India and diabetes!

[tilly-roo]

Has anyone ever been to India with your diabetes? Any advice? As in do's and don'ts, maybe certain foods to avoid etc. I am travelling next Saturday!

[DeusXM]

Haven't been to India, although I live in a place with a 70% Indian population and have popped over to Asia a few times, so take the following with a grain of salt....

Although diabetes is known in India and is in fact fairly common when it comes to T2, I'm not sure how culturally accepting they are in India when it comes to injecting in public. It may pay to be discreet - although I'm sure many people will be understanding, it may be misinterpreted.

Remember that Indian cuisine is high on carbs and fats, which may totally through your ratios off balance, in addition to the disruption you're going to get anyway from travelling. I take it you're also familiar with the concept of 'Delhi Belly', so be aware there is a possibility you could get vomiting and diarrhoea, which will also have interesting effects on your BG. Although it can also work the other way. I was told most people who went to Thailand got the runs and pukes for the first couple of days but to put it crudely, I was stoppered up for whole two weeks!

Try and get a letter from your doc explaining you have diabetes. English is reasonably widely spoken in India and is near universal for professionals so if you do encounter any difficulties you have some extra back-up.

I don't know about the availability of diet soft drinks. If it's anything like anywhere else in 'developing' Asia you may be able to find diet Coke if you're lucky. So be careful what you drink and avoid non-bottled water.

And finally - watch the roads! In my experience, Indian and Pakistani drivers have a very excitable and idiosyncratic approach to safe driving that doesn't really take into account the presence of pedestrians, lanes, or indeed other cars.

You should have a great time - all the above is general good travel advice for people with diabetes anyway. Enjoy yourself and make sure you share your photos with us!

[DeusXM]

Oh and before I forget - get something like a Frio pack for your insulin, it's bloody hot and humid in this part of the world at the moment!

[tilly-roo]

Thanks! I've got two huge frio packs! :)

[foxl]

Wish I had the opportunity.

DEus has a lot of travel wisdom.

And yes while in urban areas they are used to tourists, I still would be cautious about public behavior (like injecting) and how you might by default be representing westerners to them ... ? Or perhaps you;d be mobbed by underworlders wanting to buy junk ...

Food poisoning would be a big threat. Do NOT eat anything, I once was cautioned, that might have required refrigeration after being prepped. I was once there in a tour group and could pick out at the table each person who was going to get sick within 24 hours by what was on their plates.

DO NOT GET ICE IN DRINKS. People often overlook that one.

[tilly-roo]

Yeah, ice in drinks is a big one.

What about foods to avoid? I.e I know I should avoid coconut milk as it's high in sugar but doesn't that go in a lot of things?

[tilly-roo]

Also do you think it would be a wise idea to list a list of common dishes/foods eaten in India and their carb counts?

[zoelula]

Preparing a list of dishes/common foods and their carb counts sounds like an excellent idea, tilly-roo. That way you will know how to bolus for what is put in front of you. I don't know how much carbs you tolerate but remember that things like curry sauce have flour in them and oh those wonderful Indian breads...sigh.

[DeusXM]

Also do you think it would be a wise idea to list a list of common dishes/foods eaten in India and their carb counts?

This will be nearly impossible. Although India does have franchised operations, you will probably find more often than not you will be eating in one-offs and bespoke environments. You also won't have accurately measured by weight portions and if you start getting some carb counting scales out all the time you're going to end up looking very weird. I would start quickly learning to 'guesstimate' - on a trip to somewhere like here you will not have the luxury of having someone neatly categorise all the components of a dish for you and your ratios will be screwed up anyway. Your best bet is to test, guess, test again in two hours, learn from that, and make sure you've got a regular soft drink close to hand at all times and if you're ever in circumstances where you aren't 100% sure you may have unfettered access to buying soft drinks (on trains, in rural areas), plan ahead by taking some with you in a bag, and err on the side of caution when it comes to dosing. It is a lot easier to run a few mmol/l or mg/dl higher than you would normally like than to run a few lower than you'd like.

Put it this way though, people with diabetes have climbed mountains in the middle of the jungle and lived with hill tribes in straw and mud huts, and been able to survive. Indian cities should be just fine.

[tilly-roo]

Thankyou. :) I won't bother writing a list of foods down I will be able to manage, then. I'll guesstimate!

[faeriefi]

Hello! I went to India last summer and it was fabulous! The food can vary depending on which region you are travelling in, so the guesstimate is a good system. I did try to get an idea beforehand of the average carbs in some types of bread, and if you eat rice or yogurt (as this or other cream can be put in curries) then you may already have an idea of how many carbs you'll be consuming in meals. You may also find that there is a lot of fruit, most of which you'll probably already be familiar with, but try to just stick to kinds that you can peel. Make sure the food is always piping hot (especially fish) and any bottled water has a sealed lid. It is very hot so do protect your insulin and, if your like me, then be aware that the heat may decrease your ratios. It may be a good idea to bring along something for bellyaches, but depending where you are you may be able to find a chemist or a doctor to prescribe something for you, you won't be the first tourist looking for some relief!

I did try to be discreet about my injections as I know showing some flesh wasn't very polite, but be aware that sometimes doing this at the table can be much easier and cleaner than injecting in the restrooms.

It may be an idea to bring a dr's letter stating your need to carry insulin on the plane if you're planing any internal flights. Generally this shouldn't be a problem, but both my frio and pen did usually get thoroughly inspected before they were returned to me.

All that being said, I was one of the unlucky travellers who got ill, but mine didn't come on until I had boarded the plane home. I followed all the cautions about food and drink and still managed to pick up what turned out to be cholera. Luckily I was diagnosed at home so it was easy enough to rest and treat (basically drinking plenty of fluids and let the bug make its own way out).
So do be cautious, but most of all enjoy yourself! India is a beautiful country with a fantastic culture, so make the most of your time there!
I hope you have a fantastic trip!:D

[keeranx]

I'm not from India but I'm from Pakistan and Afghanistan...so I'm pretty familiar with curry and naan...I haven't traveled there since my diagnosis though...I would probably just guestimate everything...that's how I eat our traditional food here..I'm awesome at guessing carbs in naan and rice etc...but just cause i've had experience over the years and developed familiarity with certain kinds of foods....If I were you I'd check and hour or 2 after every meal and make sure your bg is stable and correct if you need to ^-^

[Ailsa]

When in asian countries I never eat any sort of meat or chicken unless it is in the hotel restaurant, and drink only bottled water. Particularly I never eat meat from street vendors. Even a tiny piece of bacon can make you sick. If you go to a market where meat is sold you often find there is no refridgeration. Iv'e never had a problem when sticking to that.

[sweetlife]

Few tips for you when you come to my country,well come!
*Depends on which part you visit,insulin is widely available here,cheaper than western countries.BUT may not in remote areas/small villages.Let me know which cities you are going to visit.
*Do double check on expiry date on pack if there is any need to buy insulin,better to be safe than sorry.
*0 calory diet i.e pepsi and coke and available in big shops and shopping malls,here do double check for expiry date printed on bottom for your safety.We Indians are aware of diabetes but hate to drink diet soft drinks,reason is unknown to me!
*ALWAYS order "Tava Roti"rather than Naan or Roti if you are going to eat in restaurant or in your hotel and wanna try Indian food.One Naan contains approx of 75+ carb and Roti has approx 55g carbs depending upon their size and weight,both made from Maida a refined besan of wheat,where "Tava Roti"has carb of around 18-20 Grams if weighed approx 20-22 gram.
*You will love south Indian food in India,do eat as many as Sada Dosa(without potato malasa/toppings)you like.One sada Dosa has approx 18-25G carb depending upon its size and thickness.
*Do carry your doctor's certificate with you please.
*In worst condition do have your hotel address and contact numbers with you in worst situation of Hypoglysimia,keep it in such a way that it is easily accessible.
*India has changed rapidly so dont worry,you are comming to most growing economy of the world,fastest one!Be prepare of surprises if you visited India earlier and now.
Good luck,welcome to India.Do let me know if you need any help in this subject.Cheers and have a nice time ahead.
Also do you think it would be a wise idea to list a list of common dishes/foods eaten in India and their carb counts?
Give me names of dishes I shall find out Carb value of them.

[sweetlife]

Generally coconut water is not shooting BS of my daughter as per my observation but do avoid Jelly inside coconut,it shoots up her BS like anything.
Yeah, ice in drinks is a big one.

What about foods to avoid? I.e I know I should avoid coconut milk as it's high in sugar but doesn't that go in a lot of things?

[tilly-roo]

Few tips for you when you come to my country,well come!
*Depends on which part you visit,insulin is widely available here,cheaper than western countries.BUT may not in remote areas/small villages.Let me know which cities you are going to visit.
*Do double check on expiry date on pack if there is any need to buy insulin,better to be safe than sorry.
*0 calory diet i.e pepsi and coke and available in big shops and shopping malls,here do double check for expiry date printed on bottom for your safety.We Indians are aware of diabetes but hate to drink diet soft drinks,reason is unknown to me!
*ALWAYS order "Tava Roti"rather than Naan or Roti if you are going to eat in restaurant or in your hotel and wanna try Indian food.One Naan contains approx of 75+ carb and Roti has approx 55g carbs depending upon their size and weight,both made from Maida a refined besan of wheat,where "Tava Roti"has carb of around 18-20 Grams if weighed approx 20-22 gram.
*You will love south Indian food in India,do eat as many as Sada Dosa(without potato malasa/toppings)you like.One sada Dosa has approx 18-25G carb depending upon its size and thickness.
*Do carry your doctor's certificate with you please.
*In worst condition do have your hotel address and contact numbers with you in worst situation of Hypoglysimia,keep it in such a way that it is easily accessible.
*India has changed rapidly so dont worry,you are comming to most growing economy of the world,fastest one!Be prepare of surprises if you visited India earlier and now.
Good luck,welcome to India.Do let me know if you need any help in this subject.Cheers and have a nice time ahead.

Give me names of dishes I shall find out Carb value of them.

Hello, thank you for the reply! I am going to Chennai, Maduari, Kerela, etc. If I need extra insulin where will I be able to find it quickly? I was just wondering how many carbs things like biryani will have in it as I know we will be eating a lot of these. And dhals? (Sorry, think I got the spelling wrong!)

[sweetlife]

Tilly-roo
No prob getting insulin in Chennai or other parts you have mentioned.I live in smaller city than Chennai and I easily get Lantus,Humalog and Novorapid+Levemir if I need so don't worry.Only thing I check while buying Insulin that it they kept in freeze and not in freezer,I go of my own to buy.
About carbs in INdian food,go here and you will get general idea of carb values in India plate,good luck.Its dal or daal and not dhal .
Calorie Counter, Diet Tracking, Food Journal, Nutrition Facts at The Daily Plate (http://www.thedailyplate.com/)

[Delphinus]

Has anyone ever been to India with your diabetes? Any advice?

I bring my diabetes everywhere.

I am sure if I went to India, I would bring it there as well.

I don't see why not.

[tilly-roo]

Also, about time changes...

I will be flying at 9.45 in the morning there (english time) and arriving at 1am indian time. How do I adjust my lantus? Rapid will not be a problem as I will just that whenever I eat, it is lantus that will be the problem.

Similarly, on the way home I will be flying at 8.40pm indian time and arriving home at 7.30am english time. How do I adjust my lantus for this? :confused:

[tilly-roo]

Sweetlife, which part of india are you from? Do you speak tamil?

[sweetlife]

Chennai is in South,I am in West tilly-roo.Sorry I don't understand Tamil though it is one of the most anscient language after Sanskrit.
Sweetlife, which part of india are you from? Do you speak tamil?

[UpNorth]

I've been on long flights on MDI a couple of times 2 ways, and what i do is to NOT take my basal during the flight, but take some rapid every now and then, and then take my basal at my usual time when i have arrived. I take my basal before bed so i take it day before flying, and then again before bed when i'm going to sleep the first night after arriving. Of course, means being a pin cushion during the flight, but aren't we always:D

As for diet. I haven't been to India. But i have been to China. And what i did there was to not eat too much or too many different things the first few days. But i'm one of them lucky who doesn't get much or even any jetlag, and when my body has adapted to a new timezone i can do what the locals do. Never had a problem with my stomach when travelling :) The only thing i DON'T do is buying food on the street from a vendor. Other than that i go to both big and small restaurants.

But bring acid neutralisers, immodium and pills or capsules with active yoghurt culture in it. I always take those yoghurt capsules if i know i have been eating something a tourist would normally avoid LOL