Picture this:
The raft bounces through a rapid. Sunlight glints off the water. Pine trees blur past.
No cell signal. No backup crew.
Just us, the river… and Type 1 Diabetes.
When you’re deep in the wild and scenic Salmon River wilderness in Idaho, everything you pack has to matter. There’s no quick pharmacy stop. No calling the hospital’s diabetes educators. No emergency room. Thinking through our daughter’s T1D needs was key to being able to relax and enjoy, yet be prepared for the “what ifs”. With type 1, I have learned to always have a back up plan for our back up plan.
First, create the check list. I am a planner by nature, so this comes easy to me. I started with how many days we will be gone and then figured out supply needs. I have read that when traveling, always bring double the amount of supplies needed.
So here’s what we packed for our multi-day river trip with T1D—and how one simple tool and knowledge from the ketone video from animaT1D helped me stay calm, clear, and confident in the middle of the Idaho wilderness.
Our River Readiness T1D Kit
We split our gear between two boats in the dry boxes and coolers. Here’s what we brought:
- Insulin
- Backup insulin pens + syringes, both long acting and short acting
- Omnipod replacements + extra PDM in the event we lost her phone
- Ketone meter + strips
- Dexcom sensors
- Fast-acting glucose: apple juice, fruit leathers and our go to for stubborn lows, individually packed maple syrup.
- Snacks + protein
- Emergency Baqsimi
- Laminated emergency plan for the group
- Extra tapes, patches, alcohol wipes
- Medical ID bracelet and medical ID for her life jacket
Keeping supplies dry and on her body
I put her iphone, extra insulin, an extra pod, Baqsimi and carbs in an iphone waterproof bag that she could keep on her body. When we went through rapids, I tucked the bag into her life jacket in case we went over. I also attached her devices to her abdomen so that the life jacket protected them. Long story short, our boat did unexpectedly flip and EVERYTHING STAYED on her body!!! The plan worked!
A Stubborn high
Mid-trip, her blood sugar crept up. And stayed up while we were in camp one afternoon.
We bolused insulin. We hydrated. We waited. But then it stayed high… and I decided to be safe, I should check for ketones.
When she was first diagnosed, this is where panic would’ve taken over. But instead, I pulled out our ketone meter and an image from animaT1D: “High Risk of DKA” —the same one we featured in our ketones video. I had it laminated so it was waterproof.
It gave me the confidence to check, interpret, and act. Knowledge is power. Portable knowledge is even more powerful!!!
Why the Visual Tool Helped
I was in the wild, tired, and a bit concerned. The card was simple, color-coded, and to the point. I knew exactly how to interpret the finger poke and what action to take, if needed. On the other side of the card I wrote her ketone insulin doses that her endocrinology after visit summary provides.
No guesswork. No spiraling. Just a grounded response. And thankfully, she did not have any ketones and her glucose slowly came back down into range.
A Final Thought
You don’t have to memorize every insulin to carb ratio, small ketone insulin dose or carry every tool in the world. But you do need a system that works for your brain when the pressure is on.
That little ketone card helped me have access to information I needed in the moment—and empowered me to act on it with confidence.
Thank you, Radhika!!!!
You can download it here and stash it in your meter case, if you would like to.
We know that knowledge is power when managing T1D, and “portable” knowledge is a must if we are going to, as Emerson said, “Live in the sunshine, swim the sea (or a river), drink the wild air”. T1D shouldn’t keep us from living the adventure.
What strategies have you learned to make T1D information and management “portable”?
What I Know as a Clinician
When I meet families with T1D in the clinic, I am very comfortable interpreting downloads, making adjustments, discussing sick days and exercise management — there are well-established guidelines that provide a framework for all that.
But when it comes to travel, there’s no official playbook. No neat 10–20-page position statement to fall back on.Why? Because travel looks different for everyone: A weekend camping trip. A short flight. A multi-week trip overseas. Each comes with its own set of challenges, questions, and “what ifs?”
Navigating the Unknown with T1D
Still, one theme is universal: the delicate balance between the trepidation that comes with the unknown and the desire to live life fully — to not let T1D stand in the way of joy, adventure, or spontaneity.
What I Can Offer
As someone without lived experience of T1D, I am aware of my limitations. I do my best to offer practical, experience-based tips I’ve gathered over time:
- Double up on supplies — pack twice what you think you’ll need.
- Bring backups — even if you use a pump or CGM, carry long-acting insulin and a glucometer. Don’t forget the lancets, and syringes/ pen needles.
- Know your settings — basal insulin dose, carb ratios, correction factors. If your pump fails, you can’t access that info.
- Take a photo of your sick day plan — and favorite it on your phone so it doesn’t get lost in vacation photos!!
- Plan for blood sugar swings during flights — pack low treatments and snacks.
- Bring your own food — airplane meals can be unpredictable or unavailable.
- Keep all supplies in your carry-on — preferably in one organized place.
- Learn key phrases if traveling internationally:
- “I have type 1 diabetes.”
- “I need insulin.”
- “Where is the nearest hospital?”
These tips are a starting point — but they only go so far.
Where My Patients Become My Teachers
Here’s where the wisdom of the T1D community becomes invaluable. Not every family is plugged into social media or local support groups. But they are plugged into their regular clinic visits — with me. So, I ask questions. I listen. And I learn.
The answers I get are incredible.
- A family had a bad batch of CGM sensors during travel — a local Breakthrough T1D chapter volunteer came to the rescue via a Facebook group.
- So many tips/hacks around unclipping pump tubing during takeoff and landing to avoid pressure issues.
- Switching to injections at the beach to avoid sand and water complications.
- Using customized peel-off tattoos as a medical alert bracelet at Disneyland!
These stories — small, smart, and deeply practical — are the real-world pearls that no textbook can teach.
Passing It On
I collect these pearls of wisdom and share them with other families, especially those navigating travel for the first time. And in doing so, I learn more than I teach.
When a newly diagnosed teen wants to go rafting next weekend, or a college student wants to study abroad, I may not have done those things myself — but I can say, with confidence and honesty:
It’s possible. It’s do-able. T1D doesn’t have to hold you back.
The Bottom Line
Lived experience is an irreplaceable form of expertise. As a clinician, I’m grateful to be both a guide and a listener. I learn from the families I care for, and they teach me how to better support others.
To every family who’s ever shared a story, a tip, or a hard-earned lesson: thank you! You make the next journey easier for someone else.
