Diabetes Forecast

The Captain: Erin Spineto

Sailing solo for 100 miles around the Florida Keys

By Tracey Neithercott , , , ,
Erin Spineto

Erin Spineto
Photograph by Sam Hodgson

Two years ago, Erin Spineto was itching for adventure. “I’d been around these [California] beaches surfing since I was a kid,” says the now 37-year-old. “I wanted to go somewhere I’d never been.” So after a year and a half of planning, she set off on a four-day, 100-mile sailing trip around the Florida Keys.

Solo sailing is a daunting task for anyone, but Spineto had to take extra precautions because of her type 1 diabetes. The major worry: hypoglycemia. “If you’re driving a car and you get low, you can pull over,” she says. “If you’re driving a boat, you can’t pull over.”

Though she had cell phone service at all times and could contact the Coast Guard via an onboard radio, Spineto took steps to ensure her blood glucose didn’t dip low enough to require assistance. She carried glucose-packed energy gels, which she could eat hands free when tending to sails. And she stashed extra fast-acting glucose with the rest of her diabetes supplies, all in waterproof containers stored in three different places aboard the boat—just in case any went overboard.

Spineto stocked up on meters and test strips, pump supplies, backup insulin vials, syringes, and glucose gels. “I pack probably four to five times the amount of supplies I need,” she says. “If something goes wrong, I want to be sure I have what I need.”

And in case that failed, she knew exactly where she might find help on land. “I created a map of the Florida Keys with all of the pharmacies and hospitals marked so if I had to go to shore I’d be prepared,” Spineto says. Staying safe, she maintains, is about “doing  your research.”

Long days on a hot boat posed additional challenges, including warm temps that threatened to bake her insulin. To protect the medicine, Spineto stored it out of the sun and in a cooler with ice. She tucked her pump tubing into her shorts or bathing suit to keep the insulin in the tube from the heat, and she’d replace the insulin every two days to be safe.

High blood glucose was even more of a threat because so much of sailing is standing or sitting still. To balance that, she ate less food during the day (her primary meal was dinner once she reached land and became more active) and tried to stay fit. “I had to create my own exercise,” Spineto says. “I had to do some squats.” Even then, she found that a long day at sea with little movement caused the insulin in her body to be absorbed more slowly—leaving her at risk for lows once she reached port and began to walk again. To counter the problem, Spineto learned to lower her pump’s basal (background) insulin rate an hour or an hour and a half before hitting land.

But for all the hours spent with little movement, there were highly physical, heart-pounding experiences that made her adrenaline swell—and her blood glucose with it. “On that third day, the adrenaline was flowing the whole day,” she says. Amid 25-mile-an-hour winds and giant waves, Spineto spent the day scurrying about the boat, activity that blunted the adrenaline-caused spike in her blood glucose.

She also checked her blood glucose frequently throughout the trip and wore a continuous glucose monitor (CGM). The CGM was especially useful because Spineto couldn’t always spare two hands to test her glucose. “It’s so nice not having to pull out that kit constantly,” she says. “You don’t have to do the two-handed thing and jostle everything around and let go of things.”

Spineto still sails today, going on outings near her San Diego home with a group of people with diabetes. A couple of times a year she competes in triathlons, and she’s currently training for a 12.5-mile team swim around Key West where she’ll cover 4.2 miles of ocean. As for another big adventure, Spineto has set her sights on a long-distance stand-up paddle trip she might take a few years from now.

Safety Note

Talk to your doctor to make sure engaging in extreme sports is reasonably safe for you.



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