This topic is mostly about diabetes in India, and is probably going to be split into a few posts as there’s too much to cover in one, so I’ll just cover food and supplies briefly in this post. So, if you read my blog you will know that way before I left on my adventures I wrote a post about the issues of travelling with diabetes in India; which included Supply Worries, appointment worries, and general diabetic woes that could be made worse abroad. All in all, most of what I worried about was complete nonsense as India isn’t the third world developing country that the media seems to portray it as. Yes, of course there are parts of India that are underdeveloped, but these aren’t generally the sort of places a traveller would go to (a journalist perhaps, but not a traveller).
So, what did I learn in India in terms of Diabetes ? Quite a lot actually: some things that have surprised me, some things that really haven’t. So let’s start with a major issue: supplies.
I had no idea what the supply situation would be before I came out, so I brought a fair amount with me, packed neatly into a separate packing cube. This consisted of 9 Novorapid Flexpens, 4 Lantus Pens, 2 Blood Glucose Meters, 500 needles (which will last 2 yrs), 500 lancets (which will last until I’m middle aged), and 200 test strips with 10 ketone strips. Now, normally one single insulin pen would last me 5-6 weeks at home so I thought I had plenty to last me the best part of a year. In India each pen has lasted roughly half that time, which means I’m having to buy new ones as and when I need them.
Before I came out here the great guys at FRIO kindly sent me a couple of cooling wallets and some other goodies to help me on my way; I’d already bought one cooling wallet, so this meant I had enough to keep all my pens cool. However, as we all know, theory and practice are completely different things; let’s just say that I don’t think all of my pens have been kept cool all of the time, so some potency may have worn off. This, plus the heat and the abundance of high carb food and drink, means I’ve been running through insulin pens almost as quick as I can drink a Kingfisher. Luckily in India, as there seems to be a bit more common sense here than in England, there are medical shops everywhere; even in small towns you will find at least a few, varying in size and supplies.
Now, the standard price of my pen (Novorapid Flexpen) was 617r (£6.48); this price isn’t the shop price, it’s actually the set government price so is standard throughout the subcontinent. You will NOT find this pen everywhere though, in some places (Bangalore) every shop had them, in other places (Jaipur, Mumbai) every other shop I tried had them, though shops do stock other pens such as Novomix and other pen and pump equipment (if you use onetouch stuff then you’re in luck over here-it’s advertised and sold nearly everywhere). A box of test strips comes to around £9, though for some reason I found that these vary, and of course it depends which meter you use (although I’d really love to ask for every possible pen, pump, test strip and their prices to share with you guys, I really didn’t have the time- or the patience for that matter-to do so). What I will say though is that if you are travelling to India, you really needn’t worry about supplies.
The food, at first, can be a little surprising. If you’re over here on a budget then you’ll more than likely indulge in a lot of tasty, if unhealthy, street food. Some of the street food I’ve had here has been nicer than restaurant food; it’s quick, convenient, and usually goes down well with chai; but there’s a major downside: 90% of the street food is fried and is ridiculously high in carbs. I’m not going to go into too much detail about the different foods, but just be careful; even a small, seemingly harmless samosa has sent my levels rocketing because of hidden ingredients which you don’t taste straight away; these being things like potatoes or fruits. Even when you ask the vendor what’s in it, depending on his English he may well just reply with either ‘sweet’ or ‘spicy’ which doesn’t help whatsoever.
Some of the easiest food to handle is actually the larger meals; the full on gravy, rice, bread etc meals. This is mainly because you can pretty much see what you’re about to eat and how much of it there is. The only exceptions to the rule are meals like Thali and Dosa’s as waiters may keep dumping things on your plate when you think you’ve finished eating; in this case I treat the meal almost like I would at a buffet or BBQ and just inject small amounts frequently which, for me, seems to work fine.
Obviously there are a lot of types of bread in India and it can take a while to gauge the carb content but, if you’re over here for a while, you’ll soon pick it up no problem.
Chai glorious Chai. What’s not to love about this 50ml cup of hot, milky sugar water? No, but in all seriousness, Chai is very nice. I first had it in Mumbai and couldn’t work out the taste, then after having it many times I realised it’s just sweet tea with homogenized milk, which gives it its unique flavour. Even if you’re not Diabetic, chai is not good for you; over here if you ask for no sugar, most of the time I’m sure they think this means ‘less sugar’; the only places you can get it without sugar are the better restaurants rather than the street vendors but, alas, having Chai without sugar is like having a non-alcoholic beer: it’s nice but there’s something missing, and is nearly pointless. I suppose this doesn’t help with having diabetes in India.
Of course, as mentioned above, Chai is also sold on numerous street corners by vendors; some only sell Chai, some sell Chai and food. This is where it gets messy. I normally don’t inject with a cup of Chai (I usually have Chai in the morning when I set off exploring and just leave it) but often if I’m a bit peckish I’ll grab some food to go with it; this is when I’ll check and inject. The combination of fried, high carb, high fat food (no matter how fresh or tasty it is) plus a cup of Chai is not something you skip an injection on (not that I think any of you would do such a thing; after all, we’re all perfect with our diabetes management, right?).
I’ve not gone into too much detail on these subjects as I genuinely don’t believe you need to know the exact carb content of every Indian meal, nor do you need to know how Indians live with diabetes; if you’re heading to India you only need to know how YOU will cope with it but I will say that, on the whole, diabetes awareness is patchy in India everywhere I’ve been (of course I can’t talk about everywhere; it’d take years to cover most of India). As always, I can only comment on places I’ve been to and the experiences I’ve had, so if you know any different, please feel free to comment, or if you have any specific questions about diabetes in India, drop me an email and I’ll get back to you.