You're already sugar surfing, so let's take type 1 to the beach! The weather is getting warmer, but a day at the beach with diabetes needs some preparation so you can leave your worries behind. What to take You might feel like Mary Poppins when packing for a day at the beach with kids, but add in diabetes and it’s time for a checklist. Here’s your handy Beach Checklist for a day of sun and surf:
For pumpers - a spare infusion set, infusion set cap
For kids on injections - rapid acting insulin pen
A good quality cooler bag or esky – for your pen or pump when disconnected
BG meter, test strips, ketone strips - even if you use a CGM!
Alcohol wipes - there is no soap and water at the beach
Hypo treatment – preferably glucose tabletsGlucagon pen
Water – and lots of it
Food – don’t rely on the local canteen to have what your child will want/need
Medic alert bracelet.
Pump tips There will likely be a fair bit of disconnecting and reconnecting throughout the day, so think ahead. Bring the infusion set cap, and cap the infusion set site each time you disconnect. This will prevent any sand, seawater or possible contaminants getting into the site which could cause infection. When disconnected, the pump must be in a cool place to protect the insulin, and a safe place, to protect the pump! A Frio pack will work well, as will any good quality freezer bag or esky. Place the pump in a protective pack if it will be in direct contact with ice or liquid, to prevent insulin freezing. Another thing to consider when pumping is the type of bathing suit you wear. A one-piece can make disconnecting and reconnecting difficult, and there is nowhere to clip the pump onto when wearing it. For girls, a two-piece will make access to the infusion site easier, and gives something to clip the pump onto when out of the water. For boys, shorts give you the option to clip the pump onto the waistline. Shorts with a velcro pocket will help to protect the pump during sand play. Be mindful of wearing the pump out in the heat which can overheat the insulin inside. If you plan to be out of the water with your pump on for a while, make sure you spend some time in the shade. Insulin pen tips First things first, don’t forget your rapid acting insulin. As for pumps, keep it cool. Use Frio pack or a freezer bag or esky. Place the pen in a protective pack if it will be in direct contact with ice or liquid, to prevent freezing. CGM tips A CGM can be useful at the beach if you’re in close proximity to your child to allow transmission, but make sure you have a glucose monitor, test strips and alcohol wipes to test when needed. Long periods in the water can affect the adhesive tape used on CGM sensors and you could risk losing not only the sensor but the transmitter too! Tape, tape, and tape some more before you lather up the sunscreen. Try placing a bit of cotton on top of the CGM to protect it from sticking to the tape. If your teenager is worried about tan lines, talk with them about sensor placement - they may like to move it lower on the abdomen, or onto the upper buttocks. Diabetes at the beach Here are a few important things to consider:
Increased activity – swimming and running around are strenuous and the muscles will naturally use more glucose. Cold water immersion can cause people with diabetes to experience unexpected low blood glucose too. As with any increased activity, insulin requirements will likely decrease. Think about long acting/basal rate decreases starting before you go, and whether you need to decrease meal/snack boluses on beach day.
Pump disconnection – unlike those who inject their long insulin before they head to the beach, pumpers do not have this option. If you disconnect the pump for swimming, you’re missing out on basal insulin. Pumpers need to be vigilant to check blood glucose and reconnect to give small boluses to replace the missing basal if needed.
Try, document, reassess and learn. Make some notes about what you did, what worked and what didn’t. Take this to your diabetes educator to analyse and help you work out what might be the best course of action next weekend when you hit the waves.