Backpack Hunting With Diabetes, By Cody Hoff

[Justin Crossley]

Meet Cody Hoff (@hoff1ck)

Cody grew up in Michigan's Thumb area, hunting anything that was in season every day he could. He was diagnosed with type 1 diabetes when he was 18, which really sparked his interest in medicine. Cody went to Drexel University in Philadelphia, PA to obtain his master's degree and graduated as a physician assistant. He now lives in Grand Rapids, Michigan with his wife and two kids and works as a PA in diabetes and endocrinology. Cody still enjoys deer hunting and many things about the midwest, but elk hunting has grown into his biggest passion and he looks forward to his time out West each fall.

Backpack hunting brings a lot of challenges which is one reason a lot of hunters are drawn to it. Diabetes can complicate things even more but shouldn't be a reason to stay home. Read Cody's article below about how he has overcome some of the challenges.

Backpack Hunting With Diabetes

 

[SirChooCH]

Grats Cody! Published an article and launched a podcast, big week! Hope this helps some people out with how to manage their sugar levels and get out there.

 

[Ram94]

Great write up! Type 1 here as well. Love that you touched on the importance of a good hunting partner. That’s huge for me. One thing that I do every year before a hunt is run through how to use glucagon. If it came down to it, I wouldn’t be conscious to help and i can’t imagine the feeling if I were to die out there and he could’ve saved me but didn’t know how to use the damn thing.
Never had to use it yet in 19 years, but it’s great assurance to have. If they ever find a cure, I’d be able to drop 5-6lbs from my pack weight, so that’s something to look forward to!

 

[Fatcamp]

That's cool.

 

[archp625]

Awesome article. My brother and my new hunting partner has Type 1 Diabetes. We went to Montana last year to chase Mule Deer. It was a great trip. We both were successful. We are both in the process of planning a week long Idaho backpack spring bear hunt. Maybe I can get my brother to write something up as well after our backpacking trip.

 

[MountainTracker]

Good write up, it’s good to hear this from a doctor and Hunter. I’ve been a type 1 diabetic since I was 17, now 38, and I’ve always hunted. I would agree with you that having a hunting partner who is aware of what to do in case of extreme lows. I would encourage guys to take the time to show their hunting buddies what do in case you can’t. I’ve shown my buddy how to mix and use the glucagon pen, and I think he was a little to eager to stab me with that needle

I have used a minimed pump with a cgm for many years and bc of my job I’ve been able to use it in some extreme temperatures which has allowed me to have a better understanding of how my body responds during high exertion. I have found when hunting the backcountry I use little to no insulin, even to the point where my pump is in a pause mode.

I usually carry some kind of fruit snacks in my hip belt for fast sugar and then back it up with something with peanut butter for the protein. My only big meal is at dinner typically.

Im always afraid of my infusion set and cgm coming out, so before I hit the trail I place some Leuko tape over both. I’ve never had a problem since doing that. My other concern is my insulin going bad from heat. Have you ever used a FRIO pouch? I worked many years in the AZ desert and never had a problem, but I would hate to have to hike out bc I didn’t plan accordingly.

I also make sure to change the battery on my pump before heading out. Almost all of my electronics use the same batteries. In addition to that I make sure my basic blood tester is charged and I place extra strips in the tube. I also carry a few needles in case I need to do an injection. And I have long lasting insulin. I can see all the light weight guys shaking their heads haha . Overall it doesn’t add that much weight to my kit.

As you stated the importance of exercise, that alone really helps me dial in my equipment so it’s less of an issue while out in the field. I do my best to make that a year round habit, and hit the trails as soon as they start opening up.

Diabetes shouldn’t slow anyone down, it just requires a few extra steps.


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[FrankAbagnale]

Awesome write up! I’ve been Type 1 for 24 years now. Definitely takes more planning but I agree that the Dexcom is a game changer. Fruit snacks are my go too when low. They seem to bring up my lows faster than glucose tabs. I carry both just in case.
I also have to cut my basal by 50-60%. Blows my mind but is always necessary.

 

[deserthunter2016]

Good read. I too am type 1, I was diagnosed at 9. Run a Medtronic 770g with CGM, cut my basal by 50-60%, but I find that I have to run heavier on the carbs not only to keep my blood glucose level throughout the day but for energy as well. I exercise daily and as the days get longer I go on extended weighted pack hikes, this really helps dial in my basal while active for extended periods. Usually if I am climbing any real steep elevation I suspend my insulin delivery completely and carry a pocket full of HiChews or Cliff shotbloks and eat one about every 30-45 minutes. My hunting partner is a firefighter/paramedic so I have complete faith in him to handle the situation if something were to happen, and also carry an inreach, but do everything I can to prevent that.

The worrying part for me is that I often times find myself solo hunting. Whether for the day or for a 1-2 night backpack trip. Probably not the safest to go alone being diabetic, but I love being out too much to sit at home because someone can’t go with me. So during these trips I am extra diligent on monitoring my blood sugars, taking my time getting places, and extra snack breaks. I have never let diabetes be an excuse for me not to be able to do something, as he mentioned in the article it just takes more planning, a little extra time and a few extra items and food in the pack.

Always have wondered other people’s preparation routines and methods while in the backcountry and this article brought up everything I had in mind. Great job!


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[MountainTracker]

Good read. I too am type 1, I was diagnosed at 9. Run a Medtronic 770g with CGM, cut my basal by 50-60%, but I find that I have to run heavier on the carbs not only to keep my blood glucose level throughout the day but for energy as well. I exercise daily and as the days get longer I go on extended weighted pack hikes, this really helps dial in my basal while active for extended periods. Usually if I am climbing any real steep elevation I suspend my insulin delivery completely and carry a pocket full of HiChews or Cliff shotbloks and eat one about every 30-45 minutes. My hunting partner is a firefighter/paramedic so I have complete faith in him to handle the situation if something were to happen, and also carry an inreach, but do everything I can to prevent that.

The worrying part for me is that I often times find myself solo hunting. Whether for the day or for a 1-2 night backpack trip. Probably not the safest to go alone being diabetic, but I love being out too much to sit at home because someone can’t go with me. So during these trips I am extra diligent on monitoring my blood sugars, taking my time getting places, and extra snack breaks. I have never let diabetes be an excuse for me not to be able to do something, as he mentioned in the article it just takes more planning, a little extra time and a few extra items and food in the pack.

Always have wondered other people’s preparation routines and methods while in the backcountry and this article brought up everything I had in mind. Great job!


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I also carry Hichews and Cliff blocks, and a small Gatorade


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[68Plexi]

Thank you for this. My 9 year old son was recently diagnosed with type 1 diabetes and this is all very new to us. We are a backpacking hiking/hunting family and aren’t going to let this stop that, but it definitely introduces some new challenges.

And I agree, the GCM (Dexcom or otherwise) makes real time blood glucose management a lot easier. It’s very helpful to hear others experience with T1D and miles away from help. I now always carry a few more items when we hike, glucagon, plenty of quick acting snacks and a garmin in reach mini, but we have adopted the attitude of figuring out whatever we need to so we can continue to enjoy the outdoors away from civilization for multiple days at a time.

The health industry is benefiting from the advancement in technology big time right now. We are grateful for that. CGM’s, insulin pumps, Bluetooth communication. A hundred years ago we’d have just lost our son. Perspective.


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[mstei4]

Great read! So glad to hear that there’s so many other Type 1’s out there able to get after it! I was diagnosed about 6 years back and it’s really sidelined a lot of my favorite things out of both not having the control I wanted and fear of what could go wrong. I know I have a long ways to go to get my sugars controlled the way they need to, but once I do sounds like I should be able to get out doing the things I’ve always wanted to.

 

[Ram94]

For you guys using the Dexcom on hunts, are you just bringing a bunch of extra charging packs to keep your phone running the entire time? Or do you use the handheld and keep that charged? I use the Dexcom on a regular basis but I switch to the Freestyle Libre for extended hunts because the reader holds a charge for nearly 3 weeks. It just won’t monitor unless I tap it.

 

[FrankAbagnale]

For you guys using the Dexcom on hunts, are you just bringing a bunch of extra charging packs to keep your phone running the entire time? Or do you use the handheld and keep that charged? I use the Dexcom on a regular basis but I switch to the Freestyle Libre for extended hunts because the reader holds a charge for nearly 3 weeks. It just won’t monitor unless I tap it.

I use the dexcom combined with the Tslim 2 pump. So my readings are always on the pump. I do bring my cellphone as well, which can of course show my readings. I have a power bank that I bring because my pump uses a rechargeable battery. I just make sure it's fully charged when I start the hike as well. I have never used the handheld. Just doesn't make sense when you have the app on your phone, even with out the pump integration.

I just want to reiterate that the dexcom is the single best thing I've used over the last 24 years. My last A1c was 5.9% and only low 1% of the time. All props go to the dexcom for that.

 

[go_deep]

I'll reiterate what @FrankAbagnale said. My son has been type 1 since he was 7, we run a G6 With the T slim. His in range, A1C, honestly just him being in a better place has never been better. Everyone is different, but if we're going pretty hard my son generally will get dosed 50% for breakfast and supper and all carbs during the day are free.

 

[hoff1ck]

Great write up! Type 1 here as well. Love that you touched on the importance of a good hunting partner. That’s huge for me. One thing that I do every year before a hunt is run through how to use glucagon. If it came down to it, I wouldn’t be conscious to help and i can’t imagine the feeling if I were to die out there and he could’ve saved me but didn’t know how to use the damn thing.
Never had to use it yet in 19 years, but it’s great assurance to have. If they ever find a cure, I’d be able to drop 5-6lbs from my pack weight, so that’s something to look forward to!

Excellent point on glucagon. Especially with intranasal variations available now, it’s much simpler for someone to use in a situation like that.

 

[hoff1ck]

For you guys using the Dexcom on hunts, are you just bringing a bunch of extra charging packs to keep your phone running the entire time? Or do you use the handheld and keep that charged? I use the Dexcom on a regular basis but I switch to the Freestyle Libre for extended hunts because the reader holds a charge for nearly 3 weeks. It just won’t monitor unless I tap it.

I carry two battery packs for charging purposes. One is by Anker and one is by Ravpower. I think they’re both in the 20000 mah range. Honestly, I never get through 1 on a full hunt, but I always have a second that is fully charged as well. I run my pump from my phone too, so I’m definitely using a lot of battery each day, but those packs charge fast and keep up well. Something solar powered might not be a bad option either.

 

[go_deep]

For Glucagon we got the new nasal spray for my son. Way easier than mixing a vital with a needle, just put the nasal tube in the nose and squeeze once.

 

[hoff1ck]

For Glucagon we got the new nasal spray for my son. Way easier than mixing a vital with a needle, just put the nasal tube in the nose and squeeze once.

It’s a great option for sure and the coverage is getting better. I always recommend that route when I have the chance.

 

[Ram94]

Thanks guys! I'll have to look into the nasal spray.

 

[MountainTracker]

I'll reiterate what @FrankAbagnale said. My son has been type 1 since he was 7, we run a G6 With the T slim. His in range, A1C, honestly just him being in a better place has never been better. Everyone is different, but if we're going pretty hard my son generally will get dosed 50% for breakfast and supper and all carbs during the day are free.

It is amazing how far tech has come in this area. If you haven’t seen it checkout Sensonic eversense. If they can deliver it will blow away any current cgm on the market in how long you can wear it. I’ve been contemplating moving over to the G6, I’ve always used a minimed.


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