Hiking with Diabetes - Finishing the Kokoda Track

We wanted to hear more about Duncan and his latest adventure.

Q: Can you tell us about your diabetes diagnosis and how it affected your lifestyle?

I was diagnosed with T1D in my early thirties. When I first started insulin injections, I found I often had to turn back on mountains, not because I wasn’t physically able to climb, but because I couldn’t raise my blood sugar levels. Back then, I was using long-acting insulin, with a bolus given at mealtimes. For me, the inability to change your requirements due to the long-lasting insulin jeopardised my trek, often forcing me to turn around and not summit. Today, with the development of insulin pumps, things are better for me. I can make instant adjustments, maintaining a margin of safety in remote and adventurous environments. The Dexcom CGM system takes it to the next level of help; it’s like having your diabetes educator and endocrinologist along on the trip (and as amazing as my diabetes educator is, she is not one for hiking!).

My latest feat was the Kokoda Track – 96km of mud, sweat and tears that wanders its way through the Owen Stanley Ranges in Papua New Guinea. Reaching heights above Mt. Kosciuszko, for me the walk represented the adventure of a lifetime, with amazing culture, history and an incredible environment.

That sounds like an amazing accomplishment! Can you tell us more about your trip?

Like every great adventure, it began walking out onto a tarmac to the smell of aviation gas and the sound of an aircraft idling. We were on a small, propeller-driven plane. This was the start of my gruelling, beautiful, exhausting adventure.

Landing at Kokoda was exhilarating, with the plane stopping on a small grass landing strip surrounded by rubber plantations and jungle – it was clear we had arrived! Upon reaching the plane door, I was hit by the intense heat and humidity, one I hadn’t felt before. Preparing to begin our walk, I checked on my t:slim X2 insulin pump and Dexcom. For me, it’s easiest to keep the pump in my top shirt pocket. I also need to make sure the infusion set and Dexcom sensor are slightly higher than normal to avoid my pack’s waist-belt. I know I always run above my ‘normal’ levels when I’m just about to start exercising, so I checked my levels and adjusted my basal rate; tweaking my ‘Hike’ profile. I developed this profile through long days of training and experience.

I found, as someone living with diabetes, we must plan for all scenarios; extra food and water, medication, two glucometers, two battery packs, two lots of insulin, a second spare Dexcom sensor, first aid supplies, anti-malarial medication, sleeping equipment, clothes, wet weather gear – the list goes on and on.

So off we set. The beginning of our walk was relatively flat, surrounded by two-meter high Kunai grass and rubber plantations. We eventually hit the base of the mountains and had to cross creeks, rocky beds of stones and logs. Here, we were confronted by some of the most beautiful scenes of crystal-clear water flowing down a creek and large butterflies hovering around. It was truly breath-taking!

Q: That sounds incredible! So, the walk was relatively flat?

Just in the beginning. Soon after, we reached the base of the Owen Stanley Range, with the village of Hoi marking the beginning of the climb. We stopped to have lunch, a quick swim and fill our water bottles up. I remember checking my pump to find the Dexcom CGM system was working great. I knew that I had a steep way to go, so I made sure to take that into account and adjust my Carb/Insulin ratio to suit.

The climb began easily, but soon narrowed and became muddy and uneven with tree roots everywhere. Each step takes effort, physical effort to push yourself and your pack up, and mental effort to make sure you put your foot in the correct place. The track just kept climbing and climbing. I felt as though my lungs and legs were burning – our group was begging for a down-hill run. The rain begins, and simultaneously my pump alarms. I was dropping too fast – so it was time for a snack. With the downpour, the track became a river of mud, flowing over the top of my boots, filling them completely. The rain swamped the senses; it’s all you can hear, see, feel and taste. However, walking the Kokoda Track, being remote, physically stressed and quite literally in the deep dark jungle, my mind is constantly resorting back to my diabetes. Am I prepared for all scenarios?

Do you remember what else was going through your head at this time?

Honestly, just “I hope I can make it to camp!” With my body fatiguing, there was no sign of us stopping any time soon. Every time we’d ask the porters how much longer, they would answer thirty minutes. Thirty minutes quickly turned into ninety minutes – and we were still heading uphill. The jungle is thick, wild and the sun is low. I need to remind myself: one breath, one step, one breath, one step to camp. And finally, we arrived into the Isurava Battlefield site, our camp spot for the night – and I am emotional.

I think my diabetes was always partly on my mind. The other thing was the history of this track. The cultural history of the magnificent Papua New Guinea, the history of the battles fought across this incredible track and the brave soldiers that fought to defend it. The track has so much meaning to Australians, with the stones at Isurava encapsulating why, in four simple words; Mateship, Endurance, Sacrifice and Courage. Four simple words that shroud incredible feats and suffering, pure sacrifice and what it means to be Australian! At this point, I’m emotional, the physical exhaustion of the day mixed with the incredible beauty and the history were overwhelming.

We crawled into our tents and fell asleep quickly. That first night was a lot of rolling from side to side trying to find some comfort and… a pump alarm! 12am and I had dropped too low, the echo effect of exercising all day. I reduced my background rate by 40% for the next five hours, threw a gummy-bear in my mouth and went back to sleep. Ending that first day, I’m left thinking there are still seven full days to go. My mind was racing ‘how can I do this? How can I make it?’ Then I remembered the soldiers, their courage, their endurance – I just had to stick to my goal… one step at a time!

Q: What an epic first day! It sounds truly remarkable. How was the rest of your trek?

The next seven days blended as one. Each day starts with getting up at 5am, pack, breakfast, walk, lunch, walk, dinner, bed, sleep and repeat. Having my pump at hand and linked into the Dexcom system worked well for me, as it allowed me to easily check my glucose levels at any time, even whilst on the move. The walking varied; up-hill, down-hill and across creeks. The rain seemed to come every afternoon and would turn the track into a muddy creek, but we continued. The best way to describe it, is the track blends heaven and hell into one incredible journey!

Walking up that last hill and through The Kokoda Track Gates at Ower’s Corner is something I will never forget! It was an emotional time. Physically and mentally exhausted, I finished it (I did not conquer it, but I just finished it!)

Q: What would you say to others wanting to walk the Kokoda Track?

If you get the chance, make sure you do the Track. It truly is life-changing!

Also, the only way anyone can do the track is with help, the help of the loving local people – without them, all would be lost in the jungle!

Editor note: Duncan’s amazing journey on the Kokoda Track is truly inspirational! At each bend, he and his group surged forward, climbing to new heights. With the help of the t:slim X2 insulin pump and Dexcom, Duncan was able to act quickly. The multiple profiles features on the t:slim X2 insulin pump allowed Duncan to switch between his day-to-day and trekking insulin requirements easily. More so, Duncan gained peace of mind, whilst trekking in an overseas remote jungle – as he knew that, at any step of the way, his pump would alert him if his levels changed outside of target.

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Testimonial Disclosure
This testimonial relates to an individual’s response to treatment with our products and has been edited to ensure it is consistent with the products’ indication(s). The testimonial does not provide any indication, guide, warranty or guarantee as to the response other persons may have to the treatment. Responses to treatment with our products may differ. It is important to consider individual circumstances and consult with your healthcare professional before considering any changes to your diabetes management.