Can You Sail the Caribbean with Type 1 Diabetes?
Yes, you can sail the Caribbean with Type 1 diabetes — I’m doing it. But “yes” comes with a plan, because offshore you can’t run to a pharmacy, and heat, salt water, and night watches all conspire against good blood sugar control. Here’s how I actually handle it, on an insulin pump and a continuous glucose sensor (CGM), so you can see what it really takes.
Quick note: this is my personal experience, not medical advice. Build your own plan with your endocrinologist — especially your pump-failure backup and sick-day rules.
The one rule that shapes everything: redundancy
The single biggest mindset shift for going offshore is redundancy. On land, a failed pump or a dropped vial is an errand. Two hundred miles offshore, it’s an emergency. So I pack roughly twice what I think I’ll need for the stretch between reliable resupply, and I split it into two waterproof stashes stored in different parts of the boat — so one flooding or lost bag never wipes out everything.
Keeping insulin alive in tropical heat
Insulin hates heat and must never freeze — and a boat in the Caribbean gets hot. I keep my main stock in the coolest, most stable spot on the boat, low and central near the bilge, out of the sun and away from the engine. For active-use insulin I use Frio evaporative cooling pouches — they cool with just water, no power or fridge, which is perfect on a boat with limited electricity. If I have insulin in a 12V fridge, I keep it in a buffer box so it never freezes against the cold plate.
The pump-failure backup that makes it safe
This is the offshore non-negotiable. A pump failure at sea with no way to inject is a true emergency. So even though I’m on a pump, I always carry a manual fallback: long-acting (basal) insulin and rapid-acting insulin in pens, plus syringes — and a written “pump-down” dosing plan from my doctor, laminated, in the kit. If the pump dies off Dominica, I can go fully manual and keep sailing. I also carry 2× the infusion sets and reservoirs for the trip length, plus buffer.
Keeping a CGM stuck on in salt water and sweat
Adhesion is the daily battle offshore. Salt water, constant sweat, humidity, and swimming all attack the adhesive, and a sensor or pump site that peels off mid-passage is a real problem. My routine:
- Over-tape both sites. I run GrifGrips patches over both the pump infusion site and the CGM sensor — it’s the supply I burn through fastest at sea.
- Prep the skin with a barrier wipe for grip, and a skin barrier so the extra adhesive doesn’t wreck my skin over months.
- Rinse fresh water and dry the site after every swim — salt residue is the enemy of a good stick.
I also always carry a backup fingerstick meter and plenty of strips, because a CGM that loses signal or washes off is useless, and you need the ground truth — especially when you’re wet.
Lows on night watch
The scenario I design against is a low, alone, at the helm at 3 a.m. So fast-acting carbs live in the cockpit at all times — glucose tabs and juice within arm’s reach, plus a stash at the bunk and in my foulies. And my watch partner knows my low signs and exactly where the sugar and glucagon are. On a boat, managing diabetes is a crew sport, not a solo one.
Seasickness is a diabetes emergency in disguise
Here’s the one people underestimate: seasickness can stop you eating and drinking while your basal insulin keeps working — and a pump keeps dosing no matter how sick you feel. That’s a fast track to lows and, if you get dehydrated, to ketones. So I carry a blood ketone meter and strips, an anti-nausea plan worked out with my doctor, oral rehydration salts, and written sick-day rules I can follow even when I feel awful. I know my personal “turn back or call for help” threshold before it becomes DKA.
Glucagon and a crew that knows how to use it
If I go unconscious, someone else has to act. So I carry ready-to-use glucagon (the nasal or pre-filled kind — far better than anything you’d have to mix on a pitching boat), two doses in known spots, and every crew member is trained to recognize a severe low and use it. There’s a laminated “if Ryan is confused or unconscious” card right next to it.
Crossing borders with insulin and needles
Island-hopping means customs. I carry a doctor’s letter stating I’m Type 1 on a pump and CGM and need insulin, needles, and devices, plus copies of every prescription (paper and photos), and a rough resupply plan for each country on our route — because insulin brand names differ abroad. I wear medical ID aboard, and our insurance includes medical evacuation, which you absolutely want when you’re this far from care.
So — can you do it?
Yes. Type 1 diabetes doesn’t have to keep you off the water; it just has to be planned for. The ocean doesn’t care about your best guess, so the work happens before you cast off: redundancy, a pump-failure fallback, heat and adhesion sorted, and a crew that knows your emergencies. Do that, and you get to go sailing.
If you want the full packing list I built for this, the T1D Offshore Kit Checklist is our free download — grab it here. And follow along on YouTube as Jennifer and I actually do this.
Again: my experience, not medical advice. Make your real plan with your diabetes care team before any passage.