My trip to the middle east and control issues

[bostrav59]

We just got back from 3 weeks in Egypt and Jordan on a sightseeing trip - great pyramids, temples in Luxor and Aswan and Abu Simbel, Petra, Jerash, Dead Sea. A typical tourist trip - with tour companies providing the content.

It was fun - but not a trip I’d do again. I must have a weak stomach because I got stomach problems twice and came back with a cold. I routinely travel with z-pac antibiotics because I routinely get sick.

I also had real control problems, caused I think by the violent change in diet. Egyptian diet is based on sugar - they consume more sugar than any other country per capita I think. And their bread really did a number on my numbers.

I was able to recalibrate after about 4 days (by cutting out all bread and limiting sweet intake) but it was quite a surprise about how these cultural changes reverberate into your blood sugar readings.

And then there’s a follow-on effect - because I ended up using more insulin in Egypt, I went through all of my pump supplies by the time i got home.

Anyway it’s nice to be home again.

[JessicaD]

That sounds like an incredible trip! But I had no idea that Egyptian cuisine contained so much sugar! Glad you were able to figure it out.

[needlesandmath]

Congrats on taking the trip, @bostrav59! My limited domestic travel is still rough on my BG as well. A chunk of that is time zone related, but restaurants also contribute a big share. I adore Middle Eastern cuisine, though, so a few bad days might just be worth it.

[Karl.n]

Sounds like a great experience, despite the extra problems to deal with.

I had a similar experience in Peru. “Why am I high all morning after my usual breakfast?” because they add sugar to everything there. I wouldn’t be surprised if there was sugar added to the eggs.

[Trying]

Sounds like a wonderful trip despite the BG issues. Welcome home!

I also had no idea Egyptian food used high amounts of sugar! Good to know! I think a lot of cuisines do add sugar, or maybe, it is just the restaurants that do, just like they do here in the USA!

[TomH]

Just saw this after posting elsewhere. The many uses of sugar in that part of the world is phenomenal. I worked in Turkey (military NATO HQ assignment) and found it was common to use 2 large bricks (equal to about 3-4 of our little sugar cubes) was common (3-4 bricks wasn’t uncommon) in a 3-4 oz serving of tea, IhlAmur tea (linden flower), or Tarchin tea (tasted like melted red-hots). I was there in 80’s and there were few “standard” restaurants, so you what you got is what you ate (or didn’t). The breads were great, but usually you ate them fresh today or built a house out of them tomorrow!

Again sorry your had problems with your control, but hope you got to the see the wonderful sites there!

[bostrav59]

Thanks everyone for your comments and questions. In many ways the trip was phenomenal - lots of hardcore sightseeing. Here are a few observations fwiw.

Egypt is a very crowded poor country that has very weak central government. Tourism is a big part of their economy - 15 mm tourists visit a year – and they were badly hurt by the Arab Spring in 2011 and of course by Covid over the last 4 years. So they are eager to get the rich tourists back.
This manifests itself in a standard lecture given by guides - don’t make eye contact with the hundreds of people in front of the temple who want to sell you something, because you don’t want to encourage them. Of course the guides want you to shop at the places that they direct you to.
And tipping is a hassle. Everyone expects a tip. I got a roll of 50 1 dollar bills from the bank before I went and I used them all up in 5 days. Who knows how much to tip? I was always trying to figure it out. Even in the sites themselves, the guards will show you secret parts that are roped off if you give them a dollar or two. Which I did occasionally.

Jordan is the good older brother of the middle east. Half of their population are refugees from Palestine or Syria. They have been very generous with their country’s limited resources, and their strong central government shows - especially in comparison to Egypt, which has very limited government. No one hassles you in Jordan. In contrast, you can’t really walk on the streets of Egypt without getting approached - not for any bad reasons, but just to see if there might be some opportunity for mutual gain.

Our guide in Jordan, Khalid, was palestinian, and stated that his hometown was Bethlehem. But he’d come to Jordan to live as a refugee when he was 6 months old, and now he was a grandfather. So he’d lived his whole life in Jordan as a Palestinian refugee. People do remember for generations when something is taken from them. @TomH yes we did go to that tourist trap Petra, and it was fabulous - quite overwhelming. But a tourist trap nonetheless. We were tourists and were expecting to be trapped.

After all the guided tours had ended we found ourselves at the Amman Marriott for a rest day. I just sent a survey response into the Amman Marriott, and I said it was like a fortress. Once you made it through the metal detectors and the gates etc, you were in Marriott Land. Which was just the ticket for a day of relaxing by the pool. I got to watch Lawrence of Arabia with a better knowledge of what was going on.

The last stop of our journey was Istanbul, which we had visited about 19 months before. We love Istanbul. It’s a dense mix of more than 2000 years of colliding cultures - east and west / turk and arab / muslim / christian; democracy / autocracy. Their runoff election is Sunday and everyone we talked with didn’t want Erdogan to win but expected that he would. We shall see.

Here are a few pix - I took 600 so I’ll spare you too much more…

This was our cabin on the Nile cruiser. That was fun.

Sunset on the Nile

I think this was a guard at one of the temples

Carol in front of a hieroglyph

[Marie]

What an amazing trip! I can tell you just a change to the local common bacteria can cause issues in quite a few people. I know the one time we went to Ensenada Mexico off of a cruise ship, instead of taking the cruise tours, we found a local tour company there. For $8 you got a 30 minute trip to a blowhole and lunch.You also got to catch any bus going back every 30 minutes. This was back in 2000, but $8 was still really cheap especially compared to the cruise lines $35 a person. Our guide when asked by someone how can you do it so cheap replied, remember this is a third world country.

Our guide was a law student earning his way who gave some suggestions. One, don’t drink anything poured into glasses or bottled locally if you want to guarantee not getting sick or you are prone to stomach problems. That there is different bacteria in the water that washes dishes or in the soil that unless you live there your body isn’t used to it and might revolt. We didn’t worry about the food, but we did only get bottled water we recognized. We ended up with no issues. I hope he was able to become that lawyer.

Regarding the coffee. I used to go to a Lebanese baker and off and on I took him coffee beans. He used to drink some every morning when he went in to bake. That stuff was thick and highly sweetened! I think he used to call it Turkish Coffee.

Glad you had a good time! Sometimes the BG variables are worth it!

[bostrav59]

@Marie

For $8 you got a 30 minute trip to a blowhole and lunch.

Thanks Marie - what’s a “blowhole”?

Regarding stomach, I’m pretty reliable - which is that whenever I go to a place where you have to drink bottled water, I will get stomach problems. So I always pack antibiotics. My wife didn’t get sick, and the tour guides in Egypt were assuring us that food was safe to eat. But not for me. I’ve been to India three times and was sick twice. I’m very careful but evidently not careful enough.

[Eaden]

Just gonna throw this point in as well because I haven’t seen anyone mention it: flying is one of the highest radiation activities we partake in. Radiation exposure partnered with circadian disruption will no doubt lead to increased inflammation throughout the body. Increased inflammation = greater insulin resistance, increased cortisol levels, poor digestion, etc. Surely, the experience was well worth a short period of out of range numbers.

[Marie]

@bostrav59 There are several blowholes around. But they are eye catching to watch. It’s when the ocean wave comes in and hits higher rocks and there is usually a larger channel for water to enter under and it comes up through a smaller hole in the rocks and into the air. Kind of like a Yellowstone geyser.

The first picture is a normal day for this blowhole. The second is on a king tide day with abnormal high waves and the waves were coming over the top along with the blowhole.

Edit to add. Those were 25 foot plus high waves!

[Karl.n]

@Eaden

Radiation exposure … will no doubt lead to increased inflammation throughout the body.

Interesting. Do you have anymore information regarding radiation exposure causing non-localized inflammation.

[Eaden]

Yes!
This is an excellent read. If you find it to be too long, let me know and I’ll send you some key paragraphs.

https://www.researchgate.net/profile/Dimitris-Panagopoulos-3/publication/286168695_Electromagnetic_interaction_between_environmental_fields_and_living_systems_determines_health_and_well-being/links/5ffdf1ed92851c13fe09bde9/Electromagnetic-interaction-between-environmental-fields-and-living-systems-determines-health-and-well-being.pdf?origin=publication_detail

[bostrav59]

@Eaden

flying is one of the highest radiation activities we partake in. Radiation exposure partnered with circadian disruption will no doubt lead to increased inflammation throughout the body.

Certainly, as we’ve discussed before, when you’re not active your insulin has to work harder (insulin resistance).

I am still dealing with jet lag - getting up at 3.00 am and napping in the afternoon. It takes a long time to recover from these long trips.

[Talkstr8t]

If you haven’t been I’d strongly recommend a visit to Israel. Phenomenal archeological and historical sites and much of the same mid-eastern cuisine, but also options for healthier food of all types. Tel Aviv is also one of the world’s great vibrant culture cities, with fantastic Mediterranean beaches, coffee shops, cafes and restaurants, clubs, and museums.

[jbowler]

@bostrav59

I also had real control problems, caused I think by the violent change in diet.

Yes, but the US diet is also incredibly high in sugar; for that reason I try to always get the “dressing” on the side (of salads) and then don’t eat it.

I don’t think it is anything to do with sugar, I think it is the diet change. Remember the end of “Super Size Me”, like the credits end, where he switched back to his previous diet and had the same effects as at the start.

That’s all without T1D.

I just got back from Costa Rica, a one week “adventure tour”; total tourism. The diet is total carbs; like Mexico with added carbs. Carbs are cheap. I went in knowing this was likely to happen (it happens in the UK, it happens in Europe, it happens in the US; carbs are cheap everywhere). It means barely eating, in terms of quantity, but that wasn’t a problem for me because the “adventure” part meant I was getting lots of exercise (intermittently) and that reduces my appetite. That doesn’t help with the diet change:

We got back, via Mexico City, yesterday, bought a Chicken in WalMart at the end of the drive back and I must have a weak stomach. This (according to my wife) was because I ate half a chicken and all the fat therein. She is probably right; I super-sized myself.

Best place to go for a T1D; the local markets. There’s no imperative to maximize profits because you can do that once then the customers never come again, choice is a requirement. Quite a lot of the world is T1 these days. You cater for Americans, serve carbs and demand tips, you cater for the people you see every day accommodate them, even if their requests are weird. How often do you go into a local restaurant, get a salad with the dressing on the side and sub the potatoes in the main course for veggies? I certainly never do anything else.

But it’s adaptation; I can do it in the UK (I’m a native) but it is a Royal PITA; finding somewhere in the UK with decent food is like finding water in the Sahara. Extreme selectivity is required and, in the UK, buying your own food from a supermarket and preparing it yourself is much safer. In California it is no problem; either on the side with subs or just go into a supermarket and see the world’s vegetables on display! In Taiwan, no problem; much more of the worlds vegetables and, in the markets, pick and choose, with sugar or without, cooked (as required) ready to eat. These are the three countries I am most familiar with (by a long shot); tourism is, I admit, a crapshoot.

[dmac]

A number of years ago I had several business trips to mainland China. Basically, I thought there was no problems with the food to keep to my regular T1D diabetic diet. I always keep my A1C well below 6 with multiple daily injections. At the time of my trips to mainland China my only BG measurements was with the finger stick which I did on a very regular interval before each meal, for adjustments. Of course, at the time of these visits it was before the existing international problems.

[bostrav59]

@jbowler

I just got back from Costa Rica, a one week “adventure tour”; total tourism. The diet is total carbs; like Mexico with added carbs.

Thanks for the thoughts @jbowler . I’ve been puzzling over the diet and T1d impacts. I’ll give more data when I have a few minutes - basically my blood sugars after meals would go up to levels like 350 and so I’d bolus a lot and get on that diabetes rollercoaster. I ended up solving the issue by raising my boluses for meals by about 20%, cutting out all bread, and eating a lot less - with an emphasis on salads.

Egyptian cuisine has some of the highest sugar content in the world - and their desserts are really good. So a lot of my issues were related to my overeating and eating the wrong things. As it was, though, I underestimated my insulin needs by about 20% as well, so I was on my last tandem cartridge as we were heading home.

[Karl.n]

@jbowler

Remember the end of “Super Size Me”

I wouldn’t take anything from Super Size Me as fact…

[jbowler]

@Karl.n

@jbowler

Remember the end of “Super Size Me”

I wouldn’t take anything from Super Size Me as fact…

That’s a very interesting criticism of irony.