROJECT 50-IN-50 training climbs to the summit of Mt. Shasta and Mt. Hood. We couldn’t have been more pleased with the performance.

Here are some notable highlights from the trip:

·      On Mt. Shasta**, we traveled with a third climber who is also living with T1D and wearing the G6 system. As our bodies acclimated to the elevation change during the first 24 hours of the trip, as anticipated, our BGs were all over the map. During the first night, all three of our Dexcoms alarmed on three unique occasions to alert us each of our own low episode. Each time an alarm went off, all three of us would wake up, ask “who’s going off?” and pass around a bottle of glucose tabs to the appropriate person. The only thing definitively worse than waking up to a low blood glucose is NOT waking up to a low blood glucose – so we’ll gladly take those middle of the night alarms 10 times out of 10.

·      For me, personally, the symptoms of hypoglycemia and very mild altitude sickness share a lot of similarities – dizziness, mild nausea, tiredness. Having easy access to my real-time BGs on summit days prevented me from treating false lows.

·      We love those arrows! Along with providing real time BGs, the Dexcom system also provides small arrows that point in the direction in which your glucose levels are trending. With the constant aerobic exercise, these little arrows were lifesavers in helping us prevent lows before they occurred – allowing us to avoid the “BG rollercoaster” all together.

While trekking with T1D may require some extra planning, we embrace the idea that the benefits that come from adventuring in the outdoors strongly outweigh the potential headaches that diabetes may bring. We feel strongly that diabetes should never determine the limit of what an individual desires to do and are thankful for the advances in diabetes technology that allow us to prove that ANYTHING is possible with T1D.

We’re thrilled to have the Dexcom G6 CGM System as a tool in our toolkit as we launch PROJECT 50-IN-50 this June.

*If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.**The Dexcom G6 Continuous Glucose Monitoring (CGM) System is permitted for use by the FDA between the altitudes of -1,300 and 13,800 feet.