“Fly into the rising sun
Faces smiling everyone”
Japan is a super-modern country, and it has the facilities and infrastructure to accommodate any diabetic who wants to go there. Visiting Japan with diabetes is simple if you follow some simple tips.
The most important thing to remember when traveling to Japan, or anywhere else, with diabetes is that nothing bad will happen to you. If you’re reasonably prepared (which is easy) then you have nothing to worry about. Ignore your fears, take the leap, and go where you want!
Food in Japan
Yes, rice and noodles are everywhere in Japan. The rice is mostly sticky white rice, while there are many types of noodles available. Most diabetics can eat these types of food; it just takes enough insulin to handle it. (Duh.)
How much insulin you need for the average bowl of rice in Japan depends on your diabetes regime and your own body. If you aren’t used to eating rice it may be tough to choose the right dose at first, but when you’re in Japan if you keep trying, then checking afterwards, you’ll quickly learn what to do.
Note that while rice is historically revered in Japan, it’s also a dirt-cheap and obvious side or “base” to many meals. Even locals will often skip most or even all of the rice that is served to them. Don’t feel bad if you don’t eat it all, even if you leave most of it. Nobody will think bad about you or say anything.
As for noodles, some popular types are soba, which is made from buckwheat, and udon, made from flour. They have different textures, can both be served hot or cold, and contain about the same amount of carbs. (The average serving size in restaurants depends on the meal – some noodle dishes are mostly noodles, while in others like tempura there will be less noodles and more of the main part.)
Food in Japan tends to be uniform, so once you’ve worked out how much insulin you need for, say, soba noodles at one place, it will be the same everywhere.
There are also many international restaurants all over Japan – Chinese, Italian, and Korean places are especially ubiquitous. Japan puts their own spin on these places, as do most countries, and are well worth trying. Fried Chinese dishes, as well as Italian pasta, will tend to be quite high in carbs. Korean food is often centered around piles of grilled meat and, while ultra-filling, may have relatively few carbs.
Beware of sauces, no matter what type of food you’re eating in Japan: it’s often higher in carbs than it seems.
As far as store-bought food in Japan, there are supermarkets and shops everywhere. Nearly every train station has at least one, and the same items tend to be found in all of them. Always buy low blood sugar snacks when you can, just in case, and carry them around with you. Juices and cookies are sold everywhere and are easy to identify.
Vending machines are on virtually every block of every town in Japan, but these are usually drinks only. They can be useful for low blood sugar situations but only if you know which drinks have carbs – many are teas and coffees that won’t help. Most packaged items and drink bottles in Japan have nutrition info on them but you won’t be able to see these in drink machines. Note that many drinks give their nutrition info per 100 grams of product; there are often 280 grams or so in small drink bottles so you’d have to multiply the carbs by 2.8 for the whole bottle. (Coca-Cola is common too, if you’re into that.)
Trains in Japan don’t have any food services or drink machines, except for the bullet trains (shinkansen) which do. Drink machines can be found at the end of some cars, and someone will wheel a trolley through periodically with snacks and drinks on them.
The key to successful travel to Japan with diabetes is to check your blood sugar often, particularly when eating something new. You may be surprised by lows and especially highs, but if you learn the rhythms you’ll get the hang of it by getting more data (checking).
Pharmacies and doctors in Japan
Pharmacies are very easy to find in Japan, and will occasionally have English-speaking staff but often not. Doctor’s clinics too are common. To buy most diabetes-related stuff (insulin and test strips, for example) you need to see a doctor first. You can do so without Japanese insurance; you’ll pay full price but it should be pretty cheap.
If they give you a prescription just take it to the nearest pharmacy (there is usually one nearby) and they’ll fill it for you. Prices for medicine aren’t any cheaper, so be prepared for the bill. Sometimes they’ll have what you need in stock, and sometimes will need to order it. Most things can be acquired within a day, possibly two, so give yourself time.
Negotiating all this without English can be tricky: Japanese businesses don’t assume anything about you and will wait to understand exactly what you need. It might be best to ask if they speak some English or take a Japanese speaker with you. Once everything is understood, you’ll get what you need.
But the easiest way to avoid all this is to just bring what you need with you. The best way to handle this is to figure out how much insulin, test strips, pills, etc you’ll need for your time in Japan, and then double it, splitting up your supply in separate bags. Keep some in your hotel or guesthouse room, and carry plenty with you in a day pack. Authorities are knowledgable about diabetes; you can bring an English note from a doctor explaining that you are diabetic and you need these things, if you wish.
But wherever you get your stuff, don’t go outside without it! You should get in the habit of always having everything with you in Japan.
How to speak Japanese – for T1Ds
If you need to speak to someone about diabetes stuff in Japan, you may well get lucky with a little English. Medical professionals will have heard some English, even if they say they don’t. (“I don’t speak English” often means “I don’t understand and speak English perfectly” in Japan, but it doesn’t mean they’re totally clueless.)
But if trying simple English words or showing off your insulin or blood sugar meter doesn’t work, try these phrases:
- diabetes – 糖尿病 (“tone yobe yo”)
- insulin – インスリン (“een su reen”)
- blood sugar – 血糖値 (“ket toe chi”)
In addition to these phrases – and your smiling and patience and helpful gestures – you may want to wear a piece of medical alert jewelry that mentions your diabetes. It is extremely unlikely that anything bad will happen to you in Japan (or anywhere else) when traveling with diabetes, but it can be good peace of mind and a nice backup just in case.
Story: My T1D in Japan
I’ve had Type 1 diabetes since I was 9, and I moved to Japan when I was 30 to teach English. I’ve been here off and on ever since, and over the years I’ve never had anything serious happen to me or my diabetes stuff here.
In my first couple of years here, I was not in the national Japanese health insurance system. I would just go to a tiny local clinic in my neighborhood; the doctor spoke no English but on my first visit looked up words in a Japanese-English dictionary he happened to have.
Once he had worked out what I needed – not a consultation, just a prescription for Humalog and Lantus and OneTouch strips – he wrote out the prescription. I took it to a nearby pharmacy, also very tiny, and they ordered it all. I picked it up in a few days.
After that I’d stop by the doctor again every couple of months and refill everything. Without insurance the “consultations” were about $20 and the supplies were the same price as they’d have been in the U.S.
Finally I got on the national health plan. It has greatly simplified everything and made it overall a little cheaper.
As for food, high blood sugars are part of the deal sometimes when eating in Japan, especially when eating new things you’re unfamiliar with. The good news is that junk food here – cookies, doughnuts, potato chips – are generally less heavy and smaller than overseas. They can wreak a lot less havoc on blood sugars; you can indulge in sweets and pass through with no ill effects on your diabetes whatsoever if you dose right.
Restaurants won’t be particularly accommodating for you – they serve what they serve, and that’s that – but with some experience and some insight into the food you can figure it all out fairly quickly. Try not eating the entire dish until you figure out how your blood sugar does with a smaller portion.
After several years in Japan with diabetes I have found that if you’re diligent, blood sugar can be controlled well even in the face of the often heavy carbs. Have the right attitude – check and adjust – and enjoy Japan!
Traveling in Japan often includes a lot of exercise: train stations have escalators but stairs are sometimes easier (less crowded), and there can be long hikes to your bus or your hotel if you don’t feel like taking a taxi.
Japan is a mobile society, and people don’t mind walking. Public transportation is excellent, but doesn’t remove all the effort; you’ll still be grunting up and down stairs and strolling long distances at some temples and parks, though (slow) elevators are increasingly popular. Factor this into your meals, check often while you’re out, and remember always keep that low blood sugar food on you at all times.
Your trip to Japan
If you have visited Japan I’d like to hear your experiences, whether or not you have diabetes yourself. How were the food and the tourist sites? How did you communicate with people?
If you are thinking of visiting Japan and have any questions, let me know that too. It’s a nice and modern and friendly country, and everything you need is available pretty much everywhere. Remember:
You can go anywhere with diabetes!
Share your travel stories, give advice, or ask a question in the comments section.
Next page: Tips for traveling to China with diabetes
“Tips for traveling to China with diabetes. Travel safely and smoothly with these tips on insulin, blood sugar, food, and supplies in this vast country.”