Journeying to Antarctica With Type 1 Diabetes

Climate scientist Isabel Dove shares her life-changing experience doing something she didn’t think possible after her diabetes diagnosis: Embarking on a research expedition to one of the most remote places on the planet.

When I was diagnosed with type 1 diabetes in 2019 – about one month after my 23rd birthday, two months after starting a graduate program in oceanography, and three months after sailing on my first oceanographic research cruise – I thought my career as a sea-going climate scientist was over just as it was getting started.

However, given time to adjust to my new reality and exposure to stories about other people living with type 1 diabetes not letting it get in the way of achieving their goals, I grew resolved to continue pursuing my dreams. In late 2024, I had the incredible opportunity to put my scientific training and diabetes management to the ultimate test: Conducting oceanographic fieldwork around Antarctica.

The chance to visit Antarctica was a dream come true, both personally and professionally. I am a paleoceanographer, meaning I study how the ocean and climate have changed over time. In my opinion, one of the greatest perks of this job is the ability to participate in oceanographic research expeditions (which we call cruises), where we spend weeks to months on a ship collecting samples and doing science at sea.

The Southern Ocean – the waters surrounding Antarctica – is particularly interesting to study due to its unique ecosystem and impact on global climate. I had been researching Antarctica and the Southern Ocean for about eight years before I finally had the rare opportunity to go there myself. But, how was I going to manage my diabetes in such a remote and extreme environment?

Preparing for a trip at sea

Prior to my Antarctic adventure, I had participated in two other research cruises. The first, a month-long cruise along the coast of Chile, occurred before I was diagnosed with type 1 diabetes.

Upon my diagnosis a few months later, I remember thinking that I could never do something like that again – it would be much too difficult to conduct rigorous fieldwork and safely manage blood glucose levels amid unpredictable schedules, lack of control over what I ate, and having limited access to necessary supplies. About two years later, I proved to myself that it is possible when I sailed on a 10-day cruise off the coast of New England.

It turns out that my identities as a scientist and a person with type 1 diabetes overlap and reinforce each other. My science brain – attention to detail, pattern recognition, forming and testing hypotheses – helps with diabetes management, while diabetes has helped me become a better scientist by building resilience, thinking quickly to solve problems, and accepting unexpected results. Visiting Antarctica and spending over a month on a research vessel in the Southern Ocean put all of these skills to the test.

One skill that is central to conducting Antarctic research and managing type 1 diabetes is planning ahead. The cruise occurred from mid-October through early December 2024, but preparations were in full swing by June. As I helped my supervisor and lab manager pack up our science supplies, I also began stockpiling diabetes supplies. The typical struggle of packing backup supplies for a trip was supercharged due to the amount of time I was at sea – about six weeks – and the fact that I was, well, at sea.

Since there was no way to access any provisions beyond what’s on the ship, I had to bring along everything I could need, starting with the basics that I pack for every trip: Site changes for my Tandem t:slim X2 insulin pump, Dexcom G7 sensors, insulin vials, glucagon, and a few backup syringes. I always pack extra site changes and Dexcom sensors for infrequent yet inevitable accidents or malfunctions, like a bent cannula or faulty sensor.

But what else could possibly go wrong in the middle of the Southern Ocean? What if my pump breaks? Thankfully, I got a travel loaner pump from Tandem. What if both pumps break? Very unlikely but still possible, so I would need to bring along basal insulin pens. What if I somehow lose all of my Dexcom sensors? I would need to bring enough test strips to manually test my blood sugar multiple times a day for a month.

After carefully running through worst-case scenarios, creating contingency plans, and calculating how much of everything I needed (and then some), I ended up with the following list:

Essentials

6 vials of insulin
30 site changes
10 Dexcom sensors
Glucometer and spare batteries
6 bottles of test strips
1 box of alcohol swabs
5 tubes of glucose tabs
Glucagon
Insulin pump charger
Sharps container

Backups

Loaner pump
4 basal insulin pens
1 box of pen caps
100 syringes

Travel

2 Frio insulin cooling cases
Travel letter from endocrinologist
Copies of prescriptions

Overcoming obstacles

Some supplies were easier to acquire than others. I always get three-month supplies of my site changes from Tandem, and the timing of my refill happened to be around when I was packing, so that was no issue. I needed to ask my endocrinologist for some new prescriptions, such as basal insulin and pen needles, but those were also straightforward to check off the list.

Acquiring a three-month supply of Dexcom sensors ended up being especially difficult. I had my endocrinologist write me a three-month prescription and confirmed with my pharmacy that they could fill it in September. When I went to pick it up, I was informed I could only get a one-month supply due to insurance reasons. I then embarked on a carousel ride of calling my insurance, who told me to call my doctor, who told me to call my pharmacy, who told me to call my insurance, who told me to call my doctor…and so on.

This process ended up taking weeks, leaving me with an uncomfortably narrow window of time between filling my prescription and leaving for my expedition. At one point, a very kind and helpful pharmacist asked: “Are there any CVS branches where you’re going?” When I said I was going to Antarctica, she nodded and bravely redialed my insurance company

In the end, thanks to help from my doctor, the heroically persistent pharmacist, and an understanding insurance representative, I was able to acquire all necessary supplies for the cruise. While I recognize that I am fortunate to have insurance, it was frustrating to have to fight to get everything I needed. It is also disheartening to think that people with different insurance coverage – or less time to spend on the phone with insurance representatives – are limited in getting whatever supplies they might need.

Beyond struggles with insurance, another major obstacle was the physical qualification (PQ) process. To minimize the risk associated with conducting fieldwork in remote locations, the U.S. Antarctic Program requires anyone traveling to Antarctica or conducting research on a vessel below 60 degrees south latitude to pass medical clearance. The PQ process, which involves a comprehensive physical and dental examination, is arduous for everyone – but particularly for those with chronic conditions. I was initially worried about it because of my diabetes, but thanks to years of a stable treatment regimen, lack of serious hypo- or hyperglycemic events, and a letter of support from my endocrinologist, I passed without issue.

The first leg

With medical clearance and copious diabetes supplies in hand, I began my journey on October 19, 2024. The first leg involved traveling from my home in Rhode Island to Punta Arenas, Chile, where we would board the ship. Thirty-two hours in transit to the other side of the world presented the first hurdle in diabetes management.

I travel a fair amount and am well-versed in diabetes management in airports and on flights, but the duration of these international flights put my skills to the test. While I always do my best to maintain stable blood glucose levels during travel, I tend to accept that my time in range will be lower than normal due to long periods of inactivity, disrupted sleep schedule, and lack of lower-carb food options.

The Nathaniel B. Palmer In addition to paying attention to what I ate, I was careful to keep all of my diabetes supplies in a carry-on bag and ensured with the gate agents that I could keep it in the overhead compartment on my connecting flights. After two long travel days, we were ready to settle into our home for the next month and a half: The Nathaniel B. Palmer icebreaking research vessel. The ship is specially designed for scientific fieldwork in the icy waters around Antarctica, and as a polar scientist, I was thrilled to have the opportunity to be on board.

We spent a few days in port call, which is when everyone boards the ship in port before setting out. We spent this time getting oriented to our maritime abode and organizing our lab space. I got permission from the ship’s laboratory manager, who was also one of the two EMTs on board, to store my insulin in one of the lab’s refrigerators.

During this time, we had the opportunity to get off the ship and walk around Punta Arenas. I took advantage of this by going to a grocery store and buying some dark chocolate, sugar-free peanut butter, and tea. While the ship is well-stocked with food and snacks, I knew from my previous experiences that it helps to have a personal stash of favorite treats.

Setting sail

We were finally ready to set sail on October 24. The excitement of spending the next 43 days at sea quickly gave way to trepidation, with the looming challenge of crossing the infamous Drake Passage. This narrow strip of ocean between the southern tip of South America and the northern tip of the Antarctic Peninsula is among the roughest waters in the world.

I knew from past excursions that I am – thankfully – not prone to seasickness. However, since the Drake Passage crossing was likely going to be bumpier than anything I’d previously endured, I made sure to come up with a diabetes management plan in case I did get sick. Luckily, I was spared that challenge and withstood the 20-foot-plus seas without issue.

Iceberg My reward for surviving the Drake Passage crossing was spending two days enjoying the magical environment of the Antarctic Peninsula. While the primary objective of the cruise was to collect samples for our research in the Southern Ocean, we first had to drop off other scientists and supplies at Palmer Station. The scientists and support staff at the research station welcomed us with open arms and encouraged us to take advantage of all the place had to offer during our short stay – including hiking on the nearby glacier and polar plunging in the frigid water. Since it was spring there and Palmer Station is located in the northernmost region of Antarctica, it was not terribly cold outside – both the air temperature and water temperature were around 32 degrees Fahrenheit.

Just as my prior travel experience helped me manage the extremely long flights to get to Punta Arenas, my experience with outdoor activities helped me keep my blood glucose levels in a safe range while doing extremely cool things in Antarctica. For example, I always have ample glucose tabs for treating lows on hand and put my pump in exercise mode before going on a hike. The only difference this time was that I was on a snow-covered glacier!

Once the fun in Antarctica was over, our work in the Southern Ocean began. With Palmer Station in the ship’s rearview, we wouldn’t see land again until disembarking in Lyttelton, New Zealand, on December 7.

Managing diabetes at sea

Life onboard a scientific research vessel is simultaneously regimented and unpredictable. Every ship and cruise is different, but I generally knew to expect regular mealtimes, a 12-hour shift, lots of physical activity and manual labor while collecting samples, and periods of inactivity during inevitable bouts of bad weather.

While it was helpful to always know when my meals would be (breakfast at 7:30 a.m., lunch at 11:30 a.m., and dinner at 5:30 p.m.) and what my working hours were (6:00 a.m.-6:00 p.m.), there was still a lot of uncertainty on how active I would be as that depended on factors like the ever-changing weather and the kinds of samples we were taking each day.

Research on a ship — Doing science at sea (Photo credit: Georgia Rhodes, Rhode Island School of Design)

An additional quirk of this cruise was that we spent many days in transit from the Antarctic Peninsula to research sites located along the line of longitude 170 degrees west, meaning we crossed many time zones. The ship operated according to local time, so we periodically changed our clocks back one or two hours every few days. While my friends and family back home moved their clocks back one hour for daylight saving time, I changed the clocks on my phone and insulin pump back six hours. The 12-hour grace period for the Dexcom G7 sensor was a lifesaver in terms of being able to replace my sensor at a convenient time, since times were ever-changing during the cruise.

Such unpredictability presented a challenge to my typical diabetes management strategies, which rely on routine. Regarding food, I was initially nervous because, unlike in my normal life at home, I would have little control over what I ate. For breakfast, I usually eat chia seed pudding and often bring my own when I travel. However, bringing chia seeds along wasn’t an option due to Chilean customs, and buying over a month’s supply in Punta Arenas would have been impractical.

Despite the lack of chia seeds on board, breakfast ended up being the easiest meal for me to manage because there were always low-carb egg options available. Lunches and dinners were more challenging, but I managed by eating smaller portions of higher-carb foods like potatoes or pasta and opting for larger portions of salads and vegetables. This became increasingly difficult as we ran out of fresh veggies and relied more heavily on less appetizing canned food, but the hard-working cooks ensured that we were all happily and healthily fed during our time at sea.

I also dealt with the uncertainty of what exactly I was eating for each meal by pre-bolusing three units of insulin about 20 minutes before I expected to eat (which didn’t always end up being accurate) and then dosing additional insulin according to what I actually ate. On the occasions when I pre-bolused too soon or when three units was too much, I would correct with a glucose tab or treat myself to a cookie from the ship’s snack supply. It also helped that I could anticipate some meals, such as Pizza Sunday and the crowd-favorite Taco Tuesday, and prepare an extended bolus.

Exercise was challenging in the sense that while I was often active while collecting samples, I had little control over when that was and how it aligned with my blood sugar levels. At home, I like to go for a walk whenever my blood glucose levels are rising out of range. But that isn’t possible on a ship. Fortunately for me though, this particular ship was outfitted with a gym, cornhole boards, and a ping pong table.

While I still lacked control over when exactly I exercised, I was able to be active and engage in friendly competition when my shifts ended. I was grateful for chances to get moving and bring my blood glucose levels down because I had opted to be more conservative with my insulin dosing to avoid lows. Going low while running around collecting time-sensitive samples and being unable to do my part of the research was a worst-case scenario for me, so I accepted higher-than-normal ranges.

Celebrating in the Antarctic Circle

Isabel Dove in Antarctica Despite the trials and tribulations associated with working and living with type 1 diabetes on a ship in the middle of the Southern Ocean, I am proud to report success in terms of both scientific accomplishments and diabetes management.

Analyzing my Dexcom data across 40-day periods before and during the cruise (I am a data nerd!), my metrics were only slightly higher than normal. My average blood glucose level rose by 8 mg/dL, and while my time above 150 mg/dL rose by 7% at sea, my time above 180 mg/dL only rose by 3%.

One of my favorite days of the cruise occurred on November 14 – World Diabetes Day. I woke up to find that the ship was located at a latitude of 67 degrees south, meaning we were south of the Antarctic Circle. After a productive shift, we were treated to a rare cloudless sky and a view of incredible icebergs as we sailed north to our next station.

The next day was the fifth anniversary of my type 1 diabetes diagnosis. Celebrating my diaversary in the Southern Ocean proved that my fears from five years earlier were unfounded, and that diabetes should never stop anyone from chasing their dreams.

Photo credit: Isabel Dove

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