Tips for traveling to Japan with diabetes

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“Fly into the rising sun
Faces smiling everyone”
—Deep Purple

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!

orange-bridge-and-water-sumiyoshi-taisha-shrine-osaka

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.

Chinese food in Japan: the rice is only half the carbs here.

Chinese food in Japan: the rice is only half the carbs here.

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.)

whole-octopus-for-sale-akashi-japan

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.

55.6 grams of carbs (炭水化物) in this package.

55.9 grams of carbs (炭水化物) in this package, which is 80 grams total.

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.

7 grams in this tomato juice

7 grams of saccharides (糖質) a.k.a. carbohydrates in 180 ml of this tomato juice.

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.)

shrimp-on-chopsticks-japan

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).

BG check at a snowy temple in Japan.

BG check at a snowy temple in Japan.

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.

jizo-statues-japanese-shrine

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.

tateyama-lodge-green-hills-japan

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.

Tying prayers to trees on New Year's Day.

Tying prayers to trees on New Year’s Day.

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.)

himeji-castle-blue-sky-japan

But if trying simple English words or showing off your insulin or blood sugar meter doesn’t work, try these phrases:

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.

people-top-of-tottori-sand-dune-sun-japan

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.

bgnow-94-rakugo-theater-tourist-face-figure-osaka

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.

bgnow-79-ikune-shrine-osaka

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.

japanese-humalog-lantus-pens-onetouch-strips

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.

shrine-bridge-snow-pond-yumura-osaka

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.

Billiken peers out onto the pedestrians from a building near Tsūtenkaku.

Billiken peers out onto the pedestrians from a building near Tsūtenkaku.

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.”

About the author

Jeremy has traveled to over 40 countries, taken several road trips across the United States (and Canada), and lived on and off in Japan for several years. He was diagnosed with Type 1 diabetes in 1982 but doesn't let a little thing like that stop him from exploring the world.

Jeremy writes about his travels with diabetes on 70-130.com as a way of logging his excursions and of inspiring others who might be feeling hesitant to take their own big bite out of life.

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9 comments
Tips for traveling to Japan with diabetes

  1. Thank you so much for these tips, Jeremy! I am also a T1D since 5 years old and haven’t yet had a problem traveling with diabetes! Am heading to Japan next summer with my 2 kids and hubby and was looking for any tips regarding getting into Japan with all my supplies. (Most countries never even ask for a doc note but there’s always a first!)
    I appreciate the info you’ve provided! Keep up the epic work!

    • Andrea,

      Thanks and you’re welcome!

      Getting into Japan with diabetes supplies shouldn’t be an issue at all. If you are traveling with just a few weeks’ worth of supplies I can’t imagine anyone will care. You could bring a note from a doctor in English explaining that you’re diabetic and need X and Y supplies. Diabetes is well-known here, certainly to airport staff. I’ve come and gone countless times with months’ worth of insulin pens, etc and nobody ever cares.

      Where are you visiting in Japan? I think you’ll have an excellent time!

  2. Pingback: Laundry service plus vomit: The tale of Hefei » Hefei Connect

  3. Hey Jeremy,

    My name is Benjamin I’m form Germany and I want to do a “Working Holidy” in Japan. I have T1D for over 25 years. The reason why I ask you about Japan is just simple. I looked through a lot of formus, but there wasn’t saddly any satisfying answer and so I landed here. So here are my questions. What do I definitly need to do to get my medical supply there for a year? Do I have to sign the health insurance in Japan and does it cover the meds for some %? Is it expensive, I pay here about 20$ for one pack Lantus and Actrapid. The rest covers my insurance here.

    • Hi Benjamin,

      The Japanese health system is very good. I *believe* this is true but I don’t know everything about it:

      You don’t need health insurance to get your supplies. But you do need a prescription, so you have to visit a doctor each time. Doctor visits are cheap even without insurance.

      Insulin/medicine is available here and would cost about the same as Germany. But if you have Japanese insurance you only pay 30%. Usually worth it for diabetics I think. Certainly for BG strips if you use those!

      The cost of insurance I’m not sure about. It’s based on your previous year’s salary (and maybe other things, I don’t remember). If you’re new in Japan I don’t know how they calculate it. It would probably be much cheaper to sign up for it anyway.

      My first 3-4 years in Japan were without insurance. I just paid full price for everything but I could get everything I needed. That was 10 years ago though. I don’t know if it’s the same but I think so.

      Hope this helps! Do you know where in Japan you’re going?

  4. Sorry for the late reply.
    Yes it helped me, thank you so much.

    It’s not decided where I’m going but I probably start at first in Tokyo. Kyoto would be nice too especially for sightseeing. But not sure, maybe I end up somewhere else.

    Do you have some must see places in Japan?

    • Kyoto, definitely. The Peace Park and museum in Hiroshima is a must-see. The rural areas, especially around Gifu but anywhere really, are nice if you can find a traditional Japanese inn (ryokan) to stay in. They often have hot springs, free use of yukata (kind of pajama robes) to wear around the place, and a large dinner/breakfast. Very relaxing and very Japanese!

  5. Hi Jeremy,
    We are traveling to Japan next week for the second time as a family and me and my son are both type 1. We bring all supplies needed for the trip but our main problem is/was that we didn’t know how where to get our containers emptied or get new ones. We tried at a clinic but they didn’t understand. I did not see any answers on the net. Do you have tips for us? Thank you so much!
    Greeting from the Netherlands

    • Nathalie,

      Different locales have different guidelines; often you can take things to where you bought them.

      As tourists I believe you could take your stuff to a pharmacy. If you can’t get your point across, try the word “gomi” which means trash. Smile and be friendly, it seems to help communication somehow. Also note that there may be only certain pharmacies that can do this, but any of them should be able to at least point you in the right direction.

      Have fun on your trip! Where are you going in Japan?

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