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 Education
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Culinary Wisdom for the Active Diabetic
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| Peter's east/southeast Asian Adventures |
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| I was blessed with several opportunities to witness the marvels of the far East during this past year. Thanks to my beloved family in Kobe and a lifetime’s savings of frequent flyer miles, I was able to scratch the surfaces of two countries to which I’d not previously been. |
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| Japan |
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| Preparing for a Japanese Ensen (hotbath) during our temple stay at Koyasan. |
Yaki niku, a favorite for those of us on the “Adkins for Life” plan. |
Meeting a new friend near the deer park in Nara. |
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| Taking a break among some Japanese schoolchildren. |
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| Thailand |
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| Elephant trekking in the jungles of Koh Chang (Elephant Island). |
The monsoon rains momentarily cease, offering a rare view of the mainland. |
A familiar sight along Bangkok’s charming canals. |
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Diabetes Tip; Beating Diabetes Jet Lag
Flying over a score of time zones? Not pumping? It is possible to maintain sound control under such circumstances. Let’s use mine as a case study:
Minneapolis to Tokyo is about a 14-15 hour time difference, depending on daylight savings. To most non-pumpers (assuming they’re on Lantus), this would pose a considerable problem. For example, a morning injection on one side of the globe would land around midnight on the other. And because Lantus is active for 20 hours, the math would get even more complicated after arriving. Making this kind of change is asking a lot for someone who’s comfortable with his/her injection routine.
It seems that most take their Lantus at bedtime, using a dinnertime bolus to cover the 4 hours of hyper- exposure. Personally, I begin my long-acting in the morning and use a bedtime NPH shot to cover early morning hyper- exposure. The NPH is my ace-in-the-hole when crossing latitudes.
NPH has a lifespan of about 9 hours, give or take. This information and a small trip down memory lane (to the days before Lantus, when 3-shot NPH days were the norm) is all a guy needs to beat diabetes jet-lag. It’s as simple as this: Instead of an 8 a.m. shot of Lantus, substitute NPH the day of your departure—at, say, 6:30 a.m. (Maybe you’ll take your previous night’s basil 45 minutes earlier to account for part of the difference.) If your plane leaves at 3 p.m. from Minneapolis (14 hour flight), you’re due for another shot ½ hour after take off. This sets you 13 ½ hours from Tokyo, where it will be 5 p.m. 4 ½ hours before landing it is 1:30 p.m. in Tokyo and time for your next dose of NPH. And there you have it—the next time you’re ready to basil it’s 10:30 p.m. and you’re in Japan. You’re routine hasn’t changed. You’ll wake up stable and ready for Lantus once again.
Of course not everyone is traveling from Minneapolis to Japan, nor does everyone have access to NPH. But the formula is the same no matter your itinerary:
Shorter-acting insulins + mathematical creativity = BG stability when crossing latitudes.
(In a similar way, I would even experiment with Humalog in a pinch.)
-- phn
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