Part 10 of the “What Does It All Mean?” series, a real-life reflection on living with Type 1 Diabetes, written by Dennis Goldensohn, who has lived with T1D for nearly 60 years.
By Dennis Goldensohn: T1D for nearly 60 years, advocate, and mentor
A World Full of Different Perspectives
We live in a world that is made up of many different countries, cultures, religions, and customs. In our daily lives, we sometimes think that the rest of the world and its societies are the same as ours. This is so far from the truth.
My wife and I just finished a cruise where we visited five countries: Colombia, Panama, Costa Rica, Guatemala, and Mexico. Each was different, and it was interesting to see how diverse they were. I also saw many people working on the cruise ship. They were all from different places, and their diversity made the cruise so pleasurable!
In addition to learning about different cultures, I also have a lot to share about how one deals with Type One Diabetes when they are away from home for long periods at a time!
Exciting Excursions
We scheduled many excursions throughout the trip. On those days, we met in the theater that could accommodate over 1000 people. From 7:00 AM, there was an excursion that would leave the ship every fifteen minutes. Roberto, the maître d’, stood on the stage and would announce explicit instructions when each group was to embark on their excursion. He also told us that if there was one mistake, he would get a banana. Two more, and three, he would be in big trouble. So, he asked everyone to PLEASE listen to his instructions and not to leave the ship from the back of the theater. On our last excursion, I went upstairs to the buffet for breakfast, and I took a banana with me down to the theater where we were to go on our excursion. I saw Roberto, and I said to him, “Well, you didn’t make three mistakes, but here is one banana”! He laughed, and so did everyone who was nearby. It was great! These are the moments you remember after you come home!
The excursions that took us to cities that were reflective of the people of each country we visited. Many of the civilizations went as far back as the 1500s, with many landmarks representative of these times.
During those excursions, I was reminded that sometimes citizens of the United States can be spoiled and complain about things that are of no consequence. When you travel, you realize that not every country has the material comforts that the US has. But on so many occasions, those people will still have a smile on their face. They are humble and very proud of their country, culture, religion, and customs. They are happy. They often welcome visitors and are very appreciative that you chose to visit them!
As a photographer, it was like stepping back in time. Having discussions with the locals was also interesting, and they were very attentive and willing to answer my questions. There was never a time during all of the visits that we did not feel unwelcome and at home! It was truly a delight.
While visiting each country, we noticed women in the streets selling blankets, scarves, and other items. They had them on their heads, baskets, and on their arms in the hot temperatures of Latin America. Their children were following and helping, too.
At the end of each excursion, I asked each of the tour guides what they got out of this job and what their passion was for being a tour guide. All the tour guides, Carlita from Guatemala, Andres from Costa Rica, Santa from Mexico, Maria from Panama, and Naren from Colombia stated the following: It is the pride of their country, their customs, and making those on the tour feel like they were a part of their extended family. I sat back in my seat on the bus, and I said to myself, these people are working for next to nothing, must travel many miles to get to their job, and at the end of the day, they depend on the sales and tips visitors give them to supplement their wages. Our cruise was one of the last for a few months due to the upcoming rainy season. I assumed that the people we met would not have jobs until October, after the rain.
I later learned that they either do manual labor, sell other things, or find other means to support themselves and their families. Although this is a yearly occurrence and/or reality, they were determined to make it through these tough times! It made me wonder what people in the US would do if they had to deal with seasonal work situations.
Life Aboard the Ship
Back on the ship, it is like a little city. There are 1800 people who work on the ship. This includes maintenance, entertainment, hotel and housekeeping, food preparation, cooking, entertainment, and deck and engineering. A substantial number for sure! Nevertheless, they all worked hand in hand with each other, and they all made sure that the cruise met our expectations! Ellen and I made friends with the matradees throughout the ship. There was one gal who met us with a hug and a big smile each morning. What a wonderful start to the day! Everyone was so helpful, and nothing was impossible.
Pride in Tradition
Another excursion was in Costa Rica. It was the Andalusian Horse Show and Countryside. The horse farm has been in existence since 1900. Each horse is inspected by an organization in Spain, where, if they pass all the qualifications, they are certified and registered there. Each horse gets two chances to earn this certification. The riders put on demonstrations to show us the relationship between the rider and the horse. It was simply amazing. If you are familiar with dressage, you know the communication between the rider and the horse is not noticeable. They work as a coordinated team. The last rider was only 8 years old and was a mentee of the owner of the farm. He was spectacular. My observations and reflections here lead me to believe there was a lot of pride in what they do, and they were proud of carrying on this legacy!
Familiar Brands in Unfamiliar Places
When traveling to other countries, naturally, you see products and stores that you would not see in the United States. I was shocked to find American brands like Papa John’s Pizza, Kentucky Fried Chicken, Circle K Gas Stations, McDonald’s, Domino’s Pizza, Starbucks, Home Depot, Office Max, Office Depot, and Walmart. How fortunate we were to feel at home away from home. Some things just never change, I guess.
Our Cruise Itinerary
The excursions we booked were the following:
Cartagena, Colombia,
Panama Canal
Costa Rica: Andalusian Horse Show and Countryside
Guatemala: Colonial Antigua
Mexico: Discover Puerto Vallarta and Baja Highlights, Cabo San Lucas
All of these were interesting, and we were able to enjoy the people, their cultures, customs, hospitality, and food that we were served.
The entertainment provided was for all ages, and each night there were various venues to attend. During the day, there were swimming, games, and other activities. You could not find yourself bored or out of choices.
The Panama Canal
The Panama Canal was built in the 1500s when the Spanish thought a canal would be beneficial for them. Unfortunately, at the time, they didn’t have a way to allow us to build it. The French tried, and after 20 years of digging their way through the rainforests of Panama, they decided to vacate the project. This was due to Malaria and other tropical diseases. The challenges of digging through the rainforests and the flooding during the rainy season made it almost impossible. US President Theodore Roosevelt had the vision to complete the canal, so the United States bought the rights to finish it. The construction began in 1904 and was completed in August of 1914. They were able to tame malaria by keeping the mosquitoes that spread the disease in check. Living conditions were greatly improved, and the machinery and technology used ensured that they would be able to deal with the terrain they needed to navigate it. In 1999, the canal was officially given to Panama in an agreement between Panama and the United States.
In 2007, a new canal was built next to the original one to accommodate large freighters and cruise ships that could not fit through the original one. The canal goes from the north, the Caribbean Sea, southwards to the Pacific Ocean. Our cruise ship used the new canal. There are three locks on each end. Each lock will either raise or lower a ship 27 feet for each lock for a total of 81 feet. It was at the time the largest manmade lake. It took about 12 hours to navigate the entire length of the canal. It was amazing to see how ships of this size were able to sail through the canal!!
The Food
Now let us talk about food. And there was plenty to choose from. On a previous cruise to Hawaii, my priority was to taste and buy Kona Coffee. At $54 a pound, I was expecting to taste an exceptional cup of coffee. And I did! When we visited Colombia, Costa Rica, and Mexico, my wife and I bought chocolate and coffee. We bought different varieties of chocolate and different coffee roasts. We tried all of them at home, and we have not decided which ones we like the best of the coffees and chocolates. They all have their distinctive flavors! The prices for the chocolates and coffees were very reasonable too!
The food on the ship was excellent, and the services were second to none. We were not rushed, and each course was plated beautifully. We had three specialty dinners included in our cruise package. These included Italian, Seafood, and Steakhouse. The other dinners were at the Savoy, and they too were delicious, and the service was excellent. We had breakfast at the buffet. The days we were at sea, we had lunch at the buffet. All in all, the food and service were excellent.
With all of the different choices of food, those who travel and live with diabetes have some challenges that they must deal with! If you have a set routine each day while at home and at work, the challenges of time zone changes, earlier or later scheduling of events, can have some complications in how to dose insulin for the food you eat. Meals on cruises are generally much larger and offer more courses than you are accustomed to at home. There are many more carbohydrates and fats in these meals. Guessing how many carbohydrates are in each serving can be tricky.
Managing Diabetes While Traveling
To address these issues, I bought insulin pens and needles to give myself more insulin as I saw my BG rising. I use an AID system, Omnipod, and I didn’t want to have a pod’s three-day usage cut short by infusing more insulin to adjust for the extra carbohydrates. And since I did not know what the carbohydrate content was, I could not change my Insulin-Carb ratio to compensate for the extra carbohydrates.
I also walked several miles on the outdoor track after meals to burn off the excessive carbohydrates. The intake of food rich in fat also has an effect on how carbohydrates are digested by our bodies. But it is very difficult to avoid these delicious selections, and you just have to go with the flow. There were some sensible choices like fish, steamed vegetables, and fresh fruit. During lunch, my wife and I had large salads which were fresh, and we added cheese and cold cut meats to the salads. Alcohol was kept to a minimum, and we had wine during our dinners.
My average A1C or GMI metric of the Dexcom 6 CGM was around 6.3, and my Time in Range-TIR was 89%. All good, but these readings are generally, when I am at home, 5.9-6.0 GMI and the Time in Range (TIR) around 96% to 98%. I always try to maintain the best outcomes managing my diabetes, but being in a different venue, you go with the flow. You still manage your diabetes, but you don’t want it to manage you. Vacations should be fun and enjoyable. Don’t let it discourage you. Deal with it on a daily basis, and you will be able to make changes in the daily management of your diabetes on vacation!!
Meeting Others With Diabetes
I met others who were wearing CGMs, and we had some great conversations. One young lady was wearing a Dexcom G7 and was using a Tandem AID system. The other was wearing a Dexcom G6 and using an Omnipod AID system. We had some very good conversations. One of them had T1D for 23 years, and the other had Latent Autoimmune Diabetes in Adults (LADA), often called Type 1.5 diabetes. They wore their CGMs out in the open and did not hide them. They were willing to discuss their journeys with diabetes. I was in good company, and it showed that we, as the ones dealing with diabetes, can enjoy travel and doing what everyone else can do. No limitations for sure!!!
Why Write About a Cruise?
After everything said here, why would someone want to write about a cruise? As I get older, I appreciate the things that are not materialistic and/or tangible. It was a wonderful experience to see the world from those in the countries we visited, even if just for a short time. It was also interesting to see how a ship, a floating city, was able to function and how everyone got along with each other.
If we just take a little time to better understand each other, we can make this possible! I witnessed that we are not the only ones with issues and problems. As they say, walk a mile in my shoes! The individuals I met from these five Latin American countries truly are survivors who, in their words, say they are blessed to be given another chance each day.
We truly need to be thankful as well. We all need one another. We cannot go it alone anymore. We live in a very small world!
…………………..and that is what it all means!
What Is This Series?
At Diapoint, we believe that the most powerful education comes from real people and real lives lived with diabetes.
That’s why we’re proud to introduce a new blog series by Dennis Goldensohn.
Dennis has been living with Type 1 Diabetes for nearly six decades, diagnosed at just 16 years old, and now approaching 59 years of life with T1D, without complications. His journey is not only a testament to resilience but also to what is possible with the right mindset and support.
Beyond his personal experience, Dennis brings a lifetime of dedication to service and advocacy. He spent 45 years working in aerospace manufacturing, while also volunteering with organizations such as JDF, JDRF, Breakthrough T1D, DPAC, and the Diabetes Research Institute. Today, he continues to mentor young people navigating their futures, while sharing his lived experience with diabetes to support others.
His series, “What Does It All Mean?”, is exactly what it sounds like: a reflection on life with diabetes, beyond the numbers, beyond the devices, and beyond the daily routines.
Through this series, Dennis explores:
- The realities of living with diabetes every single day,
- The misconceptions and stigma people face,
- The history and progress of diabetes care,
- The power of community, advocacy, and teamwork,
- And ultimately, what it truly means to live a full, successful life with diabetes.
This is not just education. This is perspective and lived experience.
And above all, this is reassurance that yes, you can.
