Michael Difiore : Traveling the World with Type 1 Diabetes

After 10 years at Medtronic , Michael DiFiore opened a new chapter in his life and began to travel the world. In this article, Michael shares his story of managing type 1 diabetes while traveling in India. Thank you Michael for a wonderful story and tips that will surely help other people with diabetes while traveling.

A little over 3 years ago, I left my position at Medtronic Diabetes to travel the world in search of their calling. Last year I was already lucky enough to visit Japan for work. What can I say, India is not Japan. A wide variety of adventures awaited me here.

Training

In order not to do everything at the last minute while I was waiting for my visa, I did all the necessary vaccinations and put enough insulin, test strips, infusion sets, reservoirs and sensors, as well as a spare glucometer in my hand luggage. This allowed me to eliminate the possibility that, in the event of a loss of luggage, I would not have access to the drugs and devices I needed.

Transit

My journey from Los Angeles to Kochi in the southwestern coastal state of Kerala took me through Minneapolis, Amsterdam and Delhi. In total, I spent 26 hours in the air and 11 hours waiting for transfers and moved 13 time zones. Because I didn’t move much during the entire flight, I set my temp basal rate to 110% and adjusted my bolus accordingly.

The security service at Indian airports is very different from those in America and Europe. Armed soldiers can often be found there, so I highly recommend bringing a letter from your doctor about using the pump, or at least the airport card that comes with the pump. Insulin pumps are rare in India, but I was lucky: the senior officer at the airport was familiar with this device.

Adventures

During the trip, my Indian friend once invited me to meet his family and his wife’s family. It was they who discovered for me the uniqueness of Indian culture. I was born in the south (Georgia) and I always thought I knew what hospitality is, but India proved me wrong. A real feast of homemade dishes was waiting for me, and the owners kept making sure that we were by no means hungry. After the first two courses, I nevertheless learned to say “no” politely, but if I had not refused, I probably could still sit at the table. I also realized pretty quickly that this feast required a double wave bolus, which would sometimes last up to 4 hours.

One of these feasts was attended by 50 family members, not counting those who work abroad. Surprisingly, one of those present was a doctor who prescribes pumps – a rarity in India. I took the opportunity to discuss diabetes with him.

Most of the time I lived in a house, but we also stayed in hotels. The last hotel I stayed in was in Delhi. The hotel was cheap, so the quality of services was appropriate. For example, there was no refrigerator in the room. Fortunately, I had carb snacks with me that I brought with me from the US, but it’s still better to book a room with a refrigerator. As for the insulin, I kept it at room temperature.

Food

It took me 18 years to learn how to eat with a fork, and less than a second to remember that in India everyone eats with their hands. Most of the dishes were unfried and gluten free (I have celiac disease) – mostly either vegetarian or with meat. Carbohydrate meals are usually served with a generous helping of sauce. During my entire stay in India, instead of counting carbs, I used a “guess the carb” approach due to portion sizes and the inability to look up carb information. I even often asked myself simple questions, such as “how many cakes did I eat?”

India is a country rich in culture, history and incredible cuisine. This is a country where adventure awaits everyone: both ordinary travelers and travelers with diabetes. That’s all. See you soon!