Updated
People with type 1 and type 2 diabetes go gorilla trekking successfully, but the trek needs planning: it can mean several hours of steep walking at altitude, starting early, with meals at fixed times and medical help far away.
Long exercise usually lowers blood sugar, during the trek and for many hours afterwards, so carry fast-acting sugar and snacks, test more often than usual, and agree a plan for insulin or tablets with your diabetes team before you travel. Tell your guide and the ranger about your diabetes and what to do if you have a low.
This page explains what to plan for; it is not medical advice. Your own doctor or diabetes nurse should set your doses.
What the trek asks of your body
A gorilla trek starts with a briefing around 7:30 am, then a walk of anything from under an hour to five or six hours to reach the gorillas, one hour with them and the walk back. Bwindi lies at about 1,160–2,600 m on steep, muddy slopes, so the effort can be hard and continuous. You cannot eat or drink during the hour with the gorillas, and the timing of lunch depends on where the gorillas are. See our guide to how far you walk on a trek.
Managing blood sugar on the day
Sustained exercise makes muscles use more glucose and increases insulin sensitivity, which can cause lows during the trek and delayed lows in the evening and night. Many people on insulin reduce their dose before and after long exercise, but the right adjustment is individual, so work it out with your diabetes team and, if possible, practise on long hill walks at home.
Eat a good breakfast with slow-release carbohydrates, check your glucose before setting off, and check regularly on the trail, especially before you reach the gorillas, since you will not be able to eat for an hour. A continuous glucose monitor with alerts makes this much easier.
What to carry
Carry fast-acting sugar such as glucose tablets or gel, plus slower snacks like nuts, cereal bars and bread, more than you think you need, in case the trek runs long. Keep your meter or monitor reader, spare sensors or strips, insulin or tablets and a glucagon kit if prescribed in a waterproof bag in your daypack, and share some sugar with your porter or a companion.
Insulin should be kept cool but not frozen; an insulated pouch works well in Uganda’s heat. Carry two litres of water, as dehydration affects glucose; see our guide to hydration on a gorilla trek.
Telling the team
Tell your driver-guide and the ranger at the briefing that you have diabetes, show them where your sugar is kept and explain what a low looks like and what to do. Rangers can arrange a slower pace and may assign a family that has been closer recently. Hire a porter, at about US$15–20, to carry your bag so you can focus on walking and checking your levels. Our guide to how fit you need to be has more on preparing.
Travel and supplies
Bring at least double the supplies you expect to use, split between two bags, as diabetes supplies can be hard to find outside Kampala. Carry a letter from your doctor listing your medication and devices for airport security. Time zone changes affect insulin timing, so plan with your team. Make sure your travel insurance covers diabetes and medical evacuation, and note that the nearest well-equipped hospitals are many hours from Bwindi. If you take malaria tablets, ask your doctor about any interactions; see our guide to malaria prevention.
Frequently asked questions
Yes, with planning: discuss doses with your diabetes team, test often and carry plenty of sugar and snacks.
Usually, both during the trek and for hours afterwards, including overnight.
Eating is not allowed near the gorillas, but in an emergency, step back with the ranger and treat the low.
Use an insulated cooling pouch and store it in a lodge fridge, not the freezer.
