Cruising with diabetes: Guidance for onboard buffets and dining

To everyone else, having multiple delicious meals served each day sounds like a tasty (and wonderfully lazy) way to enjoy oneself during a cruise. However, to a diabetic, several days of restaurant eating and a consistent lack of nutritional information can sound much like a nightmare, despite the many luxuries that fine dining can bestow and the astounding variety of global cuisine.

Diabetes is a condition that does not pair well with unpredictability. This creates a problem in that people with diabetes enjoy dining out and about as much as everyone else does but, in doing so, they have introduced uncertainty when it comes to what they’re eating and what nutrition is contained within. This leads to complex thought processes in a situation that is supposed to be enjoyable and relaxed.

What if you can’t weigh out ingredients and calculate carbohydrate totals in the restaurant? How many slices of bread will that house special sandwich contain? Will the more exotic dishes be served in smaller portions?

What if a given restaurant is unexpectedly busy and the insulin kicks in before food arrives at the table? What if there’s a buffet where there’s no indication of what will be on offer until you get there? And should you even be indulging in all this tempting food anyway? And what will your HbA1c blood test give away on your indulgences when you get back home? Ugh.

These are all typical thoughts of a person with diabetes who has been taken out of their normal environment, far from their trusty kitchen scales and nutritional guidebooks and plunged into a world of catering unknowns.

And they are not just questions being asked for the sake of being difficult. If a diabetic’s meal doesn’t arrive on time or they miscalculate the carbohydrate present within a meal, there can be serious implications when it comes to blood sugar levels leading to being seriously unwell.

For example, if a large group arrive within a restaurant and place their order ahead of a diabetic, it is likely the insulin that has just taken could send their blood sugar into an aggressive downward trajectory if there is a resultant delay in serving times. If a diabetic spots what has happened, they are likely to be concerned that they have taken their medication too quickly. Cue nervously watching other tables to see how long it now takes for food to arrive while comparing that with the speed of the insulin taken.

If things are slow, a diabetic may wonder if they should order a fruit juice to sip on as they anticipate a looming attack of hypoglycaemia. By doing this, they potentially keep an unwanted problem at bay but then they have to remember to keep checking their sugar levels and take extra insulin at a later point, interrupting their meal to do so, to counteract the inevitable raised blood sugar that would follow. All because the restaurant become temporarily busier than usual.

In scenarios such as these, diabetes feels much like plotting out strategical battle tactics while simultaneously trying to maintain conversation at the table and remembering to also have a nice time. It’s exhausting.

This uncertainty will typically follow a person with diabetes throughout breakfast, lunch, dinner, whenever drinks are had and when exercise may follow a meal. It will happen on the first day away from home as well as the last day and all others in between. The relentlessness of the condition is so impeding that it could dissuade a person with diabetes from going on a cruise in the first place.

It needn’t be this way. For however complicated diabetes makes enjoying repeated dining out on a cruise, it is the simplest of solutions that empower a diabetic passenger and allow them to enjoy on board catering as much and as safely as everyone else. Primarily, this requires nutritional information to be openly available and some advance preparation to counteract some of the unpredictability that comes with eating among others in a busy and ever-changing environment.

Thankfully, in recent years, cruise lines have much more become aware of the difficulties, many of which are subtle and hard to spot, that diabetes can present to passengers with the condition. Here are our top tips for navigating diabetes while partaking in on board dining and buffets.

1. I’m diabetic – Make yourself heard

The first step to ensuring that diabetes doesn’t spoil what should be a glorious and relaxing cruise is to make yourself heard. While managing diabetes is frequently a dominant and time-consuming task, it may not be immediately obvious to those around that you have this testing condition to manage. Diabetes is usually classed as a non-visible disability because, if you choose to, you can usually hide the various issues that it brings in its wake.

While this is a noble strategy, getting the best out of your cruise experience is much more achievable if you are simply open to sharing the presence of your diabetes with your cruise line. This shouldn’t feel like wearing a badge or label, instead you merely require a willingness to state ‘I’m diabetic’ and allow the cruise line to assist where you feel it would help most.

For example, would dining on board feel much less strenuous if you knew the next day’s itinerary and being able to plan for an earlier breakfast or a later dinner? If so, your cruise line can ensure you have advance notice of unusual activities or crossing into other time zones long before these happen.

Would knowing the carbohydrate total of a given meal streamline taking insulin and remove a lot of stressful guesswork before you eat? Chances are the cruise line can direct this information from the kitchen to your table if you can make them aware of this requirement beforehand.

Remember that a cruise is a holiday for a person with diabetes too. Allow yourself permission to cast your need to simply battle on overboard and allow your cruise line to take some of the strain of managing diabetes off your plate. Aim to avoid memories of frantic on board carbohydrate counting with a magnificent three course meal that you enjoyed in the ship’s most decadent restaurant instead. By first making yourself heard, this is not an unobtainable fantasy.

2. Get organised – Consult menus early where possible

If you’re diabetic, chances are you’re more than aware of how the time between being handed the menu and having dinner arrive on the table can be a frantic one.

Instead of simply enjoying where the server has placed you in the restaurant, joining in with the ‘Cheers’ that accompanies the first sip of wine and lazily trying to decide what to have for dinner, your mind is alight with numerous problems that all feel like they need tackled at once.

Now that you’ve sat down, what is your blood sugar doing prior to eating? Upon scanning the menu, you’re busily eliminating the meals that will spike your blood sugars regardless of whether you think you’d enjoy them or not.

Then, there’s not much time before the server comes back and so exists pressure to choose something that will work well with managing blood sugars. At the same time, you’re probably also scanning for a private spot for a subtle insulin injection or wondering if the person behind you will jolt you with their chair as you juggle your diabetic kit and a sharp needle or two.

On top of that, you’re frantically trying to take your best guess at the carbohydrate in your meal while praying that just the right amount of time passes between ordering and beginning dinner. Phew!

As a diabetic, going for a meal often feels like a race against the waiting staff, the kitchen, your diabetes medications and even yourself. Did you even hear what your dinner partner said about how nice the restaurant is while all that was going on? Probably not.

To avoid this chaos, it really helps to either look up online or ask the restaurant for copies of the menu in advance. This allows you to choose which restaurant you want to go for at a given time as well as knowing what will be getting served when you arrive and most crucially what carbohydrate and other macros will be in the meal you opt for.

While this may feel a little less spontaneous than rocking up and ordering on the spot, you will thank yourself when you can simply take a little insulin and be fully present when your group chink glasses together and begin discussing the ambience of the eatery you’re residing in.

3. Iron out unpredictability – Speak to the restaurants and befriend the Maitre d’

When it comes to diabetes management, even with the best of planning and intentions, there’s nothing quite like a dose of unpredictability to unravel your stellar efforts. This is where speaking in advance with the restaurants and or the Maitre d’ on your cruise can prove highly worthwhile.

One of the easiest ways to get caught out in a restaurant setting is ordering during a particularly busy spell and being caught by delays from the kitchen. You can avoid this by speaking to and booking with a restaurant in advance. They may be able to advise on how busy they anticipate they will be at a given time or they might be able to estimate how long it will typically take for a meal to arrive from the kitchen.

It is often very helpful to book your table in advance, ideally slightly outwith peak serving time to minimise the chances of disruption.

If uncertainty exists when it comes to the ingredients that will be within a meal or you need to pare-down on the calories, cholesterol or other macros that could trigger an intolerance issue, a discussion with the Maitre d’ on your specific dietary requirements can yield great benefits.

Having the Maitre d’ on your side is priceless – they can act as a filter on your behalf, ensuring that you can simply tuck in and enjoy without worrying if a certain ‘red flag’ ingredient may be present at your table.

Of all the meal types, a buffet is probably the most testing for a person with diabetes to navigate. With so many different and complex foods on offer, it can be very challenging to estimate carbohydrates correctly. Additionally, even if you are successful in that regard, what foods you’ve allowed for with diabetic medications could be gone by the time you return to the buffet to collect it.

Again, this is where speaking to restaurant and Maitre d’ in advance can help. They may be able to advise on what an upcoming buffet will feature and perhaps even keep a portion aside for you.

When it comes to taking insulin at a buffet, it can be easier to have a rough carbohydrate total to aim for when approaching the buffet table rather than trying to work out what’s in the food you’re collecting as well as splitting insulin doses across the meal so you can adjust total medication and food consumed as needed throughout.

4. You are not alone with diabetes – Utilise a cruise ship’s back-up

While hopefully you would never need to ask the crew for medical assistance or to retrieve additional equipment from the onboard medical room, it can be reassuring to know these are available to you should you require them.

Never feel embarrassed to ask at the help desk for an extra sharps bin or if it might be possible to refrigerate some medications while you travel. Basic medical supplies are always present on board a cruise ship and if you think you might be caught out, it never does any harm to ask.

It is always a sound idea to notify your cruise line that you are travelling with diabetes so should something occur, you will have prompt and efficient medical assistance. Aim to have a copy of your prescription medication and any allergy information in an easily accessible spot in your cabin.

Similarly, with a condition that can be highly unpredictable and challenging, such as diabetes, it is good to know that should you need medical assistance or advice, a medical room is always present upon a cruise ship. You might not spot another diabetic while on board a cruise but equally you are most certainly not alone in managing the condition while out at sea.