Pumped for the PCT: Thru-Hiking with Type 1 Diabetes

Hello!  I’m Kristina Larson, I’m Type 1 Diabetic, and I will be starting a NOBO PCT attempt in April 2023 with my little brother.

My little family (husband + dog – two very large cats)

What is Type 1 Diabetes?

I was diagnosed with Type 1 Diabetes when I was 17 years old, and since I’m now 34, I’ve had been diabetic for half of my life!  Type 1 Diabetes is an autoimmune disease and is thought to be genetic (research is ongoing!).  Your immune system basically hulks out one day and in a supremely misguided moment of over-achievement, it targets and attacks your beta cells in your pancreas who, up until that point, have been dutifully producing insulin so that you can actually convert glucose into energy.  Because Type 1 Diabetics can no longer produce enough or any insulin at all (me), we become dependent on an external source of insulin to keep on living.

T1D Treatment Options

There are two main options for insulin therapy – MDI (multiple daily injections) or pump therapy (now you’re understanding the punny blog title).  After years of MDI and giving myself upwards of 7 injections per day of long and fast acting insulin, I switched about 10 years ago to pump therapy.  I use an Omnipod5 insulin pump, which sticks to my tummy and has a small cannula inserted that gives me fast-acting insulin throughout the day and after I eat carbs.  The beauty of this particular pump is that it is, as the name implies, a pod and thus there are no pesky tubes ready to catch on any and everything.

Changing my insulin pump in the backcountry

In tandem with my insulin pump, I wear a Dexcom G6 CGM (continuous glucose monitor).  CGMs have allowed diabetics to go from pricking our poor finger tips (to measure our blood glucose level) 10+ times a day to virtually never having to manually test AND seeing blood sugar readings every couple of minutes on our phone screen!  It even yells at you if your blood sugar is high or low, which has literally saved countless lives!  Being able to see your blood sugar graphed like this also allows you to make more informed decisions since you can see the trend visually (versus just seeing a singular data point when you prick your finger).

Why am I hiking the PCT?

1. Because I want to.

Snowshoeing in Bend, Oregon

First of all, I really really want to.  I absolutely love backpacking and the thought of doing it for many months with my little brother (who is my bestest friend), supported emotionally and resupplied by my all-star husband, is a no-brainer for me.

My “little” brother, Nik.

2. Anything is easier when you see someone else do it first.

Second, ANYTHING is easier to do if you see someone else do it first.  As a Type 1 Diabetic, I avoided certain adventures and experiences for many years simply because I didn’t think that they were possible with T1D.  Between not seeing anyone online with my condition doing those things and doctors telling me it was not even an option, I figured that I was just destined to lead a lower-risk (and lower-fun) life.  But then my stubbornness kicked in and started figuring out through trial and error how to do harder and bigger things with my Diabetes.  Even now in 2023, with at least a couple of T1 Diabetics having completed the PCT, I struggle to find anyone who has done it on pump therapy (which is a non-negotiable for me).  I’m here to tell my fellow diabadassers how to plan pump/sensor/insulin resupplies, how to keep that insanely expensive insulin cold, how to bring backup supplies for any anomaly, and how to manage your blood sugars so that you aren’t riding the world’s least fun rollercoaster (i.e. your blood sugar roaring up and down endlessly).

Diabetes FAIL: when your pack was resting on your poor pump

3. Regret is heavy.

Third, regret is heavier than the extra diabetes supplies that I have to carry.  It’s also heavier than the extra stress, on top of all the usual thru-hiking stress, of managing your blood sugars, treating lows and then immediately resuming a hard climb, coordinating meds refills, carrying tons of Diabetes supplies to reduce your dependency on hiking into towns, etc. There will never be a convenient-enough time to do something like this and the years will just keep ticking forward.  Furthermore, you truly never know what the future holds.  When all of these reasons for hiking finally pushed me over the edge and I turned to my now-husband on the couch and said, “What if I hike the PCT next year?” and he said “DO IT”, the decision was made.

Affiliate Disclosure

This website contains affiliate links, which means The Trek may receive a percentage of any product or service you purchase using the links in the articles or advertisements. The buyer pays the same price as they would otherwise, and your purchase helps to support The Trek's ongoing goal to serve you quality backpacking advice and information. Thanks for your support!

To learn more, please visit the About This Site page.

Comments 9

  • Amanda : Mar 12th

    Omg this is so exciting!! Can’t wait for the updates 🙂

  • Tracey : Mar 13th

    Hoping to see you when you come through the Hat Creek Rim area. I also have Type 1 Diabetes and provide Trail Magic to hikers coming through. Maybe I will catch you coming through. Best of luck and be safe!

    • Kristina Larson : Mar 15th

      That’s awesome – hope I see you, Diabuddy!

      • Nicole Yount : Jun 17th

        Hello Kristina
        I’m Nicole and also diabetic Type 11/2. Had Hyperinsulinism as a child and then had an 2 emergency caesareans which resulted in having to be insulin depending. Gestational Diabetes for both
        I’m 64 next month and would love to do this but now major orthopedic issues and massive arthritis all through my back is prohibiting me from any attempt , for now
        I’m living vicariously through you on your trek and am fully aware of the challenges you are facing.
        Hang in there Do your best and thank you for having hoopstah to do this incredible adventure
        We live in Depoe Bay Oregon and maybe one day I could do the Oregon part
        It’s funny I’m really always been that person who thinks that Roughing it is staying at a motel w/o room service
        Go forward and Damn the Endocrinologists

  • Andrea Dean : Mar 15th

    I have T1D and am hiking the AT this year. I toyed with the idea of going back to MDI to save weight, but I just can’t imagine doing this without my trusty devices. I’m using a Tandem pump and Dexcom. Curious how many days/weeks of supplies you’re carrying? Are you planning to pick up insulin in town or have it sent from home?

    • Kristina Larson : Mar 15th

      Hey! It’s great to hear about someone else thru hiking with the pump setup. The amount of supplies I’m carrying depends a bit on whether I can convince my insurance to give me more pumps at a time, but I’ll probably carry at least a month of supplies split between me and my brother’s packs. I’ll carry two vials of novolog at any one time in case one breaks, and one vial lasts me about a month in regular life (and I’m sure will go a bit further on the trail). I also will carry a Lantus pen in case I have pump issues. Worst case I can also bridge days between pump supplies with Lantus + Novolog syringe shots. For insulin resupplies, I’ll probably get them from my husband at least in California (we live in SoCal) and if I need a refill in Oregon or Washington I’ll probably call it into a pharmacy (my endocrinologist knows this may happen and is ready to send a prescription to a rando pharmacy). Before I leave, I’ll make a list on my master Google sheets of which towns have pharmacies and their times.

      What were you thinking of doing for amount of supplies and insulin refills?

  • Michael Obara : Mar 17th

    Major kudos to you! That’s quite an undertaking with the pump supplies, large Dexcom G6 inserters, and tons of alcohol pads! Hope you find a great support crowd in your PCT prep.

    I was diagnosed with T1D at 20 and got into running several years ago (currently in my mid 40’s). I have 20 marathons, a bunch of triathlons (one full ironman) and three 100 mile trail ultra marathons under my belt. Boston marathon next month and another trail 100 in May. I’m a Tandem pump guy, and I agree with you about the hose. Still, I like having the flexibility of CGM and delivery that’s independent from my phone.

    Keep up the good work. Woo hoo!

    • Kristina Larson : Mar 17th

      Well that is truly impressive. Keep on rocking!

  • Mark Yaeger : Mar 20th

    A friend forwarded me a link to your story. Couldn’t agree more with your reasons for going. Congrats on the decision… you’ll do great.
    I’m a 44 yo Type 1 diabetic (diagnosed when I was 27). I thru-hiked the AT in 2015 using an Accu-Check pump and no CGM. (I wear one now, and am definitely a fan). I have no doubt you’ll figure out what works for you as you go.
    Happy hiking. -Mark


What Do You Think?