Pre-Trail Prep: A Diabetic’s Approach to Mail Drops

Pre-trail logistics are a major cause of stress before embarking on a thru-hike. Where do I get food? How much money should I spend a month? You know, normal things. Luckily there are numerous articles, blogs, and resources that break this information down for the average hiker.

I, however, have had the unique experience of planning medical supply drops for a 2,190-mile hike. For those who don’t know me, I have been a type one diabetic since the age of eight. At 23 years old, I now have been a diabetic longer than not.

Any outdoor activity can be hard to navigate, and having diabetes has presented its own unique set of challenges. Rather than share how I manage my disease in the wild, I wanted to share how I am planning resupplies for my thru hike.

During all my research, I have never found another diabetic who talked explicitly about their resupply planning process. My hope is that this might provide some tips for future diabetic thru hikers. I also plan to update this upon completion of my hike to see what worked and what didn’t!

Type One Crash Course

Type one diabetes is an autoimmune disease. Your immune system is the part of your body that recognizes pathogens (like a virus) and alerts your body to remove them. An autoimmune disorder occurs when your immune system attacks your own cells rather than pathogens.

In the case of type one, your immune system attacks the insulin-producing cells of the pancreas. Insulin is a signaling molecule responsible for blood sugar regulation, aka making sure your cells receive energy in the form of sugar.

Without the ability to regulate blood sugar, type one diabetics are required to take artificial insulin via daily injections or an insulin pump. I could take up a whole post just to talk about the difficulties of this, but I hope you can see how this level of 24/7 attention may be hard.

My System

I use a T-Slim insulin pump and Dexcom CGM to control my diabetes. An insulin pump is a replacement for injections. Instead of injecting every time I eat, I insert a small tube under the skin every three days. This allows me to take insulin at any time.

A CGM is a continuous glucose monitor which takes a blood sugar reading every five minutes, all day every day. This device operates by a small electrode inserted under the skin attached to a signal transmitter which sends real-time readings to my pump and phone.

So, let me do some math with you.

For my pump, one site change consists of a needle, reservoir, and insertion site. This is changed every three days. My Dexcom consists of the electrode sensor and the transmitter. The sensor must be changed every ten days and the transmitter every three months.

IF I were to carry six months’ worth of supplies on the trail, that would be 61 needles, 61 reservoirs, 61 sites, 18 Dexcom sensors, and 2 transmitters. This isn’t including emergency supplies and backup materials.

Enter: The Mail Drop System

I think it goes without saying that I will be using mail drops to get supplies. I of course knew this without doing that math but wanted to give you working pancreas people an idea of what goes into keeping my body functioning.

From previous backpacking trips, I know I can comfortably carry 10-14 days’ worth of supplies and extras with me. For something longer like a thru hike, I also have to account for mailing myself insulin, backup supplies, and certain snacks.

My Approach

Step 1: Develop an Itinerary

The first thing I did was loosely plan out my entire thru hike. To do this, I created an excel document that has the day, starting mile marker, camp for the night, and potential resupply points. I used Wiki Trail Hike Planner, a free resource that estimates where you will be on the trail when. Although I don’t intend to follow this itinerary exactly, it was necessary to get an idea of where I will need drops.

Step 2: Mark Resupply Points

While creating the excel, I followed Appalachian Trail Resupply Points to mark where I could access towns. I then went through and highlighted a mail drop point every 10-14 days based on those resupply towns. This only continued until Connecticut because once there I am in range of my support system who can drop me supplies in person.

Step 3: Research and compile exact addresses

Next, I reviewed highlighted towns and tried to find hiker-friendly businesses to send drops to. I tried to avoid post offices as much as possible due to their less-than-ideal hours. This information was compiled into a list with the addresses of the drops and the supplies I will need so my support staff (hi mom) can send them as I go.

My intention with having a drop every 10-14 days is that when I am about four days from a drop site, I will text my mom to confirm the supplies I need. This way, I won’t be sent too much or too little. I carry extras with me, so in the case, I don’t end up needing them between drops I don’t want to start accumulating five extra sites every time I pick up a box.

It Is What It Is

This is information I could never find in all my research leading up to the AT, and I wanted to share this in the hopes of giving aspiring diabetic thru-hikers a starting point. Some of the starting guidelines were picked up from my previous experience backpacking, so my plan might not work for everyone. It’s important to discuss your plan with your support and healthcare teams to ensure you will be safe in the backcountry. Here are my current planned drops:

1. NOC Outfitters
2. Fontana Dam, NC
3. Standing Bear Farm Hostel
4. Roan Mountain, TN
5. Rural Retreat, VA
6. Daleville, VA
7. Waynesboro, VA
8. Harpers Ferry, WV
9. Port Clinton, PA
10. Fort Montgomery, NY

We will see how it goes, and again I fully intend to update what ended up working post-hike. There are many challenges to managing diabetes in the woods, but this was definitely one of the harder aspects for me. To all my pancreatically-challenged friends out there, good luck and hike on!

Don’t Get Dead,

Carly