Effective education for diabetes self-management

 

Why high mountains? Let us say immediately that, like all high-end sports activities, even high-altitude climbs are not part of the normal treatment package prescribed for people with diabetes. In our intentions they have a triple value:

 

- First of all, they are a message of hope for everyone, patients and family members, who every day live the difficulty of a condition still often wrongly considered limiting.

 

- In addition, top athletes are testimonials of the importance of good control to be and function well, and show by their example that good control is achievable... even in adverse conditions! This message, amplified by the resonance of the sports enterprise, is more likely to be heard by young people and also by people with type-2 diabetes.

 

- Finally, if we consider that the exploits of the champions can attract towards the same sport, high-level mountaineering has the added value of promoting activities such as hiking and mountain trekking, which are particularly healthy since they are aerobic and usually prolonged, often over four to six hours.

Wild Blue-2019 – 10th DAM Meeting

Wild Blue-2019 – 10th DAM Meeting

5-11/10/2019. Beautiful ductility of an acronym! Already last year, on the occasion of climbing the Cima Grande di Lavaredo we "bent" our logo ("Diabete e Alta Montagna”, i.e. Diabetes and High Mountains") to mean "Diabete e Arrampicata in Montagna”. This year, when - on the idea of Luigi Montanaro - we signed up for the famous 7-day trek overlooking the steep cliffs of Baunei Supramonte, in eastern Sardinia, the embarrassment for our logo was overcome by converting its meaning to "Diabete e Arrampicata al Mare” i.e. Diabetes and Climbing by the Sea.

Selvaggio Blu (Wild Blue) is an itinerary described since the late 1980s, rediscovering ancient paths frequented in the past by Sardinian coal men and shepherds. The route winds through the Ogliastra region, and has been modified over the years to adapt it to the needs of different hikers. Of course we have chosen the most demanding (or almost) version among the proposals of one of the local organizations: Explorando Supramonte.

Participants. Twenty people joined, including: 9 chronically ill (5 with T1 diabetes, 2 with celiac disease, 1 with MS, 1 post-breast cancer, 1 post-aortic valve implantation); 4 expert mountaineers (including the alpine guide Piero Bosetti and 3 instructors of the CAI two of whom with T1 diabetes); 3 diabetologists (AM, Gianfranco Poccia and Claudio Molaioni, himself with T1 diabetes); 6 accompanying persons not affected by chronic diseases (Catia, Chiara, Costanza, Milena, Pierfrancesco, Sara).

Route. The trail includes six stages of 6-7 hours each consisting of walking at a calm pace on variable limestone ground, almost always covered by a dense Mediterranean bush composed mainly of Holm Oaks, Strawberry trees, Junipers, Arboreal Heather, Brooms, Wild Rosemary, Oleasters. Normally each stage, which develops from south to north close to the coast at an average height of 300 m, ends on a beach (Portu Pedrosu, Cala Goloritzé, Cala Mariolu, Grotta del Fico, Cala Biriola, Cala Sisine), on which every evening the organizers arrive by rubber boat and unload the bulk of our luggage with all the materials that we did not need to carry in our backpack, as well as plenty of water, other drinks and the foods with which they prepare a dinner, always very good. The following morning the dinghy returns to prepare breakfast and deliver the sandwiches for the mid-day meal, as well as to collect our bags with tents, sleeping bags, and other materials . So the new stage can begin.

A particular overnight stay was that in the Grotta del Fico (Fig tree Grotto) - the last known habitat of the Monk Seal in Sardinia - already explored for several years in part by our friends of Explorando Supramonte and currently managed by them. After a guided tour with Stefano, we placed our tents in the atrium of the cave and spent a "strange" night both for the dampness of the environment and for the echoes amplified by the dome vault.

The mountaineering difficulties of the route are not very high, as long as you are familiar with rappelling. From the third day, in fact, the descents become more frequent and longer, often with stretches in the void, to culminate with the spectacular 50 m descent on Cala Biriola. The anchorage of the rappels is almost always made up on an old juniper tree and, for those used to super-equipped stops on cliffs or modern rock routes, this can give a strange sensation. However, you quickly get used to trusting juniper, a very solid and resistant wood, used by shepherds to build ancient sheepfolds, and often adopted along exposed paths to create narrow but trustworthy walkways. The living saplings clinging to the rock are evidently so solid that for years they have supported the weight of ever more numerous hikers.

As for the difficulties of progression, they consist of short stretches of generally easy climbing, with some 4th degree passages, and traverses on limestone rock or on slippery and exposed terrain.

Given the size of our group and the rather uncertain mountaineering skills of some participants, the organizers and our guide preferred to equip the challenging sections with fixed ropes, allowing everyone to progress quickly and safely. A single via ferrata of about 100 m in length north of Cala Goloritzé, first transversely exposed and then vertically on the edge, has excited us more than usual for the beauty of the environment and total exposure to the void.

Meeting on diabetes. After the shorter stage, in Cala Biriola, while waiting for the dinghy, we were able to organize a group meeting on diabetes management, which was attended by doctors, diabetics and some companions. There has been an interesting exchange of views between those who prefer multiple insulin injections and those who prefer the insulin pump, and there has also been talk of continuous blood glucose monitoring with the most sophisticated means of the moment, whether or not equipped with alarm systems and possibility to automatically act on the pump. The origin of diabetics from various areas of the country then diverted the discussion towards the different ease of free access to the most sophisticated treatment and monitoring tools among some Italian regions, and unexpected information emerged.

Weather conditions. With the weather we were lucky (but not extremely lucky). In fact, the climate in early October in that area is ideal, cool enough to walk but warm enough in the early afternoon, once you arrive on the beaches, to enjoy wonderful sea baths. In our week it never rained and this made everything more pleasant (including the assembly and disassembly of the tents!). However, the perfect success of the program also depends on the sea, which must not be rough, to allow the dinghy to dock on the beaches in the evening and the following morning. For two days this did not happen, and the organizers were forced by the bad sea conditions to make us give up the beach and to opt for an overnight stay in a couple of camping sites, reachable with their off-road vehicle by land. However, the organizers' ability and inventiveness have allowed us to fully respect the original program.

Conclusion. After the last arrival in Cala Mariolu we were taken with two inflatable boats to Santa Maria Navarrese, where our adventure ended at the restaurant with a big thank you to the companions Nicola, Sandro and Stefano, and to the organizers of Explorando Supramonte: Claudio and Mario , as well as to the two Manuela.

Then overnight in B&B (at last!) and the next day back on the continent… With so many more memories and a little bit of heart less, left in the woods of Ogliastra.

The DAM group, in sea version (with Nicola)

Monte Rosa-2019 – 9th DAM meeting

Monte Rosa-2019 – 9th DAM meeting

11-14/7, 2019. This year's project included, at least for the more "ambitious" of the group, the ascent to Punta Dufour (4634 m), the highest peak of Mount Rosa and the second highest peak in the Alps. In reality, once on site, we realized that the time at our disposal was too short to guarantee a safe return and, although the weather conditions were excellent, we gave up the "enterprise" and limited ourselves to a ride on the numerous "4000" of the fascinating massif.

Twenty-one people attended this meeting, of which 8 with T-1 Diabetes, one with multiple sclerosis (Antonella Perna), one post mammary cancer, 2 diabetologists (AM and Gianfranco Poccia), one mountain guide (Piero Bosetti) and 6 experts mountaineers or CAI instructors (Giuseppe Astori, Giampaolo Casarotto, Marco Peruffo [with DT1], Paolo Seraglio, Stefano Gelain and Pietro Vincenzi [with DT1]) who acted as rope leaders, and finally four companions: Michela Fabris, Chiara Giorgi, Costanza Micarelli and Catia Montebello. The group was also joined by two fathers: Sandro Giorgi and Marco Vincenzi, as well as Alberto Frascari, a friend of Pietro's, who moved independently.

11 July. The appointment is at 10 in Staffal, a village of Gressoney-la-Trinité, to climb all together to Capanna Gnifetti (3647 m), where we will spend two nights trying to acclimatize ourselves at least in part. – Although we know that to sleep on the third night at Capanna Margherita (4554 m) is really too early for an effective prevention of altitude sickness. – For the morning gathering, the "Southerners" (those coming from central Italy) preferred to stay on the spot, so eight of us met together the day before in Gressoney-St-Jean, where we enjoyed the exquisite hospitality of the Hotel Lyshaus, which we believe deserves more than the three stars it possesses. The bulk of the "Northeners" arrives on time and stops by us for a coffee and for the distribution of some materials (in particular the ropes) to be carried up. Four of the "Northerners", on the other hand, having not freed themselves from their last commitments, will go up in the afternoon and join us at the Gnifetti hut in the evening. Arriving at the gondola, a group of "tough ones" eager to soften their ascensional speed (as well as to try themselves) decides to go on foot for part of the climb, keeping tight – it goes without saying – their heavy backpacks. So, after a group photo, we say goodbye to Alberto, Federico, Luca, Luigi, Marco, Michela and Paolo, whom we will see again at the refuge in the afternoon.  (Photo "Arrival at Capanna Gnifetti": A. Fiorentini).

 

12 July. The program designed by Marco  – the usual creative mind of the group –includes Punta Giordani (4026 m) and the Piramide Vincent (4215 m) by two itineraries. A group of more experienced /trained faces the SE ridge of Punta Giordani, called Cresta del Soldato divided into five rope parties: 1) Paolo Seraglio + Rosa and Michela; 2) Giampaolo Casarotto + Gianfranco; 3) Giuseppe Astori + Costanza; 4) Alberto Frasari (replacing Pietro Vincenzi) + Luca; 5) Stefano Gelain + Martina. All participants reach the summit around 12:30, partly overcoming, partly bypassing the greater technical difficulty constituted by a plaque with 4th grade passages. There are no problems of any kind, except the actinic conjunctivitis of a participant, which will continue to afflict her in the following days. (Photo "Cresta del soldato": G. Astori).

 

The other group, less eager to climb, ascends to Punta Giordani by the normal route and then reaches the PiramideVincent by a snowy ditch along the S face, divided into two roped parties: 1) Marco Peruffo + AM, Catia, Federico and Luigi; 2) Piero Bosetti + Antonella, Edoardo and Alberto. A participant with diabetes has difficulty managing his blood glucose levels throughout the day: after starting very high, he ends up in hypoglycemia during the descent, with a slight state of mental confusion which slows him down in conception and movements, but he succeeds to manage and arrives in good shape at the refuge. It is not necessary to inject glucagon (which two out of three diabetics in the group have with them). Another participant with diabetes breaks his continuous blood glucose meter stepping on it with a crampon and, not having a spare, will be forced from then on to rely on individual capillary blood glucose measurements. (Photo "Piramide Vincent, South ditch":A. Fiorentini).

 

Pietro stays with Chiara, who has been complaining of slight malaise, perhaps prodromes of an acute mountain sickness, since the previous evening, and calmly reach the Piramide Vincent by the normal route, together with their respective fathers.

In the afternoon we take advantage of the tranquility of the empty dining room to carry out an hour-long educational meeting during which we analyze the critical points in the management of diabetes that emerged during the day, and I reread some relevant passages from my recent review published in "Il Diabete" .

13 July. Today’s program previews the climb to Punta Gnifetti (4554 m) and the transfer to Capanna Margherita, which is located on the summit: the highest refuge in Europe. The tough Rosa, who suffers from headache since yesterday, decides to stay at the refuge and to go back down as soon as possible. The other participants, divided into seven roped parties of 3-4 components each, start along the normal route, that leads towards the summit through the Lys glacier and the Lys pass (4248 m). The weather is clear but cold and windy, with gusts from NE around 50 Km/h. A single rope party, led by Marco Peruffo, with Alberto and Michela, makes an important detour: once they reach the Lys pass, they turn eastwards and, leaving the backpacks at Piode Col(4285), they climb along the N ridge of Ludwigshöhe (4342 m); then they descend along the S ridge to the Zurbriggen pass (4272), they traverse towards SW and climb to the Corno Nero (4322 m) by the W wall, then descending from it. Then they go back down to Piode col, take back their rucksacks and climb up Punta Parrot (4438 m) by the W ridge, then descend along the N ridge to Sesia col (4299 m), and from there take the normal route up to Capanna Margherita.  (Photo "SW face of Ludwigshöhe from Corno Nero": M. Peruffo).

 

Almost all the others arrive at the refuge within 4h - 4h30 from the departure. Only the rope party led by Piero Bosetti, with Federico and Gianfranco Poccia, is lacking. At around 14, more than 7 hours after departure, we start to worry, also because the precariousness of telephone connections does not allow us to communicate. At long last Piero and Gianfranco arrive and explain to us that they have had to climb almost twice. In fact, Federico, who had not been well yesterday, suffered increasing problems after their departure, until when, having reached the Lys pass, they realized that he could not continue and they accompanied him back to the refuge, and then restarted their climb. Calling between the two refuges, we learn that Federico is fine and that they have placed him in a bunk because the Capanna Gnifetti is full; tomorrow he will go downhill independently, and he will meet with Rosa.  (Photo "Capanna Margherita at Punta Gnifetti": AM).

 

The evening ends with a dramatic episode that fortunately does not concern our group. Shortly before sunset I am called to visit a young man who is very sick in his bunk; I also involve Gianfranco Poccia and together we agree that he has severe symptoms of acute mountain sickness and, although he does not yet show signs of pulmonary or cerebral edema, he immediately needs intravenous cortisone – which we practice – but above all he must be taken down by helicopter – which we can achieve by insisting a little on the phone with the doctor of the emergency service. The fact that the boy, a young and robust sportsman, did not even know the existence of altitude sickness, that the guides of the group had not hesitated to make him rise from an altitude of 3650 to an altitude of 4550 even though he already had a severe headache after the only night spent at Capanna Gnifetti, and that he was loaded on the helicopter being hooked alone to a winch with the weight of the backpack which made him turn upside down (with the strong headache he had!), made us reflect on the thoughtlessness by which even professionals are sometimes tainted for desire for profit.  (Photo "Sunset from Capanna Margherita": L. Avataneo).

 

14-July. Final day, for which we had planned Punta Dufour. However, despite good weather conditions (even if with a probable change in the evening – as it will indeed happen), considering the average speed of the participants, the experts of the group decide to limit our ambitions to Punta Zumstein (4563 m). (Photo "Punta Zumstein and Punta Gnifetti": AM).

Before leaving, acute mountain sickness strikes again, although in a less serious form than yesterday evening. Chiara, who had already suffered minor ailments in previous days, complains of headache, nausea and weakness of moderate intensity: just enough to induce us to inject her intravenous cortisone and recommend an immediate return downhill, which she will promptly do – accompanied by Pietro Vincenzi, Stefano Gelain, the two fathers and Alberto Frascari – soon regaining full well-being.

All the others reach Punta Zumsteinin about one hour, passing through Gnifetti Col (4454 m), and for the way back they separate into two groups. Three roped parties (Marco Peruffo with Antonella and Alberto; Piero Bosetti with Edoardo and Gianfranco; Giuseppe Astori with Michela and Catia) go down the normal route to Capanna Gnifetti.  (Photo "On top of Punta Zumstein with the photographer": AM)

 

Two other roped parties (Giampaolo Casarotto with AM and Luca; Paolo Seraglio with Martina, Costanza and Luigi) follow in part backwards the path traveled uphill yesterday by Marco & C. Indeed, once arrived at Sesia col (4299 m), we deviate to E and go up the N ridge of Punta Parrot (4438 m). Then we descend along its W and S ridge to Piode col (4285 m) and then climb the N ridge of Ludwigshöhe (4342 m), descend from its S ridge, traverse W of the Black Horn (to which we give up due to lack of time) ) and finally go up briefly on the Balmenhorn (4167 m) adorned with a large religious statue and equipped with the efficient and ancient Giordano bivouac. From here we easily reach the normal descent route that skirts from W the Piramide Vincent.  (Photo "On top of Punta Parrot": AM).

Having reachedCapanna Gnifetti, where we retrieve the materials we had left in storage, we continue towards the downhill facilities from Punta Indren(this time used by everyone) and, once at Staffal, we grant ourselves a well-deserved drink (not necessarily alcoholic) with payment of a bet relative to the reliability of the various weather forecast programs in the mountains... The “Northerners” then set off on their departure, while the “Southerners” return to the beloved Hotel Lyshaus, where they will enjoy the comforts of civilization and a good dinner at the Braciererestaurant , and from where tomorrow morning they will leave, in part directly to the south and in part to Cortina so as not to leave the mountains too abruptly.  (Photo "Short stop downhillat Capanna Gnifetti": AM).

 

The photographic story of the meeting, as well as some personal considerations and memories, can be downloaded below ↓

 

The DAM group at the end of the 9th meeting: Monte Rosa-2019.

Cima Grande di Lavaredo-2018 – 8th DAM meeting

Cima Grande di Lavaredo-2018 – 8th DAM meeting

19-22 /7, 2018. For the first time, the DAM group project envisaged two days of rock climbing, followed by the usual ascent in high altitude, this year to the Ortler summit (m 3905) along the west ridge by the classic ”Meranesi route". The uncertain weather conditions, however, allowed us to realize only the first half of the program.

19 July. Ascension to the Cima Grande di Lavaredo (m 2999) by the "Normal" route on the south wall (GrohmannInnerkoflerSalcher: 1869).

It is a classic way of not very high technical difficulty, with steps of 3°/4°- degree, but discretely demanding for the length, exposure and complexity of the track. We have faced up to it in 9 (4 of whom with T-1 diabetes) divided into four four roped parties: Marco Peruffo, from Vicenza, the project's creator, led the team of three, with Paola Maldonato and her father AM; Giuseppe Astori, from Vicenza, led the rope with Luigi Montanaro; Pietro Vincenzi, also from Vicenza, linked another person with diabetes to him; Piero Bosetti, guide from Cortina, led Costanza Micarelli. (A curiosity: casually two ropes were driven by people with diabets and two were not: one roped party consisted of only diabetics and one only of non-diabetics, while two were mixed, according to a scheme that in fact exploited all possible combinations: DNN, ND, DD, NN).

To avoid the crowds, we left the Auronzo refuge at 5:30, and we were on top at 10:00. A time not to recordo, but of complete satisfaction for a large group including also some muntain climbing beginners. The descent. carried out with numerous desents on a single rope and rappels, took place partly by an alternative route, more to the west than normal, which however probably did not save us much time. At 2:30 pm, nine hours after departure, we were returning to the refuge, satisfied with this new realization of the DAM group.

Group members who did not feel ready for rock climbing, ascended Mount Paterno (2746 m), adjacent to the Tre Cime and famous for many historical events related to the First World War. The strong mountaineer from Vicenza, Giampaolo Casarotto, kindly accepted MP's request to accompany them to the summit on the "normal" via ferrata, and so Catia Montebello, Martina Maddalena and Nicola De Marco were able to appreciate the ascent to this historic peak, also favored by a splendid weather.

20 July. Ascent to the Cima Brentoni West (m 2584). The program planned by MP was to climb the southern edge, with difficulty similar to that of the day before, and then descend by the normal route, which had some steps of 1st and 2nd degree on rocks. The strong threat of storms has led us, however, to choose the normal route also for the ascent.

The participants were 11, including 6 with T-1 diabetes. Just before the summit the worsening of atmospheric conditions led us to go back. Only two fast participants: Pietro Vincenzi and Luigi Montanaro (both with diabetes) were allowed to continue, and afyter about half an hour they reached us along the rocks of the descent.Despite the black clouds and the many thunders all around, the weather has assisted us and only a few drops of rain have reached us before returning to the refuge.

Before leaving, after a quick meal at the Tenente Fabbro refuge, we exchanged impressions on self-management of diabetes. Luigi praised the advantages of the new FIASP rapid insulin, which - he said - is particularly useful with the pump. Everyone showed interest, but they agreed that it would be good to test it in normal life, before using it in the mountains. Almost all of them supported the great usefulness of continuous glucose monitoring, particularly with tools that give reliable results and forecasts on trends. As for each one's results, there were a couple of episodes of hyperglycaemia, which were corrected fairly quickly, and only one mild hypoglycemia, very well perceived at 75 mg/dl (4.2 mMand readily corrected.

M. Etna-2018 – 7th DAM meeting

M. Etna-2018 – 7th DAM meeting

1-4 /3 2018. Winter hiking with ski or snowshoes on Mount Etna (3300 m).

Participants: 10 mountaineers with T-1 diabetes (among them Marco Peruffo and Cecilia Marchi), one with MS (Antonella Perna), and 11 escorts, among whom 3 diabetologists (Valeria De Donno, Giampaolo Magro and AM).

After the first two days afflicted by bad weather, with strong wind accompanied on Saturday by snow mixed to rain, at long last Sunday 4th we could face with decent weather the climb to the central crater from the south side, starting from the upper station of the Sapienza refuge chairlift.

After about 900 m of ascent, all the participants reached the edge of the crater in a cold wind contaminated by unbearable sulphureous vapours that escaped from the fissures of the lava soil. Of the 22 participants, 14 (6 of whom with diabetes) used skis and seal skins to climb, and descended to the Sapienza ski lodge; 8 (4 of which with diabetes and one with MS) went up and down with crampons, since the snow was hard enough not to require the use of snowshoes.

The report of the winter climb on Mount Etnaa description (for lay people) of what it means today to live with the Type-1 Diabetes, and the vivid memories of some participants, are published on Planet Mountainalong with a photographic review by Maurizio Oviglia.

M. Elbrus-2017 – 6th DAM meeting

M. Elbrus-2017 – 6th DAM meeting

21-29 /7 2017. Ascent to M. Elbrus (5642 m) west summit, from the south side.

This year we aimed high: the roof of Europe, in the Caucasus chain. It is a long but not demanding climb, which attracts many climbers from all over the world, also because it is part of the so-called "Seven Summits", i.e. the highest peaks of each continent.

Group members: 11 mountaineers with T1 diabetes, one with MS (Antonelle Pernawho, on return, for the first time told her 10-year living with interferon and the mountains), and 6 companions including a diabetologist (AM), guide Piero Bosetti and a dentist (Costanza Micarelli). A total of 18 participants, 16 of whom reached the summit.

July 21st. After a long organization lasting for months, after somelast-minute adhesions and withdrawals, we finally meet at Bergamo airport, from where the low-cost glight of Pegasus will depart, and, after a long stopover in Istanbul, will take us to Mineralnye Vody. The fear of an error in baggage handling, which could compromise our ascension, has led us to wear the essentials, including high-altitude boots: which makes us look rather strange in this torrid July.

Having left at 14, we land at one o'clock in the Russian territory and we are loaded on two buses that in three hours lead us to Terskol (2100 m), location at the base of the Elbrus volcanic complex, where at 5 am we arrive exhausted in the friendly Hotel Alamat, logistic base of our company: the Mountain Guide. A few hours of sleep, and at 11 am a rich breakfast. Then in the afternoon we starton a first excursion of about 600 m in height, in front of the rocky ridge surrounded by glaciers that separates our Russian region, Kabardino-Balkaria, from Georgia.

very famous Russian guide welcomed us at the airport and will stay with us until the departure: 79-year-old Nickolay Cherniy, with an impressive track record, which includes Everest twice, many other "8000" and many "7000": with us he will climb Elbrus for the 77th time!

The next day another acclimatization excursion is planned, to the Maid's Braid waterfalls and to an observatory at an altitude of 3200 m. The day is rainy and the departure takes place between numerous moans. But then the minds (and the weather) become serene. Towards the middle, the path is dominated by particular very interesting lava formations that Gianni, the geologist of the group, shows us with wisdom and passion. The waterfall called ”Maids Braid" enchants us with its loveliness. Finally, downhill, a curious encounter: a shepherd who accompanies a large flock of sheep explains in good Italian that he is married to an Italian girl and lives usually in Milan; but in summers he comes back there, where he was born, to let the flock graze.

Finally, on the 24th we go up to the Garabashi refuge (3780 m) served by old lifts: a cableway in two sections and then a chair lift. In fact, more than a refuge, it is a group of metal containers equipped with bunk beds, and a common room used as a cafeteria. What strikes us is that all the food and water anticipated for our stay (3 or 4 days) is brought up by us, first on the van that accompaniesus to the base of the cableway (2350 m) and then on the lifts . Also the pretty cook, who will prepare and serve three meals a day, comes up with us. Four “tough ones" of the group, after helping to transport the materials, go up on foot, while two others disdain only the chairlift, climbing the last 280 m on foot.

In the afternoon a glacier ascension is planned up to a height of 4500 m, while for the next day, the eve of the ascent to the summit: rest. So after lunch we climb in single line with a slow and regular pace, on the now soft snow, until at about 4200 m a strong thunder causes us to desist.

July 25th. The day of rest is used in various ways by the participants. Antonella and Costanza, who have old leather boots that yesterday were soaked, take the opportunity to quickly return to the Alamat Hotel, which is equipped with a stocked warehouse for the rental of any high-altitude materials, where they will find beautiful Scarpa plastic boots, which despite the justified fears, in the end will be perfect. I accompany them, determined to take advantage of the day off, and I take the opportunity to clean up a bit and recover my Crocs. Most of the others go up along the glacier up to 4500 m, and only a small minority really rests, considering that even Antonella and Costanza, to try on the boots, climb up below the last chair lift.

Meanwhile, at lunch time, five of us decide that, for the ascent to the summit, they will take advantage of the snowmobile up to 4600 m, while the others will walk up from the refuge.

July 26th, ascent to the summit. The weather was inclement for two days, but today, as expected, the day is announced beautiful, with a slight wind from NE. For those who have decided to leave on foot the alarm is at one o'clock and the departure at 2. For the five who have opted for the snowmobile,the departure will be at 3:30.

Every hour /hour-and-a-half people with diabetes check their blood sugar, and those who have a continuous meter verify their reliability. Around 4:00 we are fascinated by the dawn and then by the first sun light around us.

The ascent proceeds regularly with the group divided into three sections, each accompanied by a guide. With altitude, however, acute mountain sickness begins to be felt, limited for some people to a little headache, but for two participants the symptoms are more pronounced and recommend a rapid descent: one participant gives up at around 4800 m; another at an altitude of 5300 m, less than 2 hours from the summit.

The good weather also assists us during the 1900 m gradient downhill, during which a couple of participants gave in to the temptation of a ”lift" on snowmobile, starting from the usual altitude of 4600 m.

Return: time for celebration and balance. Returning to the base we expect a dinner in joy, during which Nickolay delivers the summit diplomas.

But first, in the afternoon, we meet to reflect together on our experience. From the mountaineering point of view, the importance of acclimatization at high altitude was evident: the greatest problems were incurred by those who could not climb at least once around 4000 m in the period before the expedition. However, the climb was free of technical difficulties and good weather has helped us once again. From the diabetes point of view, the importance of good control and careful check of blood sugar levels was confirmed: an episode of quite severe hypoglycemia, with a slight state of confusion, was brilliantly overcome and the patient was able to reach the summit, recognizing retrospectively the errors made.

Participants were invited to write: "One thing I learned/confirmed about the treatment of (my) diabetes".   Below are their writings, as well as the photographic story of the meeting. ⇓

M. Cevedale-2016 – 5th D.A.M. meeting

M. Cevedale-2016 – 5th D.A.M. meeting

>15-17 /7 2016, Ortles-Cevedale Group: crossing of the southern peaks.

The enthusiasm of Marco Peruffo has led him to propose two meetings this year. (The first, which took place in Abruzzo with a base in Avezzano around May 1st, was not blessed by good weather and was resolved in three pleasant walks: in the National Park, the Stiffe caves near L'Aquila, and the Gran Sasso. )

The more challenging July proposal included the crossing of the 13 peaks south of Mount Cevedale, a high-altitude route classified as AD-.

Participants: 9 mountaineers with T1 diabetes and 7 companions, including 1 doctor (AM), the guide Piero Bosetti and the two well-known mountaineers Maurizio Oviglia and Giuseppe Astori. Among the "new entries" with type-1 diabetes, Cecilia Marchi - gynecologist in Cagliari, strong rock climber and wife of Maurizio Oviglia - has told on Planet Mountain about this new experience of hers.

The start was from the parking of the Forni refuge (m 2178), to which two brave pure climbers wished to climb on foot, traveling with their heavy backpacks about 5 km of road from S. CaterinaValfurva. Instead, three less pure and cautious ones (including AM) took advantage of the transport by car to the Pizzini refuge (2700 m), from which they also continued on foot. In any case, all 16 participants met at the Casati refuge (m 3254), where they shared two spartan bedrooms.

The following day, divided into four rope parties of 3 and one of 4, in a continuous ups and downs mostly on mixed terrain, we reached and crossed the peaks of Mount Cevedale (m 3769), of Cima Cevedale (m 3757 ) (only two rope parties of 3), Mount Rosole (m 3529)Palon de la Mare (m 3685) and Mount Vioz (m 3645), to reach after 9 hours the Mantova refuge (m 3535), which was thankfully much more comfortable than the previous one. Some participants, perhaps not yet properly trained, have felt fatigue for a stage that was harder than expected: two in particular did not feel like facing a second day of ups and downs perhaps even harder than the previous one, and the following morning they preferred to return to the valley autonomously for the shortest route.

On the third day, start at dawn and, after going back up to Mount Vioz, we crossed the Cima Linke (m 3631), from which we descended “on the rope" to the Vioz hill (m 3330), then to cross Punta Taviela (m 3612) and Cima di Pejo (m 3549). On the latter we put an end to our ride and, with a long descent through the Forni glacier, we reached the Branca refuge (m 2478) and from there, along the cartroad (six of us using the car service!), the starting point at 2178 m.

The mountaineering outcome, even if we did not reach all the 13 Peaks, was quite respectable for such a large group. From the diabetes point of view, such an intense and prolonged activity at high altitude has been a continuous challenge even for the most experienced, who have been guides and examples for the "new entries". The hypoglycemia episodes were more or less one for each participant, always well perceived and promptly treated. There was never a need to use the glucagon vials we had with us.

Bishorn-2015 – 4th D.A.M. meeting

Bishorn-2015 – 4th D.A.M. meeting

>23-30 /8 2015. DAM meetings are now a consolidated tradition and from this year we also have a logo that illustrates the initiative, linking diabetes and high mountain with a knot of love.

Let us immediately say that our project was the Weisshorn (4505 m) by its north ridge, which is long and challenging... perhaps too much for many of us, who did not at all despair learning that the mountain this year was absolutely unfeasible.

The mountaineering outcome has therefore consisted of the Blanc de Moming ridge (3750 m) and the Trifthorn (3728 m), reached respectively on August 24th and 25th  from the Cabane de Mountet (2886 m); on the 27th we climbed to the Cabane de Tracuit (3256 m) and on the 28th most of the group climbed the Crete de Milon with 4th and 5th grade passages, up to the Tete de Milon (3693 m), with Piero Bosetti and other 4 guides come up for the occasion. Others, with Armand Salamin, have risen to the Bishorn (4153 m), an easy "4000" located at the base of the N ridge of the Weisshorn. On the 29th some went down to Zinal calmly, while some fast ones, with Marco Peruffo and Piero Bosetti, climbed to the Bishorn and reached the rest of the group in Zinal for lunch time.

This year having more time available, we could formalize the educational activity, in a series of meetings dedicated both to the comparison of different self-management tips in the difficult environment of the high mountains, and to self narrative using the autobiographical approach. Significant moments were two meetings with Jean-Philippe Assal, the European father of Therapeutic Education, and with his wife Tiziana, who explained to us two ways of education they have introduced in recent years: the theater of experience and the painting workshops.

Participants: 7 people with T-1 diabetes, 1 with MS, 1 companion and 2 diabetologists: AM and Gianfranco Poccia, as well as 2 guides always present: Piero Bosetti and Armand Salamin, and 5 other guides occasionally present: Andrea Basso, Carlo Cosi, Christian Hofmann, Ferruccio Svaluto Moreolo and Romain Tavelli. 

 The detailed description of the meeting and the impressions of the participants can be downloaded below ⇓

Dom-2014 - 3° D.A.M. meeting

Dom-2014 - 3° D.A.M. meeting

>4-6 /9/2014. After the success of the climb to Monte Bianco last year, the desire to continue to combine diabetes self-management education and high mountains brings us on the Dom (Valais, CH), 4545 m, the highest European mountain located entirely in one country. In addition to PieroBosetti, I involve a Swiss guide I have known for many years: Armand Salamin, and the appointment is at Randa, in the Zermatt valley, to climb to the Domhutte refuge (2940 m). Participants: 5 people with T-1 D, 1 with MS, 1 doctor and 2 escorts. On the morning of September 6th we start, divided into three rope parties: two of 3 and 4 people respectively led by the guides, and one of 3 people led by Marco Peruffo. One person with diabetes who could not train in the previous weeks remains at the refuge for an excursion.

 

The weather is nice and in the early hours we proceed at the light of the front lamps, stopping every hour - hour and a half for a quick check of the blood sugar. At dawn we are at the base of the steep NW ridge, theFestigrat, and after passing a couple of challenging steps, in almost 8 hours of ascent even the slowest reach the summit, and then descend via the normal route.

 

Here the pictures of the ascent to DOM can be seen.

Monte Bianco-2013 – 2nd Diabete e Alta Montagna (DAM) meeting

Monte Bianco-2013 – 2nd Diabete e Alta Montagna (DAM) meeting

>2-7 /9 2013. Second attempt to climb the M. Biancothe chosen route, called the Trois Monts Blancs, is the same that I "explored" with Piero Bosetti in 2011 and also the period is the same because the climate is usually more stable, and refuges and routes are less crowded. The photographic report of that ascension can be seen here.

This time we plan for all participants three preliminary training/acclimatization days on Monte Rosa. So, on September 2nd, we meet at Gressoney la Trinitét o ascend to the 3585 m of the Quintino Sella Refuge at Felik. The participants are 6 people with T1D (including 1 doctor), 1 with MS, 4 doctors: AM, Gianfranco Poccia, Claudio Molaioni (with T1D) and Gianfranco Rosati, as well as two guides: Piero Bosettiand Paolo Pieroni... In total 12 people, to whom 2 will be added (one with T1D and one non-diabetic escort) for the ascent to M. Bianco.

On September 3rd, departure at dawn for Mount Castore (4200 m). (I do not join due to a microfracture in a foot caused by a fall while rock climbing two weeks before, which will also prevent my ascent to M. Bianco)On September 4thcrossing of the Lyskamm Nose (4100 m) and descent to Morgex in the welcoming Valdigne Hotel . The participant with MS had a malaise related to an intestinal disorder and decided to retire, together with GR, one of the doctors who accompanied her. The total number of participants remains 11: 7 of whom with T1 diabetes and 4 companions.

September 5th: as the cableway from Chamonix is temporarily closed, we take the cableway from Courmayeur to the Torino Refuge (3329 m) and from there we cross the Vallée Blanche to the Refuge des Cosmiques (3613 m). In the evening we are joined by 3 other guides, as one guide can accompany a maximum of two clients on the Mon Blanc; so we meet Alessandro Bosio(*), Philippe Favre and Nicolas Meli.

* Alessandro will perish in a tragic fall in June 2017.

On September 6th at 2:00 the group leaves for the summit, divided into 4 rope parties of three and 1 of two. The weather is splendid and they will reach the 4810 m of the summit at the first light of dawn. Only one rope party stops at the Brenva pass (4303 m) due to the sickness of a person with diabetes, assisted and advised to desist by dr Poccia. Upon returning to the refuge, after the due rest, I ask participants to write down their impressions, which are reported here attached. The doctor with diabetes, Claudio Molaioniis so struck by this adventure that once back home he will decide to write a book: Il Racconto Bianco.

 

On the morning of September 7th, we climb to the Aiguille du Midi by its sharp north ridge, and the meeting ends with the cable car descent to Chamonix.

Below is the photographic story of the meeting ⇓

Gran Paradiso-2012 - 1st Diabete e Alta Montagna meeting

Gran Paradiso-2012 - 1st Diabete e Alta Montagna meeting

>10-14 /9 2012.  Seven years after the ascent in Pamir, we wanted to renew the message that people with diabetes fond of mountains, with normal strength and skills, can be very well, and even reach mountaineering and control outcomes that others may consider impossible. This time we decided to do so with the ascent to the summit of Mont Blanc by one of its "normal" routes. Participants: 9 people with T1D (including 1 doctor), 1 person with MS, 3 diabetologists (one of whom with T1D), with 2 mountain guides. Part of the members met a few days before on Gran Paradiso (m 4061) to train and acclimatize: 4 with T1D, 1 with MS, 3 diabetologists: AM, Gianfranco Poccia and Claudio Molaioni (with T1D), and the guide Piero Bosetti: altogether 8 people.

For a mistake, one of the aspirants with diabetes went alone to acclimatize to the Plan de l'Aiguille refuge (2207 m) on the French side of M. Bianco, planning to meet us at the moment of climbing to the Aiguille du Midi... but, seen how things went, the group will only meet him next year.

In fact, after the three days spent at the Vittorio Emanuele Refuge in Valsavaranche, at the time of moving to M. Bianco we had to give up because of impossible weather conditions.

The two ascents carried out: the summit of Gran Paradiso (4061 m) and Tresenta (3609 m), and the sharing of experiences in diabetes management have nevertheless laid the foundations for continuing this high altitude educational experience. On this occasion, two participants passed 4000 m for the first time.

 

Below are the pictures of the excursions on Gran Paradiso

ISLET-2005 (Internat. Snow-Leopard Expedition T1)

ISLET-2005 (Internat. Snow-Leopard Expedition T1)

16/7 14/8, 2005Pamir, Kyrgyzstan. International expedition open to the participation of mountaineers with type-1 diabetes from all over the world. The mountaineering goal was the summit of Pik Lenin, 7134 m. (The term Snow Leopard refers to the 5 main 7000 m peaks of the Alai-Pamir region).

Participants: 9 mountaineers with T1 diabetes from three countries, 5 supportive non-diabetic mountaineers, 8 doctors (6 Italian diabetologists4 of whom aiming at the summit, and 2 Spanish "expedition" doctors), 1 educator and 1 cameraman mountaineer.

The expedition was organized by ADIQ (Alpinisti Diabetici in Quota, President M. Peruffo and by ANIAD (Associazione Nazionale Italiana Atleti DiabeticiPresident Dr. G. Corigliano), with the support of ComET.

The climbing result is visible on the picture. Eight people reached the 7134 m of the summit: 3 with diabetes, 4 support mountaineers and the cameraman. Five people (3 with T1D and 2 doctors) passed camp 3, reaching altitudes between 6450 and 6800 m. Five people (1 with diabetes, 2 doctors and 2 support mountaineers) reached the 6148 m of the relief called Razdelnaya (just before camp 3).

Almost all the participants, returning from high camps, climbed MPetrovskogo (4830 m) on different days, starting from the 3600 m of the base camp.

As already happened in 2002 in Tanzania, drugs, diagnostic devices and funds were donated to the Kyrgyzstan diabetic association.

Below you can download: 1) some pictures of the expedition; 2) the story by Giannermete Romani; 3) the on-the-spot comments of the Italian participants.

Diabetici Italiani sul Kilimanjaro (DIsK)

Diabetici Italiani sul Kilimanjaro (DIsK)

>7-17/1 2002. Expedition organized by ADiQ (Alpinisti Diabetici in Quota), led by Marco Peruffo. Participants: 11 people with type-1 diabetes, 5 doctors, 1 husband. 

 

The detailed description of the enterprise can be downloaded here (as well as a short report by M. Peruffo of his subsequent ascent to M. Kenya)  ⇓