Europe, 2016/17
Most if not every intrepid traveller or holiday-maker will end up in Europe at some stage in their life. My trip to Europe spanning the latter half of 2016 and the early months of 2017 marked my first experience of truly living overseas for and extended period of time, as well as another chance to backpack for a few months or so. The first part of my journey saw me on university exchange in Norwich, England where I spent three months living and studying at the University of East Anglia. With the uni semester ending just before Christmas I planned to spend the rest of my time backpacking throughout Western and Central Europe with my girlfriend. Perhaps it was the length of time that I was away that made this a bit of a bumpy trip but nonetheless I can safely say that it was still such a fun and enriching experience that I will never forget or regret. Given the diverse problems I faced and the diverse places where I encountered them, it is best to break things up for the sake of clarity and comprehensiveness. So let’s start at the beginning.
United Kingdom
Ah England, how much you taught me. Given I was at uni while I was in the UK it was inevitable that I was going to learn a thing or two. To name a few, pork products are in fantastic abundance with bangers and bacon in every staple English diet. Public transport is daylight robbery as you’ll see yourself paying through the nose to get a 20 minute bus or tube ride. But you’re not here to listen me complain about the economic crippling I suffered at the hands of National Rail. No, you’re here because you’re bold enough to love travelling whilst managing diabetes. As with any trip, I set out with all my supplies, hoping that pharmacy and doctors visits would be few and far between, if any at all. This was my second trip to England and one where I didn’t expect to encounter many issues regarding my diabetes. For the most part this was true but my trip was not without its hiccups.
Carrying five months worth of supplies is heavy but beats the hassle of navigating a foreign healthcare system. For me this meant carrying a large shoulder bag. Never part from your supplies, even on a flight. Before boarding your plane just let the bag check-in staff know that you need to keep it with you as it contains medicine. I was given a sticker allowing me multiple carry-on bags without question. Packing light is often the mantra of many a traveller but for diabetics more is definitely more. One thing I will stress for extended travel is to pack plenty of blood test strips for your glucometer. When you are overseas the last thing you want to be doing is rationing strips. This is doubly important when you factor in new and exciting foods and lots of walking where it is important to keep a keen eye on your sugar activity. Much like Asia and USA I found that most pharmacies stocked Accu-Check meters and strips so I would recommend bringing one if you own it.
For those who have read about my trip to Malaysia and Thailand you may remember that I struggled to find low glycemic index foods in that part of the world. In England I experienced the opposite problem. Don’t get me wrong, there is plenty of fast sugar in drinks and lollies in the UK. Yet for a country that absolutely loves a naughty sweet or two, I found it quite difficult to locate the diabetic’s weapon of choice — jellybeans. As Australians we have been taught from day one to always carry jelly beans with us as they tend not to melt together in the heat like other lollies do. Naturally this isn’t as big a problem in the UK as the sun forgot that country a long time ago.
However there is something comforting about having the familiar sugary legumes by your side. If you find yourself low on the go and need a sugar hit, don’t expect small pharmacies to stock many sugary products. Some may sell bottles of soft drink but none seemed to have jellybeans or other lollies on hand. After searching high and low I managed to find some jellybeans at Tesco. When I did I took full advantaged and stocked up. If you have the space, I would recommend taking a lot of jellybeans because you really can’t have too many.
Beyond my struggle to locate jellybeans, the UK was relatively straight forward. As I was living on campus I was able to keep all my supplies in my room and my insulin in the communal fridge. Fortunately I was living with about 10 other fantastic people in my flat and they were completely understanding and helpful when I explained the importance of keeping my insulin cool. In Australia I keep my insulin in the fridge door as it can get a bit frosty at the back of the fridge so that may be something to keep in mind.
Another thing to keep in mind the importance of timing. As a pump user I change my infusion set approximately every three days, usually in the morning or at night. Timing comes into play more when you are travelling as often you may spend the entire day away from replacement insulin and supplies. One morning I changed my line right before I left for the day. This just so happened to be a dodgy set so I had to go home and replace it immediately. Luckily I was only about an hour from home but it made me realise that when I changed my line I needed to either make certain that it was working properly before I left for the day or bring a spare set in case. This isn’t really an issue specific to those travelling but is nevertheless one to avoid.
The last thing I will say (again) about the UK is that it really is a very cold place. This means your body will be working overtime to keep you warm and you will spend lots of time indoors with lots of other people. Sadly this means you are likely to get sick which can affect many people’s sugars. Personally I tend not to see a change in my sugars when I have a cold however in the UK I found that my sugars were uncharacteristically high when I was sick so I ran a temporary basal to account for this. If you know your sugars are affected by cold or flu then it may be worth brining medication from Australia so you know how the meds will affect you.
In the end I managed to spend an amazing and busy three months in the UK without needing to see a doctor or restock on any supplies apart from jellybeans. This included a weeks trip to Edinburgh and the Scottish Highlands which were identical to England concerning diabetes management. Of course the Highlands are quite remote at times but there are many small towns littered across the country. My biggest piece of advice for the UK would be to bring plenty of jellybeans, stock up when you can, and don’t worry if you have to make the temporary switch to other lollies. Also get used to eating pork.
Barcelona & Paris
If you’re planning a trip to Europe be wary of those friends who say things like “oh my god you’re in Lisbon at the same time I’m in Helsinki we should meet up!” Ok that’s an exaggeration but people do exist who too frequently mistakenly equate the ease of travelling with the size of Europe. Don’t be fooled, it is a big and diverse place. Despite everything I’ve just said it is probably best to break down my travel through continental Europe into Western and Central Europe, given the relatively short amount of time I was in each place and for the sake of the accuracy of my information.
I began travelling in Spain and France just before Christmas and culminated my journey in Belgium after going through Luxembourg, the Netherlands, Germany, Czech Republic, Hungary, Austria and Switzerland. Unsurprisingly I found the natural border to separate these two regions was Berlin as its historical segregation demarcates where Soviet occupation has influenced the people and culture. So let’s being with Western Europe.
I spent no more than around four days in each place I visited and the first stop was Barcelona in Spain. This actually took place towards the end of my time in England but it is more appropriate to speak about it here. Almost every person I spoke to before I went said “Barcelona is amazing but watch out for pickpockets”. I heeded this advice but unfortunately it didn’t stop me getting mugged on just my first day. While this didn’t have a profound impact on my diabetes, as only my phone and wallet were taken, it is worth mentioning for several reasons.
First, your pump may be mistaken for a phone by those unfamiliar with one so be extra careful to watch your pockets in tourist areas such as La Rambla. Second, without money you cant buy anything you may need such as jellybeans so you should always have a packet on you even if there are shops and sugar in abundance. Finally, I keep my glucometer in a leather pouch that looks a lot like a wallet so from now on I will keep it in something more medical looking so as to avoid the preying fingers of thieves. This was definitely the most difficult part of my whole trip but in the end it’s important to remain positive. I still had my pump, meter and all my supplies and was unharmed so it could have been much worse. Despite this I’m glad to say I had an amazing time in Barcelona. One great feature of Europe which I first encountered in Barcelona was that most if not all pharmacies are often highlighted by large neon-green crosses which make them easy to spot. However when I did visit one, not one member of staff spoke English, which, though understandable, was nevertheless frustrating when I was trying to discover if they stocked my brand of blood test strips. Beyond that my time in Spain was uneventful from a diabetes standpoint.
Next on the agenda was France. Fortunately, I had no encounters with the medical system. Sadly that does you no good as I cant offer too much insight. However, France is widely considered one of the most developed and prosperous nations in the world and I’m sure this would reflect in the quality of their healthcare. In saying that, Paris is a very busy and very large city so I would definitely make sure you know where the closest pharmacy and hospital is located if you are staying there. The only other noteworthy thing is that, like the UK, I struggled to find jellybeans however there is another lollie called Dragibus which are almost identical to jellybeans. I found these worked faster than gelatine based lollies like gummy bears so they are my best bet as a jellybean alternative. Similarly, France too employed the large neon signs to identify pharmacies.
Belgium
After spending only a couple of nights in Paris I headed to Arlon in southern Belgium. Arlon bookended the bulk of the travel as this is where I stayed for Christmas and New Years and for the last few days before returning to Australia. My girlfriend and I were lucky enough to stay with her parents who lived there. To be frank, my time in Arlon cant really be classed as travel as I treated it much more like a home-away-from-home. This was a welcome break from months in student accomodation and hostels however it doesn’t offer much in the way of helping others who are thinking of travelling there with their diabetes care in mind. In saying that, we did go on day trips and of course, I still had to take care of the day-to-day management.
Arlon is a very small country town and really gave me my sole glimpse into rural Europe. One thing to note is that there are certain times of day when stores may temporarily shut for a lengthy European lunch. I found that many stores, including pharmacies, were closed between 12 and 2 PM and may more stores were totally shut on Sundays and many Saturdays. This is important to note if you are thinking of putting off a restock of jellybeans or supplies. On that topic, if you happen to see a film — be prepared for them to ask you to give up any food you have as they enforce a strict no-food policy unless purchased from them. They will go as far as to check your bags so be upfront about your jellybeans. After about five minutes of broken-French explanation it finally got through that they were medicine at not snacks. Yet this may only be an issue when language is a barrier.
Bruges and Bruxelles however were much larger cities that had everything you would need. Just make sure you bolus for all the chocolate, waffles and beer. Ultimately I found that Belgium was much like France. Pharmacies were clearly labeled with large neon-green crosses and both low and high GI foods were easy to find. My biggest piece of advice is to take advantage of open and well-supplied stores.
Amsterdam & Berlin
Following Belgium, my girlfriend and I set out on the road for a month of immense travel. Our first destination was the Dutch capital, Amsterdam. This was both a beautiful and exciting city that has something to offer for everyone. Some picture Amsterdam as an exclusively party destination which may dissuade some people, and particularly diabetics, from visiting but it is definitely more than just that. It is bittersweet that I must confess I have very little to report in the way of diabetes for Amsterdam. The city is not as big as many other European capitals so even if you do find yourself walking most places you can expect to find shops and sugar with ease. However I was not able to maintain my newfound love for Dragibus lollies (they’re delicious, trust me) in Amsterdam nor could I locate jellybeans. I had to settle for gummy bears which I found I absorbed slightly slower than the other forms of sugar.
Next on the agenda was Berlin which was a six hour train ride away. We travelled exclusively by train with our Eurail passes which we found to be a fantastic way to get around. However you should keep a keen eye on your bags as pilferers have been known to go through people’s belongings on extended train journeys. However we had no trouble whatsoever and arrived in Berlin ready to explore. Perhaps if I had done some more research I wouldn’t have been so surprised at the city’s size. It is enormous. Fortunately it is serviced by a very reliable underground network but it is extremely spread out in terms of sights and shops. If you go out for a day of exploring take all the sugar you will need with you as you may find yourself caught out with no open shop in sight.
In Berlin I stayed at one of the best hostels I’ve had the pleasure of visiting. The sole fault was that there was no communal fridge to keep my insulin in so I had to ask to keep it in the staff fridge. They were more than happy to accomodate however when I went to retrieve my insulin I noticed they had put the insulin right at the back in what was a very cold fridge. Fortunately the insulin had not frozen nor denatured. However I would now advise anyone to always request that the insulin be put in the fridge door or insist that you put it in the fridge yourself so as to avoid the chance of it being too cold.
Prague & Budapest
At this stage in our journey we ventured across the cultural border into Central Europe with out first stop Prague. This Bohemian wonderland was truly spectacular. When we first arrived at our accomodation I was a bit taken back. Though we stayed in a beautiful redeveloped monastery, it resided on top of a snow covered hill in a very suburban area. Hard to access places and lack of shops always puts me on edge for fear that should I run out of sugar, it would be very hard to find. If you haven’t figured it out yet, I’m slightly paranoid about access to sugar should the need arise. However these fears were promptly swept aside as our Airbnb host walked us through the local area and showed us nearby supermarkets that would have been otherwise difficult to locate.
Though the shops were close enough, Prague in winter is far too icy to walk everywhere so you will eventually need transport, particularly at night. There is no public transport to speak of and from what I have researched, the taxi network is rather corrupt and often rips off and intimidates tourists. Fortunately, Uber is both cheap and abundant in Prague and was a great way to travel even if you are on a strict budget.
There were a few pharmacies littered around the older parts of the city but again I had no need to visit them so I cannot elaborate as to what they had to offer. What Prague did give me was a chance to rekindle my newfound love with Dragibus as a jellybean alternative.
From Prague we ventured south-east to Budapest. Of all the places on our itinerary, Budapest was the one place I knew the least about so I really had very little idea of what to expect. In hindsight it was my favourite place. I loved it. While Prague almost appeared to market their Soviet heritage as a tourist draw, Budapest embodied an intriguing mix of post-Soviet grunge and proud imperial worldliness. I digress. Despite my preference for Budapest over Prague, Hungary was almost identical in terms of diabetes management.
Both are big and cold but have many shops and pharmacies. Many of Budapest’s most renowned attractions sit atop Buda Hill on the west side of the Danube. This is a relatively large hill that can be ascended by way of funicular or foot but can be extremely icy in the cold. Take everything you will need for the whole day up the hill but do not be alarmed as there are also plenty of shops up there.
The biggest lesson I took away from these two cities would be that when visiting snowy areas, you should always research where the closest shops are to your accomodation and becoming familiar with how to get there and their opening hours before arriving.
I thoroughly enjoyed my time in Czech Republic and Hungary and wish I had of spent more time in both however it was back to Western Europe.
Vienna, Salzburg & Zurich
We concluded our month backpacking with a quick-fire week beginning in Vienna and concluding in Zurich with a few days at Salzburg in between. Vienna and Zurich both reminded me a lot of Melbourne. Contemporary with a bit of old-world charm thrown in. Not to mention trams. These cities did not seem to be in hibernation at all during the colder months of winter as most shops and places remained open. Salzburg has to be one of the most picturesque places I’ve had the pleasure of visiting. Though we were only there for little over two days, we managed to cram in so much including a half day-trip up Untersbergbahn which is a massive mountain not too far outside the city. Being my paranoid self I was conscious of access to sugar on the snow heaped mountain but fortunately being a popular skiing destination there was plenty of open stores and people around which helped ease my mind. Being the second last stop on my trip and a very cold (-16°) place I kept my insulin locked in my hostel locker rather than in the fridge to avoid the hassle of parting with it. While I would always preach prudence sometimes it is just easier to take a small shortcut if the circumstances permit.
I couldn’t help but feel a massive sense of relief and accomplishment when I finally made it home. Diabetes management has never truly been a huge weight on my shoulders at home but it certainly pushed me on the road. The thing I disliked the most was the constant packing, repacking and moving. There is something very reassuring for me in having all my supplies in the one location. More so than perfect blood sugars, I believe peace of mind is the ultimate goal a diabetic can achieve when travelling. At the end of the day you have to do what is best for you whether it is a strict regime or a more relaxed outlook. One thing you must do though is back yourself in and have confidence knowing you are going to take the best care of yourself and have the time of your life.
