A diabetic walks the Camino

James Windle asked us, one Practcial Pilgrim day, about making the pilgrimage as a diabetic. We found that we were unable to give him much advice, and he offered to report, and allow us to share, his experience. We are grateful to him: his account appears below. He has also offered to answer - non-specialist - questions about his experience, and we will be happy to pass your questions on to him: contact the office.

To walk the Camino to Santiago is an incredible experience.  For some years I have wanted to participate but I was concerned that my diabetes would make it difficult.  I am a 61 year old who has been dependant on insulin since 1997.  I normally inject Humalog Mix 25 three times per day.  After deciding to follow the Camino Francés I had difficulty finding specific advice so I agreed to record my experiences for the Confraternity journal.  I am not medically trained and I cannot stress too strongly the importance of discussing your plans with your doctor: Don’t assume this article will cover your circumstances.  I am fairly fit and normally aware if my sugar level goes low and I would imagine the risks are much greater for a diabetic who is sometimes taken by surprise by a low test result.

I started on 19th May 2009 and walked from St Jean to Santiago in 33 days, a total of 500 miles.  My daughter (33) walked with me for the first week.  At 10:30 on the difficult first day, after four hours of hard walking and steady climbing, I rather suddenly felt very feeble and a test showed that my blood sugar was low.  Food and a short rest put me back on my feet but I was very tired by the time we reached Roncesvalles (as are most people!).  From then on I started to test regularly to pre-empt low sugar levels.  I had no further significant problems but during the following days I found it necessary to reduce my insulin dose considerably.  I have no idea if this reduction in insulin needs would be typical for other diabetics.  I suggest you get an opinion about this from your doctor.

For emergency food I started out with oatcakes from England but could not find them in Spain.  When necessary, I found that dried apricots were a good quick pick-me-up.  I carried digestive and savoury biscuits, cheese, dried fruit and nuts (cashews and almonds) and a few cereal bars as my emergency rations.  Normally I was able to get breakfast consisting of coffee, fresh orange juice and bread and jam or a croissant either before starting out or within an hour of doing so.  Lunch was a ‘bocadillo’, a length of French bread and either ham or cheese and a piece of fruit.  Bocadillos are available from many cafes and they will usually add tomato if you ask.  Supper was normally the big meal of the day.  Often the ‘pilgrims menu’ included spaghetti and then meat and potatoes or something similar.  It was nourishing, if short on green vegetables.  At the end of the walk my weight had dropped from 90kg to 82kg.  This weight loss is not unusual for walkers on the Camino.

Before I left I received lots of conflicting advice about footwear.  During the Camino I met one very experienced walker (not a diabetic) who always walks in trainers.  I used walking boots and I am still not sure they were the best choice.  My feet have high arches and the skin on the soles of my feet is dry and prone to cracking.  I always use a urea based cream and during the walk I applied it twice daily.  I had relatively little trouble with my feet: Just minor blisters.

See a diabetic consultant and carefully consider his advice.  If you decide to go ahead the guidelines I would suggest are:

Everyone says that a pilgrim should prepare by doing regular walks with a loaded rucksack.  I agree but I met very few people who had done so.  However, depending on the time of year, Spain will be hotter but in other respects it is possible to see how you will cope by doing a three-day walking trip with a fully loaded rucksack.  Do this even if it means walking from home and returning each night.  Aim to walk at least 15 miles each day as a fair test.  At the end of that you will know whether you would be able to cope. 

Before I left I discussed the walk with my diabetic consultant and I did so again after returning.  His opinion was that the risk was not justified and he would advise me not to do the walk again.  His main concern was the effect on my feet and the risk of ulceration in the feet and legs.  If you are a diabetic and you decide to walk the Camino I think you should have a medical examination with a diabetic specialist and carefully consider his advice before committing yourself.  It is then a matter of balancing the risk against the opportunity.  For me the walk was a fantastic experience.  The greatest pleasure came from deep discussions with the pilgrims I met.  Conversations started during the day would continue into the evening over a meal.  Others were most moved by the scenery or a particular church or the arrival in Santiago: Everyone gets a different outcome but the massive sense of achievement is impossible to describe.