Amelia's story: Completing the Duke of Edinburgh expedition with type 1

I was diagnosed with type 1 diabetes in 2019 when I was 10. Since then my younger sister, Tilly, was also diagnosed with type 1 so we’ve been managing the ups and downs together.  

I have been involved with Diabetes UK's Together Type 1 team for around a year now. The team has been so supportive to me individually and also have given me the opportunity to meet and get to know other people with type 1. For me it’s made diabetes more of a community rather than just a struggle I have to manage by myself.  

Before going on my bronze Duke of Edinburgh (DofE) expedition I was nervous about how I was going to manage my diabetes on top of the walking. I couldn’t find any online resources for people with diabetes embarking on a DofE expedition.  

I have now completed my bronze and silver DofE levels. These are some of the things I’ve learned that I thought might help other people with type 1 thinking of attempting DofE. 

With more exercise than a regular day, I had to make sure I ate more food, especially carbohydrates, than on a regular day to keep on top of energy levels.  

I bought a mix of short and long-acting carbs so I could eat them throughout the expedition to help me manage my blood sugar levels. Some examples of snacks I bought were jelly sweets, cereal bars and brioches.  

I’ve found that eating some protein with carb-dense meals reduces a spike in my blood sugar, so I prioritized protein as well as carbs. I included ham, tinned tuna and chose cereal bars with higher levels of protein.  

It’s hard to include fruit and vegetables into your meals on an expedition. I took apples and fruit juice - which I could also use to treat hypos!.  

I made sure I kept well hydrated by drinking plenty of water. There are lots of water-carrying options – including water bladders and bottles.

For my bronze DofE, I used two hydration bladders – one containing water, and one containing Lucozade which I had little sips of throughout the day to help manage my blood sugar. However, on my silver DofE, I just had a bottle of each because I found the tubes of the hydration bladders annoying while walking.  

It’s important to bring all your diabetes supplies and devices with you (including enough for a backup plan).

In my rucksack, I brought the kit I keep in my school bag, a finger-pricking set and a spare cannula. I also carried glucagon in my bag in case of a severe hypo.

I gave the rest of my diabetes supplies to the DofE leader to keep with her so I didn’t have to carry the extra weight. 

Before going on the expedition I talked with my diabetes team in the hospital as they have had previous experience with people taking on the DofE expedition.

My team suggested that I raise my glucose target (as it makes a significant difference on a closed-loop system) and to adjust insulin ratios. They explained that the increased exercise levels meant less insulin would be needed to keep within the target range.

Additionally on an insulin pump a temporary basal/exercise mode can be used. Having advice that was tailored to me was really helpful – and I think talking to your team is the best place to start when planning something like this.  

I used a Frio wallet to carry my insulin because it is amazing at keeping insulin cool in warmer weather. I use the wallet at other times too, not just during DofE but also when traveling, staying at a friend's house, or any time I don’t have access to a fridge for a few hours. 

The clothes you bring heavily depend on the time of year that you do the expedition, so I recommend looking online (at the location where you’re doing the expedition) to further guide you with what to bring.

I wore the same type of clothing when I did the expedition: sports t-shirts (NOT cotton), fleece, leggings, tracksuit bottoms. The quantity of what you’re bringing depends on which level you’re doing as the length varies. 

DofE is famous for giving everyone blisters. I’m aware that as someone with type 1, I could be more susceptible to foot problems, so I made sure I looked after them while walking long distances on consecutive days.

I really appreciated having good-fitting boots and socks specifically for walking because walking with a blister for multiple days isn’t an enjoyable experience!  

Walking for multiple days just following footpaths on a map and then camping is both mentally and physically tough. Adding the need to manage blood sugars on top of that doesn’t make it any easier.  

For me, the middle of the walk is always the toughest part - when the enthusiasm has died down and the end still feels ages away. But just keep going, one foot in front of the other is all it takes.  

Communication with your group is essential – hopefully, you feel comfortable and relaxed with the other people in your group. Before the expedition, I made my group aware that I have type 1 and what to do in emergency situations. It was helpful for me to have that talk so if I got into difficulties, I knew that they knew how to help me.  

During the expedition, I felt able to ask if I needed to sit down for a minute to check my blood sugar, treat a hypo, or just take the weight off my back for a couple of minutes. I think everyone appreciated having a rest before continuing with the day. 

So don’t give up! One of the best feelings ever is getting to the meeting point at the end knowing what it’s taken to get there!