Sailing with Diabetes: What You Need to Know

Yes, you can go sailing with diabetes. It takes planning, good control, and some adjustments to how you eat and store your meds, but it’s absolutely doable. I was diagnosed with Type 2 diabetes in 2017, right in the middle of our cruising years on Barefoot Gal, and the diagnosis didn’t end our time afloat. It changed how I ate and how I thought about medical care, but we kept cruising the Keys and the Bahamas for years afterward.

If you’ve just been handed a diagnosis and you’re sitting there wondering whether your cruising plans are over, they’re not. Here’s what I learned.

A Quick Primer on Diabetes

If you’re newly diagnosed (or trying to understand what your partner is going through), a bit of background helps.

Insulin is a hormone your pancreas makes. It moves the glucose in your blood into your cells so they can use it for energy. It also stores extra glucose as fat.

Type 1 diabetes is when your body doesn’t make insulin. Type 1s must take insulin every day, for life.

Type 2 diabetes is when your body makes plenty of insulin but your cells have become resistant to it. Your pancreas pumps out more and more, trying to force glucose into the cells. Some Type 2s eventually burn out their insulin-making function and end up needing insulin too.

Uncontrolled diabetes leads to serious long-term problems: loss of sight, poor circulation, amputations (toes and feet especially), kidney and liver damage, slow healing from injuries and infections. Poorly controlled diabetes also brings immediate dangers. Blood sugar can spike dangerously high or crash dangerously low, and both can kill if you can’t get to an ER fast.

That’s why the question “can I still go cruising?” feels so heavy. Good control is the answer to almost all of it.

Symptoms I Missed (and You Might Be Missing Too)

Everything you read lists the classic diabetes symptoms as drinking more than usual and peeing more than usual. But if you’re cruising in the tropics without air conditioning, everyone drinks a lot. Dave noticed I was peeing constantly, but we both chalked it up to the heat.

The symptoms I actually had, but didn’t connect to diabetes, were these:

• Muscle cramps, first at night and then during the day. I had leg and back pain from muscles in spasm. A chiropractor didn’t help. Muscle relaxants and painkillers didn’t help. Turns out all that peeing flushes electrolytes out of your body, and in a hot climate that’s a real problem.
• Shoulders too painful to sleep on. I’m a side sleeper, and suddenly couldn’t lie on either side. Diabetics can develop “frozen shoulder” with limited range of motion.
• Floppy foot. My left foot started flopping when I walked. I thought it was sciatica. Nope. It can be a symptom of diabetes.
• Numbness in toes and fingers. Sometimes accompanied by pain.
• Mental fuzziness. I didn’t notice until after I was in control and suddenly felt sharper.
• General tiredness and loss of stamina. I had chalked it up to getting older. Ten times the energy now.

If any of these sound familiar, talk to your doctor and ask for a blood test. Cruisers are notorious for skipping non-critical health care because it’s inconvenient, or because we don’t want anything to mess with the life we’ve built. Don’t do that. Early diagnosis matters, whatever the diagnosis is.

Getting in Good Control

The key to sailing with diabetes is being in excellent control. It matters for everyone, but if you’re planning to head somewhere without a nearby ER, it’s non-negotiable. You have to stay out of the danger zones of “hypers” (dangerously high blood sugar) and “hypos” (dangerously low). Both can kill.

My approach is low-carb, high-fat eating (LCHF). It’s more restrictive than keto and considerably more carb-restricted than standard American Diabetes Association guidelines. The initial switch takes discipline because it’s a big change from how most of us were raised to eat. But it works, for both Type 1 and Type 2.

With minimal carbs, blood sugars don’t swing up and down the way they do on a higher-carb diet. There’s far less chance of a dangerous high or low. Eating this way, I stopped worrying about dangerous blood sugar swings on passages.

Resources that actually helped me

My doctor gave me essentially no information at diagnosis. The nurse called me, told me I had diabetes in 30 seconds flat, said she was calling in a prescription, and that was it. So I started Googling.

The first thing that genuinely helped was a TEDx talk by Dr. Sarah Hallberg on reversing Type 2 with diet. It changed my outlook. It told me I could control this disease instead of letting it control me.

From there:

• Dr. Bernstein’s Diabetes Solution (Amazon) — a clear explanation of what’s happening in your body and why low-carb works. Bernstein is Type 1 and I needed to be more restrictive than his recommendations, but it’s still the best primer I’ve read.
• Type 2 Diabetes Straight Talk — a Facebook group for Type 2s (request membership). Go through the New Members Class you’ll be directed to when accepted. There’s a lot of material; take it slowly.
• Type1Grit — Facebook group for Type 1s following the same very-low-carb approach (request membership).

On working with a coach: If you want one-on-one help making the transition, a diabetes coach can be worth it. Just make sure you find one who supports a low-carb lifestyle rather than the traditional approach of “eat lots of carbs and cover them with meds.” That’s a different philosophy entirely, and you’ll save yourself frustration by matching at the start.

One note on switching to LCHF: your blood pressure is likely to drop, sometimes dramatically. Get a blood pressure cuff (Amazon) so you can check it if you feel lightheaded when you stand up. Talk to your doctor about decreasing blood pressure meds as your numbers come down.

Meds, Monitoring, and the Temperature Problem

Here’s the practical piece that matters most for sailing with diabetes: your meds and supplies have temperature requirements, and boats in warm climates are often outside those requirements.

Medications

I take metformin (an old, safe drug that makes my cells more sensitive to insulin) and Mounjaro (one of the newer injectable drugs). Metformin is fine at room temperature. Mounjaro is temp-sensitive and has to be refrigerated.

This is the biggest change in diabetes care since I was first diagnosed. A whole generation of injectable drugs (Mounjaro, Ozempic, Trulicity, Wegovy, and others) has become common for Type 2 management, and insulin has always needed refrigeration for Type 1. If you take any of these, you need a reliable way to keep them at the right temperature on your boat.

This is a whole topic on its own, and I’ve written a separate article on it: Cruising with Temperature-Sensitive Medication walks through how to evaluate your boat fridge, what products work for a backup cooling setup, and how to build a backup plan for when your main system fails.

Test strips

Most blood glucose test strips can’t be stored above 86°F for long, and where I lived in the Keys it’s above that six months a year. Strips also can’t be frozen (most say not to store below 40°F). When I called the manufacturer, they told me refrigeration was the best option for my situation, just to keep the strips in the warmest part of the fridge.

Getting refills while cruising

Getting diabetes prescriptions filled while cruising works the same way as any other prescription. It takes planning, particularly if you’re heading to foreign countries, and some meds will be harder to find than others. I’ve written about the whole process in Cruising and Prescriptions.

Choosing a meter

I’ve been through a few meters over the years and settled on the Dario meter. It plugs straight into my phone (no separate device to charge or sync), it’s tiny enough to carry in a pocket, and the subscription model works out cheaper than buying strips separately if you test frequently. The app tracks food, exercise, weight, and meds alongside your readings, which makes cause-and-effect easier to see.

If you’re picking a meter, the priorities in order are:

1. Accuracy (non-negotiable)
2. Strip cost (the meter is cheap; the strips are what get you)
3. Strip availability as you cruise
4. Ease of use and portability for boat life
5. Data logging so you can spot trends

On CGMs

Continuous glucose monitors (Libre, Dexcom, and others) have become the standard since I was diagnosed and they’re genuinely useful, especially for catching trends and seeing how specific foods affect you. But here’s the catch: CGM readings can be off, sometimes by 20 points or more. You still need finger-stick strips to confirm before you adjust medication, and any time a reading feels wrong. CGMs are a great tool; they don’t replace strips entirely.

If you’re cruising internationally

Don’t count on buying strips that fit your specific meter wherever you go. You may need to buy a local meter if you can’t get your usual strips shipped to you. And remember the temperature rules: most strips can’t sit above 86°F, so watch out if they’d have to clear a customs warehouse in a hot country.

Food and Cooking Aboard

Food, cooking, and provisioning don’t look wildly different with diabetes than before. The bigger change is what’s on the plate.

For me, that means:

• No fruit
• Far fewer vegetables (and a narrower variety)
• More meat, fish, and seafood
• More eggs and cheese
• No beer

That changes a few things about provisioning. Canned meat and seafood often have starches or sugars added; tuna is about the only one that usually doesn’t. Dehydrated meat works as a backup but I’m not fond of it for everyday, especially since I can’t mix it into casseroles and skillet dishes the way I used to (those are all too carb-heavy for me now).

That means I eat simple proteins: grilled or pan-cooked meat, fish, and seafood. Which means I need reliable refrigeration or freezer space if I’m not near grocery stores or catching fish. On Barefoot Gal we added an Engel portable fridge/freezer alongside our Isotherm to handle the extra meat storage.

The grilling change

I used to cook skillet meals: protein, starch, and vegetable all in one pan. Most of those went off the menu after diagnosis. Instead I turned to grilling. Chicken breast, pork chops, beef kabobs, shrimp skewers — delicious, low-carb, and you can grill most vegetables too.

I actually ended up loving grilling, which surprised me because I’d hated our old grill. I wrote about the new one I bought and why it made grilling enjoyable in my Magma Newport II Infrared Grill Review.

If you want boat-friendly LCHF recipes, I’ve been posting them over the years. You can find the whole collection of keto and LCHF recipes here.

The Electrolyte Problem

Remember those muscle cramps I had pre-diagnosis? On an LCHF diet, electrolytes become a real ongoing issue, not just a tropical-heat issue. Lower-carb eating means your body holds less water, and along with the water goes sodium, potassium, and magnesium.

Most electrolyte mixes on the shelf have sugar or artificial sweeteners that spike blood sugar. You have to read labels carefully. I put a few drops of Hi-Lyte Sugar Free Electrolytes (Amazon) in my water every day.

Bottom Line

Sailing with diabetes is possible. But if you’re going to head somewhere without quick access to medical care, you have to be in excellent control. Find a doctor who supports what you’re doing (easier said than done), talk through your plans honestly, and discuss the real risks.

It comes down to the same thing every cruising decision comes down to: choosing your priorities. Living an adventurous life on the water meant more to me than eating a piece of bread ever did. I do whatever it takes to stay in good control so that I can keep doing what I love.

Real Cruising Info, Every Week

Diabetes is one piece of cruising life. There’s a lot more to figure out: provisioning, weather, anchoring, the daily rhythms of living aboard. The Boat Galley Newsletter goes out free every Wednesday with practical cruising content drawn from real experience on real boats. It’s the ongoing companion to articles like this one.

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