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There's nothing quite like a dip in the Mediterranean Sea at sunset. The warm, clear water, shimmering clouds, and sound of families enjoying aperitifs at beachside cafes--it was the perfect start to a late-summer Italian holiday. We were visiting my boyfriend's brother, who had moved from England to Genoa a few years prior. It was my first time across the Atlantic, so my boyfriend Dunstan and I tried to make it count with 10 days filled with dinners, family celebrations, a road trip to Rome, hiking, and plenty of swimming.
I'd been on dozens of vacations throughout the U.S. before, so I packed as I would for any other getaway. With more than double the supplies I'd need to manage my type 1 diabetes tucked inside my suitcase, I thought I was all set to dive into the lifestyle and pretend I was Italian for a few days. There were enough books, films, and stories from friends to warn me about the 10 p.m. dinners and carbohydrate-heavy diet, but I figured as long as I checked my blood sugars every couple of hours, I would adjust just fine to the Italian way.
It wasn't until we were drying off from our swim that first day that I realized I'd left all but one set of test strips back in England, where we had stopped over for a night. I didn't have a prescription, doctor's letter, or a sense of the country's healthcare system to even guess how to restock my dwindling test strip reserve. I was also quite new to Dunstan's family, and I felt strangely embarrassed about having to explain why I needed to go to the chemist and pick up little pieces of plastic that would take in my blood and read it.
There was also the whole matter of being flung into a new time zone nine hours ahead of my home in San Francisco. I had planned on waiting at least a day to take my next dose of long-acting insulin and leaning on my short-acting in the meantime to ease into the new schedule. With just a few test strips left, though, I wasn't sure my plan was going to work.
Maybe it was the champagne that we drank with every meal, the romantic seaside scenery, or the love-life-to-the-fullest ethos of the place, but I decided the best thing I should do is just go with it, while tuning into my body and noticing how I was felt from moment to moment. This was our vacation, after all. Instead of fretting too much over perfect numbers and inexact carbohydrate counting, I would do my best to guess insulin matches while enjoying the fruits of this incredible new place--as long I was feeling OK and not showing any signs of sustained high blood sugars.
Over breakfast the next morning, I learned exactly how flexible I would need to be. It turns out that most of Italy doesn't really eat much more than a small, sugary biscuit or croissant, along with an espresso or two, for breakfast. Cereal? Nada. Fruit? Forget about it. Eggs? You wish. A bread-pasta-and-beer lunch usually follows a light breakfast. If people get hungry before a late-night dinner, they turn to gelato for a snack. I was suddenly kicking myself for not doing more research or at least telling my hosts about the importance of regular meals and a more balanced diet for type 1 diabetics.
Over breakfast, I casually mentioned, in English, that I was looking forward to trying the region's other gastronomic trophies: for example, nutritious aubergines (eggplant), fresh fish, and ripening tomatoes. I was also hoping to make a stop at the pharmacy. The mention of prescriptions brought up questions, of course, but I was surprised at how gracious and eager Dunstan's brother and family were (including those who spoke only Italian).
Benedetta, who is engaged to Dunstan's brother, Alastair, spoke the most English, so she took me to the chemist around the corner. There, she kindly explained my situation, and I showed the man behind the counter my empty container of test strips. His face quickly lit up as he pulled out a full box of my brand. In the end, it cost me about double what I would have paid without insurance in the U.S., but I remembered that I might be reimbursed by my insurance company when I got home, so I slipped the receipt inside my wallet for later.
With new strips in hand and my long-acting insulin adjusted to suit the needs of our new time zone and eating schedule, I was ready to fully embrace the good life and all of the multi-course meals that come with it. The pasta was light and nutty, the fresh cheeses creamy and almost grassy in taste, and the wines an epicurean's dream. Shortly after a waiter removed our plates of ziti, another platter arrived, full of just-tender millerighe pasta drenched in the local pesto.
"Don't worry," said Benedetta. "I usually have a few bites of everything. Eat as little or as much as you like." With that, I felt relieved that I wouldn't have to choose between my heath and offending my new family's culture. And I didn't have to sacrifice the experience that is so central to Genoa and the rest of Italy: food.
And so I ate--in moderation: Colorful gelato, croissants that were more sweet than buttery like brioche, gorgeous focaccia with jewel-like cherry tomatoes buried inside the dough, and crisp, flavorful beers that took the edge off of the humid Mediterranean air.
Throughout the drive to Rome later in the week, I continued to check my sugars and give myself enough correcting insulin to cover all the time we spent stopping at roadside cafes and sitting for long hours in the car. Our destination was a 400-year-old apartment between the Coliseum and Pantheon. From the top floor, windows looked out over all of Rome, and it wasn't hard to picture yourself in a classic Fellini movie.
Alastair and Benedetta knew Rome well. Business and shopping trips often took them to the apartment that the family rents there. And so, at first, it didn't faze me how quickly we managed to grab great tables at restaurants the whole city was trying to get into. Then one night, I noticed Benedetta whispering something to the host of the hippest dinner club in Rome.
"Oh, I told him you were diabetic and needed food right away," she said, without the least bit of questioning or remorse. To be honest, it was a trick I myself had thought of many times, but like many other diabetics, I don't think of the disease as an excuse or card to play. I later pulled Benedetta aside and gently suggested that we shouldn't abuse such things. But I somehow appreciated the fact that my Italian friend was so accepting, and maybe even funny, about something that many new friends are scared of or very serious about.
To me, it meant that there was no reason to hide my pen injections or pipe up if I needed to check blood sugars or grab some juice. I could walk throughout Rome's winding cobbled streets and alleyways, knowing that even far away from home, diabetes was totally manageable. If I felt worn after a big lunch and miles of circling the ancient ruins, there was no reason not to sit down and check in with myself. Even in a foreign land, people understand--or better yet, don't even notice. I could still blend in and take good care of myself while doing, well, as the Romans do.
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.