New forum poster; TransAm W2E on recumbent trikes, plus Type 1 Diabetes

[2Trikes]

Hi everyone!

I have been lurking and reading for several weeks now trying to absorb the great wealth of experience here (plus, smiling at some of the endless debates).

My wife and I are planning on doing the TransAm next year; Astoria to Yorktown during July, August and September. We are going to ride self-contained on ICE Sprint trikes with rear suspension, panniers, tent, etc. In keeping with the idea of riding towards home, we are contemplating adding on to the end of the trip by riding down the East Coast to our home in Central Florida

While we are going to camp out, we also hope to check into a motel/hotel/B&B each week.

One of the biggest challenges for me on this trip is that I am a Type 1 Diabetic (T1D). I use an insulin pump, a matching blood glucose meter, and a continuous glucose monitor (CGM) that gives me a reading every 5 minutes. I will have to carry spare insulin with me that can't get too hot, plus a good bit of kit of things that eventually will stick into me, but need to be clean and dry until needed. The CGM needs to be charged every 5-7 days.

So, I hope to pick your brains a bit to help organize my thoughts and sort the logistics out (logically, if at all possible).

Let's start with where to start? Do we skip Astoria and go to Florence? Either way, do we bike from PDX grab a bus, train, rent-a-car, etc?

Also, if you know of any T1Ds that have done the TransAm, please point them in my direction.

[RussSeaton]

I am familiar with diabetes and bicycling for a summer.  But 23 years ago I used regular and levemir or NPH, not a pump.  And syringes and a meter.  Based on the size of the CGM inserts and pump cannulas and connections, you will need to figure out a way to have a month or so of supplies shipped to you at various locations.  Probably overnight shipping and you will need to spend 2 or 3 days in one location.  And have a knowledgeable contact at home.  And figure out a way to have prescriptions filled while you are away from home and not there in person.  Not sure if you can have other people get your prescriptions or not.  Carrying the insulin is not a concern.  It can get warm and not suffer.  And inside a dark pannier, it will be cooler than the outside air.  Even if you happen to ride in 100 degree sunny days.  You could carry an entire summer's worth if you chose or have it shipped to you.  Due to the complexities of getting supplies and riding with a pump and CGM attached, you might consider discussing with your doctor changing for the trip to regular and levemir administered by syringe.  Also abandon the CGM for the summer.  Go back to the pump and CGM after the ride.  Even going for multi day rides where one pump canula change is required involves extra supplies and space and trouble so to speak.  Using a syringe simplifies things considerably.  The blood meter has no problems.  Its small and the batteries last almost forever.  Strips are small and you can carry large numbers easily or have shipped.

[2Trikes]

Thanks for the thoughtful suggestions, Russ. Really greatly appreciated.

I plan on carrying 30 days of supplies at a time; having additional supplies sent USPS General Delivery along the way by friends and/or our house-sitter. The insulin I carry with me will be in a Frio pouch http://www.frioinsulincoolingcase.com/ which is an evaporative cooling case.

For me, I can't imagine giving up the pump. The ability to set temporary basal rates along with using only one type of insulin (Humalog) is critical for me. I am pretty insulin-sensitive, so when I am riding, I frequently set my basal rate to 0%. Similarly, the CGM gives me a lot of flexibility to fine tune along the way.

Now I will be doing some multi-day trips over the next 8-10 months to see how well my infusion sets/CGM sensors hold up, because if I have to replace them every day, then I will have to consider an MDI (levemir, humalog/novalog) and syringe approach as you suggest.

I have only done single day rides of up to 70 miles so far, or 2 consecutive days totaling 80 miles. Even in the hot, humid Florida heat my pump and CGM have worked well. Yes, I have lost an infusion set, but it's pretty rare.

The lesson I am taking so far is I will have to carry more diabetic kit and fewer clothes.