Flying Osaka to Stockholm: The trip begins

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(the article below accompanies this video)

How do you keep your blood sugar in a good range while flying in an airplane across time zones? It can be pretty hard. Personally, I’ve never been very good at it. But it’s worth working on, especially if you’re a diabetic who loves to travel. F.W.D. (flying while diabetic) is a whole skill unto itself.

So when I found myself flying from Osaka, Japan to Stockholm, Sweden to begin a three-month excursion through Europe I decided to see what I could do with my insulin and food in the planes and the airports I would be spending so many hours in.

What makes blood sugar high on airplanes?

I’d like all my pre-meal BG readings to all be between 70 and 130, of course. But on airplanes I often find myself over 300. It’s not only the food that twists your numbers into grotesque shapes, but it can also be the stress of flying (“this plane could crash!”), the weird sleep schedule and positions, and even the excitement of the trip.

• Emotional stress. You can be excited and nervous to be traveling; even “positive” stress can make BG go up.
• No sleep before the flight. We were leaving the house at 5:00 am in Osaka for the airport, and I decided to stay up all night and pack. Not a bad plan from a sleep standpoint, but a difficulty for diabetes.
• No exercise on the airplane. A big factor, and one of the main reasons I don’t really like flying to begin with. Man is it dull.

• Airline meals. I quite like airline meals. I like the “demented picnic” feel of eating them in my bleary, cramped little seat. But even when I think I know the carb content, a generous blast of Humalog often seems not to take care of it. Mix the lack of exercise and the dense food and things are bound to get tricky.
• Time zones vs. basal insulin. It’s just simple math to figure out what to do with my once-daily Lantus dose, but still it seems to take a day or two of adjusting to it after taking half-shots at weird times in airports.

The airplane meals

On this day, Masayo and I had a short flight from Japan to Beijing then the main flight to Stockholm; there would be a total of three meals. Tasty, sure, but that’s a lot of carbs to mix in with this crazy sleep schedule.

At first it wasn’t that bad — I was 180 during the flight to China after the meal. Unfortunately the day wouldn’t always be as smooth as that. By the time I was in the Chinese airport waiting for the next flight, I had gone up to 224. The madness has begun.

Later on the flight to Stockholm, already groggy and with my psyche smeared across several time zones, I took another shot for a meal. This third and final meal of the day was a bowl of chow mein noodles of undetermined carbs. I had little hope my blood sugar would be lower than the upper 200s afterwards.

But I was pleasantly surprised once we arrived a million hours later in Stockholm and had trudged through Old Town to our hostel.

The resulting BG in Stockholm

Stockholm was chilly; it was a dark, northern night and the October air was clear and cold. After taking a bus called Flygbussarna into the city center — expensive but of course comfortable, reliable, and clean — we walked 25 minutes to Ånedin Hostel, which was on a large boat floating off the edge of Old Town.

In the room, I finally got a chance to check — I was 108! The little wooden room with its tiny dark porthole was quiet and Masayo and I were both out of it and eager to sleep, but I was extremely pleased about my BG. Despite my underlying philosophy of rationalism and reason, I do get a kick out of omens and portents: if Stockholm is welcoming me with a 108 then I know our next few months in Europe are looking pretty good!

But will it last?

Normally I’d think 108 was too low for before bed, but I didn’t know what to do in this situation. It was bedtime, and I had no juice with me: the security lady at the airport had taken it from me lest I detonate it while aboard the aircraft. (Intercontinental ballistic grapefruit juice.) I ate some Calorie Mate instead and headed to sleep. If I got low in the night, would I wake up – or was I too worn out? Sometimes you have to trust the fates.

The next day

We awoke at 6:30 am local time and my blood sugar was… drum roll! … 131!

“Flying while diabetic” lessons

It’s good for a diabetic to learn as much as he or she can from everything that happens, and the lesson from Day 1 of this trip was pretty simple, if curiously elusive: when stress, lack of exercise, and thick, fat foods are how you spend a day flying, just calculate a little more insulin doses. Take diabetes seriously, check blood sugar often, and adjust the best you can.

Anyway, the highs on the planes sucked but my BG evened out because I kept checking and didn’t get discouraged. Remember, if you get it wrong and end up high or low, great! You’ve learned something for next time.

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