Studying Abroad: T1D in Japan

February 5, 2019

Mykel Greene
Temple University
I am a senior double major at Temple University. I will be graduating in the fall semester of 2019 with a Bachelor’s in Music and a Bachelor’s in English. I’m an aspiring Young Adult/Adult novelist but am equally as eager to become an editor of those same types of work. I like to help people achieve their goals, especially if they are similar to my own. This is why I started writing about my diabetes. I used to view it as obstacle, but now I view it as a vessel to help other people with diabetes to not fall into my pitfalls and provide support.

Managing diabetes at home can pose many challenges. You have to make sure juice and crackers are always on hand. You have to make sure your pens, vials, or pump has enough insulin to go about your day-to-day. Let’s not even talk about the other necessities that you have to lug around with you every day.

That being said, what about when you go abroad? It is almost inevitable that your diabetes regimen and management will change as you adjust to the new country and culture that you’re in. Some countries, like Japan, don’t have a large enough population of people with type 1 diabetes that resources may be harder to come by. I faced this challenge when I studied in Japan through Temple University in my spring 2018 semester.

Unlike when traveling to European countries, Japan is very strict about what medical and cosmetic supplies come into the country. I had to fill out a form, called Yakkan Shoumei, for each individual supply I needed to bring with me into Japan. These forms requested the name, quantity, purpose, and description of packaging of the product. This way, they can identify it in customs at the airport.

“Don’t let these kinds of things deter you from the wonderful opportunity to see the world. Diabetes cannot stop you from seeing the Gothic cathedrals in Italy, the shrines in Japan, Machu Picchu in Peru, or the pyramids in Egypt. There are accommodations to be made but with all the right research, you can do anything.”

If you have a strict diet or you are simply a picky eater, it is always worth looking up the usual diet that people in the country in which you’re studying abroad eat. I wasn’t aware that meats were more like novelties in Japan. Therefore, unless I purposefully sought it out, my meals usually consisted of noodles, rice, vegetables, and fish – a lot of fish. This is drastically different than my McDonald’s diet.

This means that my body was taking in more carbohydrates that were harder for my body to break down. I quickly found out that Japanese rice took longer for my body to digest than the rice I eat here, which made me go low a few times before my sugar would soar above the clouds. It is worth it to know how particular carbs affect you, and then be prepared for any deviation  because of the difference in the foods available where you’re from and where you’re going.

In my article, “Type 1 diabetic travelers to Japan, be prepared,” which is available on the official The Japan Times website, I outline the benefits of using other ways to monitor your sugar levels and your insulin dosages. While preparing for Japan, I started using a Continuous Glucose Monitor (CGM) to help me as I went through time zone changes, diet changes, and lifestyle changes. Prior to going to Japan, I have struggled to sense my blood sugar dropping, which lead to a brief but just as impactful history of seizures.

Since I was going 6,600 miles away from home, my family and I also thought it would be beneficial and safer for me to have a CGM. It did come in handy when my sugar was in the pits and I was sleeping and thus didn’t answer my phone when my family called approximately 20 times. My residential director was able to provide me with the assistance I needed and the crisis was avoided.

“Diabetes, type 1 or type 2, is not an obstacle unless you make it one.”

Additionally, you can evaluate which way is the best way for you to administer your insulin while you’re abroad. You might want to err on the side of caution by continuing to use the method you already use because you are already familiar with it. It is definitely worth the consideration of what will be easiest as you undergo a major lifestyle change when you study abroad in another country. I am an avid vials-user but switched to pens because I knew that I would frighten Japanese people with the sight of syringes in addition to my foreign appearance.

Diabetes, type 1 or type 2, is not an obstacle unless you make it one. Studying abroad is possible for us. Whether you’re there for four months like me, or longer or shorter, the experience is invaluable. The opportunity is there. You just have to seize it with your own hands.

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