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Joseph Cobb
Written by Joseph Cobb
Published on 21st April 2021
6 min read

There was a point, I remember vividly, whilst walking through the trodden-down jungle surrounding Peru’s most famous attraction – and perhaps the world’s most famed ruins - when I had had enough.

I was chewing numbly on my fourth Snickers bar, rinsing the caramel and fur from my teeth with a Lucozade Sport and frantically jousting at my fingertips with my blood testing kit. I had been awake most of the night before listening to the incessant communal snoring of a high-altitude twelve-man dorm and inhaling Haribo Starmix. After nearly nine months of travelling through South America with Type 1 Diabetes I was no longer tired, I was exhausted.

In 2016 I ventured for the first time across the globe on a trip that would last nine months in total. I had previously dipped a toe into the redeeming waters of the more avant-garde holidaymaking scene, but nothing quite as fantastic and extensive as ‘travelling’. Aside from the unavoidable snags of life, I bounced carefree and expectantly through the year, attaining passport stamps and visas from New Zealand, Australia, Fiji, Japan and South Korea. 

My adoration for exploration hit me like a melancholy tidal wave upon my return to the UK; I was caught in the riptide of travellers’ blues. With little hesitation my girlfriend, Camilla, and I immediately began planning our next big adventure in 2018: South America. However, I couldn’t wait that long. Whilst Camilla finished her degree at Sussex University, I managed to land a job as a chalet assistant for a small holiday company in the French Alps. I had never before put on a pair of skis, but I had an unexplainable penchant for mountain living and had to give it a go. 

Unfortunately, my alpine escapade was cut short. I became very ill within two months of being away and reached the point where I physically could not do my job. Sadly, the inevitable happened and I was forced to retreat to the unspectacular grey mass of North London suburbia. I was told I had developed Type 1 Diabetes not long after I got back to the UK. It was an unexpected and confusing diagnosis to receive at the age of twenty-five as, to me, Diabetes was a disease reserved for the unlucky and the unhealthy. I was one of the unlucky ones.

Iguazú Falls, Argentina

Less than a year after I was given the bad news, I was in South America. The preparation for the trip was more extensive than before: doctors’ letters, medical supplies etc. etc. However, all-in-all it felt manageable, like it was an uneasy and apprehensive new path to tread but conquering it would serve as the achievement of a lifetime. This was the same attitude I had towards travelling. 

We flew from Gatwick to Madrid, and then from Madrid to Santiago. From Santiago we took a bus to Valparaiso, and then from the bus terminal in Valparaiso a taxi to our paint-splashed hostel atop a long, glute-burning flight of stairs cutting through the bohemian heart of Chile’s ‘Valley of Paradise’. This was to be the first of many new tests. I had quickly learnt from my previous time away that travelling light was the only way to travel. This time, however, I was burdened with 10kg of legal drugs. Diabetics never travel light. Never. 

I proceeded to lug my extra suitcase of medical goodies around Latin America for ten months, fearful of every local bus, water taxi and cross-country coach journey, because if the case was stolen or lost or damaged – unfortunately, all major possibilities, then it would ultimately mean saying adios to any onward plans. The stress of keeping my bags safe soon became a constant, especially as the transport systems in South America proved to be as inconsistent and as unstable as my blood sugar levels. But nobody throws the towel in because of extra luggage.

The real kicker in keeping medical supplies safe is keeping them safe. Insulin must be refrigerated, blood testing strips have to be dry, needles must be clean and so on. And so began the tension headaches … A lot of the time, travelling with a mass of medical supplies felt as though I was travelling with a puppy: I had to know where it was, whether it was safe and whether it had been rolling in shit.

Perito Moreno Glacier in Patagonia.

Aside from the pain of dragging the extra diabetic equipment around with me was the ‘pain’ of Type 1 Diabetes itself. There are, without question, more debilitating life-long conditions than Type 1 Diabetes. And while I would never want to compare diseases or medical misfortunes, there is a horrendously frustrating characteristic of my illness that messes with one’s mind rather harshly. 

Type 1 Diabetes is a condition that fills you with faux confidence and cripples you with very real anxiety in equal measure. There are times when you feel your body is your best friend: reliable, trustworthy and likes doing all the things that you like doing. Then, for no explainable reason, it is the exact opposite. It is an invisible condition, meaning that people around you assume everything is hunky dory, which often rubs off on you, and you can get to thinking that everything is hunky dory. But hunky dory has consequences. Nasty consequences. 

Low blood-sugar levels are no joke, and neither are high blood-sugar levels. Essentially, if your blood-sugar levels are not within a loosely perfect range then you are heading into a coma. Highs have to be really high quite consistently for this to happen, but it takes just one low episode to be fatal. When in South America I was averaging around five near-fatal lows every week. Heading out to do anything unprepared can be a costly endeavour, and this really can suck the spontaneity out of adventure. This was a million miles away from how I was used to living, especially whilst on my travels. My tendency was to censor the diabetic parts of me and ignore the choices that would have made travelling with my condition easier. More often than not I was too proud to make the correct decisions. Poor decision-making often resulted in sitting with my head between my legs on the side of a dirt road chugging back Fanta orange and hoping that the sugar hit my bloodstream before I passed out.

The unfortunate truth for adventurous diabetics is that this infuriating disease loves routine, not travelling. It loves breakfast at 8am and a poo at 9am. It loves a mid-morning walk and a post-work game of squash. It loves an eight-hour sleep in a firm bed and a British climate. There are, in truth, countless little twinges that can affect one’s blood-sugar levels, but the main perpetrators are:

Food. For the fragile-tummed Westerners in South America, this continually bears the risk of sickness. Also, hard to come by when on a strict budget and jumping from place to place every few days. You are not eating to be healthy when away on a big trip; you are simply eating because you have to.

Sleep. It almost goes without saying that your snoozing averages plummet somewhat when sleeping in sweaty dorms, damp hammocks, overnight buses and high altitudes.

Stress. Touring the globe is an immeasurably fulfilling privilege, but fucking stressful at times. A lot of people are out to scam, rob and deceive you, and all in a language that you do not understand. Transport systems fail, plumbing systems can be staggeringly bad and fellow travellers can make you want to smother them in the night.

Weather. In South America, the weather is as chaotic as the politics. Plus, when you are on the move constantly, the climate changes quickly.

Alcohol. Travellers drink. They do. It’s the way they socialise, regroup and organise trips. And the humidity makes a beer or two or three an unhealthy sleeping aid.

These recurring themes are unavoidable and problematic to someone with an underlying health condition. They all help make big trips away from home so memorable, but also bring cataclysmic shifts in one’s physical health and wellbeing. A fit and healthy sightseer often feels the self-inflicted strain of a ten-month tour of foreign lands. A tourist with a pre-existing health condition reliant on permanence feels it tenfold.

Fitz Roy Mountain Range in Patagonia.

On the rocky track up to Machu Picchu I remember one emotion ringing louder in my ears more than any other: homesickness. Previously, this infamous burden had eluded me. It was so far back in my mind that I sometimes questioned its reality. But now it was very real. Pre-Diabetes I couldn’t think of any place I wanted to be more than in a foreign land without a clue as to where tomorrow would lead. Then in Peru, with my heavy new chain to carry, I couldn’t think of any place I wanted to be more than at home with a cuppa and a plate of crumpets. I was grateful for the trip; I was still enjoying the trip. I was still in awe at the world I was seeing unfold before my eyes and the experiences and people that fluttered in and out of my personal trajectory to self-betterment, but I was ready for less. The culmination of months and months of mental and physical instability had rendered me a scrabble bag of mixed emotions, and in this space I had grown appreciative of old favourites.

To anyone wanting to set sail and see the wonders of our planet who has unfortunately been spanked by the unjust backhand of life, I say do it. Do it and then come home and do it all over again. Just, do it responsibly. Do your research, know your illness, and give it your best and most carefully calculated shot. Be prepared and willing to compromise on things that others can do, and will do, better than you and without hesitation and rigorous planning. 

I would have changed many things I did on that second trip to have made my time away easier and less anxiety-inducing, but I still would have gone. You have to know your disease to survive your disease, and knowing the limitations a health condition puts on you is a good thing, because you learn to live around it. Some conditions can be conquered and some cannot. So, that has to be okay. You have to be okay with that unsavoury truth to surpass it. To ignore a problem only really adds to a problem, and to not treat a serious medical condition with the management it needs is infantile and irresponsible. 

I would prefer to live and travel without Type 1 Diabetes, but since being back from South America I have made peace with the condition. Part of my personal journey now includes this illness, which means it is just another bag to carry. I take it seriously, I make better decisions to accommodate it and, ultimately, I live my life through it. I will be going away again, and I am fully aware that there will be difficulties along the way, but with a bottle of Lucozade, a better understanding of my illness and a whole lot less pride, I will continue the adventure.