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A few years ago my husband and I spent a sybaritic week in Italy before and after ten days on an Italian cruise ship on which we were two of the thirteen English speaking passengers and the only two from the United States. To say that our cruise in the Western Mediterranean was a mind-opening experience is an understatement, but it is the several days of driving around the Italian countryside in a Fiat that even today brings back a smile and "do you remember that trattoria in Stresa?"
As a person with type 2 diabetes who was not taking insulin, my preplanning with my physician consisted of a quick health checkup before departure, a copy of my medical prescriptions and a diagnosis from my physician, along with an extra supply of my diabetes pills, blood glucose monitoring kit with extra test strips and lancets tucked safely away in my carry-on bag. Had I been on insulin, I would have added an extra vial of each type of insulin, syringes, and a storage case to protect insulin from temperature extremes, both hot and cold. I would have also discussed with my doctor any changes I should make in my injection schedule during my long airplane flights, technique to use in drawing the insulin while on the plane, etc. Also in my carry-on case were plenty of carbo snacks, a roll of Lifesavers, and my glucose tablets to have in case of flight delays, delayed meals, or low blood sugar reactions. I personally did not have need of anti-motion medication, but I did carry a supply of anti-nausea and anti-diarrhea medicine -- just in case. I also carried identification that indicated that I have diabetes which included my doctor's name and telephone number.
About a week before our initial flight, I called the airline to order a heart-healthy meal (if you ask for a diabetic meal, it often is only fruit and crackers. Since our flight left New York City at 7:30 p.m. I had a light snack before departing for the airport and ate lightly when the dinner was served around 9:30 p.m. A breakfast of juice, roll, fruit, and cheese was served a hour before we landed in Milan. I left the juice, but nibbled on the fruit and cheese and ate the roll. That would tide me over until lunch somewhere between Milan and Genoa, 6 hours away.
After picking up our car at the Milan airport, we began our education in driving in the Italian countryside. We had plenty of maps, and back at home it had all seemed so easy -- one just drives from point A (the airport) to point B (the hotel next to the railroad station in Genoa). Even the tiniest village is clearly marked and the maps are like works of art.
In actuality, the Italian countryside can daunt the most competent of map makers. A town may not have the same name as on the map, it may actually have several names, or the road has been moved to not even go through that town anymore. And all this time, the native drivers are whizzing around your car at speeds that defy the condition of the road.
But one only has to look at the scenery passing our eyes to know that we're traveling in a corner of paradise and as my husband says, 'If we've survived the freeways of Los Angeles and the taxi drivers of Manhattan and Boston, these country drivers are a 'piece of cake'."
As we head south through the Lombardy region we are impressed with the diversity of agriculture. Rice is a major crop and rice paddies abound as far as the eye can see -- rice for risotto, the traditional dish of Lombardy. Interspersed are farms raising ducks and geese and large dairy farms which produce the milk for the many cheese for which Lombardy is famous -- Gorgonzola, Taleggio, Robiola, Bitto, and Bel Paese. The rows of almond trees are heavily laden, ready for harvest.
When our route brings us to a hilly region covered with vineyards, we suspect we are in the eastern region of Piedmont, an area known for its powerhouse reds and delightful whites. A quick stop for coffee brings us to a delightful trattoria built by the side of the road in a former stable. Once inside we decided that we would partake of the wonderful aromas emanating from the kitchens, and ordered an antipasti which could have been up to a baker's dozen dishes. But we were lucky when the owner/host brought five little dishes which included a small portion of veal tonnato, a regional dish. There were also two small slices of a thin frittata made with fennel, leek, and spinach; a salad of shredded carrots with thin slices of local goat cheese and fresh basil; tiny white onions stuffed with a savory blend of bread crumbs, Parmesan, and ground almonds; and anchovies in a spicy red sauce. When sampling new foods like these, it's important for a person with diabetes to monitor their blood sugars both before eating and two hours after. Since the portions were quite small and all relatively low in fat, I could be confident that they would fit within my meal plan as long as I got in a long brisk walk and limited my evening meal to something light. After downing a couple of bottles of mineral water, taking a quick guided tour of their herb garden, and saying "gratzi" to our Signore hostess in her kitchen, we were off to Genoa with a rejuvenated spirit and a renewed appreciation of Italian country food.
A few hours later and we are negotiating the funicular that brought us into Genoa, the principal city of Liguria, the Gold Coast of Italy that hugs the Mediterranean from France to Tuscany. The funicular brought us right to our hotel that overlooked the railroad station and the Port of Genoa beyond where on the morrow we'll board the S.S. Eugenia for a 10-day cruise to Spain, Majorca, Tunisia, then back to Sicily, Naples, and Genoa. The area is best known for its seafood and its wonderful vegetables so that's exactly what we ordered for dinner after a brisk 3-mile walk down to the port to watch our ship dock and to inspect the catch of the fishermen coming into port after a successful day at sea.
Dinner was indeed light--a perfectly grilled little local fish whose name I was never sure of, but it looked and tasted something like sea bream, along with an assortment of beautifully grilled vegetables -- radicchio, fennel, tomato, and baby yellow squash. I declined dessert but had a small spoonful of my husband's kitchen-made gelato (a tradition that he started that night, ordering a different kind of gelato every night of our 17-day trip).
Breakfasts on our trip were simple -- fresh rolls, luscious fruits and berries, an occasional thin slice of cheese, and lots of hot, very strong coffee which we quickly dubbed "Italian breakfast coffee" -- as strong, but not as bitter, as espresso. For lunches both on the ship and ashore, I kept to salads without dressing, vegetables, and an occasional half portion of pasta. Dinners always offered grilled fish and lots of vegetables. One had only to look to our slim Italian shipmates who were obviously glowing with health to see that even aboard an Italian ship, one could eat healthily and keep within one's diabetic meal plan. Of course, walking several miles each day up and down the hills of the ports of call helped. And if that wasn't enough exercise, there were aerobic classes on deck before breakfast each morning, a gym complete with sauna, a lap pool, and then of course, the three discos that kept us dancing well past midnight every night.
Back on shore we headed to the hills of Santa Margherita and nearby Portofino. Since we were traveling at the end of the summer the nights here were chilly, so crackling fires in the fireplaces of our Santa Margherita Hotel were a welcome sight and our dinner table set right in front of one welcomed us. Antipasti tonight included some focaccia stuffed with local olives and stuffed baby eggplants redolent with garlic and herbs. Dinner was freshly made tagliatelle with a variety of seafood -- squid, mussels, clams, and tiny shrimp -- all steamed in white wine and herbs and dressed with a smidgeon of olive oil and lots of fresh local tomatoes, garlic, and parsley. A few fresh grapes (always present on our table throughout the trip) ended another delicious meal.
The next day took us to Portofino. Since it was raining, we situated ourselves under a large umbrella on the south side of the quay to watch the locals come and go in their fishing boats and the rich and famous arrive by launch from their off-shore anchored yachts. Two elderly aunts of the restaurant's owner were sitting on nearby chairs rapidly making the most delicate and intricate designed lace that I've every seen. Coffee and rolls progressed into a grilled fish and radicchio salad lunch.
From there we stayed close to the sea, going from small village to town all the way to France, stopping at local trattorias for lunch, relying on the hotels at night to direct us to our source of food. Picnics of cold frittata, fruit, and focaccia from the hotel restaurant sustained us for more than one picnic lunch as we stopped to watch the sheep graze and the birds soar above the cliffs overlooking the sea. Everywhere the air was perfumed with fresh herbs growing wild along the roadside.
Our next to last day was a mad dash to Stresa on the shores of Lake Maggiore. Once again, the maps of Italy reminded us of our lack of knowledge of the Italian countryside when an autostrada suddenly appeared where one was not indicated. Before we knew it we were seeing signs of the approaching Swiss border. After consulting with the men in a tollbooth, we were sent off through the countryside again. Each toll booth seemed to be calling ahead to "look out for the two lost Americans," as at each stop we were expected and redirected through tiny villages that looked like a back lot of a movie studio, vineyards that were being harvested by hand, and dairy land where the cows and goats roamed on both sides of the fence, lazily wandering onto the autostrada among the whizzing cars.
We arrived at our hotel in Stresa, ten minutes after their dining room closed. But the desk called ahead to a trattoria that only locals use and we were off for what was perhaps the best meal of our trip. The trattoria was actually an after-hours gathering place of all of the chefs and restaurant owners from throughout the region and we were the only "English" speaking in the charming front of a stone house. We put ourselves in the "hands" of the owner and weren't disappointed. Grilled anchovies, a light mushroom broth, and a perfectly baked chicken stuffed with vegetables were soon placed on our table. When I asked what our waiter was grating onto my plate (it looked like a hard, knobby fungus about the size of a tangerine), he merely smiled and continued to grate. He drizzled a tiny bit of local olive oil on top and added a generous grinding of fresh pepper. He then stepped back and indicated for me to taste -- my first taste of fresh white truffle (it had been harvested that afternoon) and I quickly understood why it's priced as it is. Pure heaven on a plate! A mad dash to the airport in the morning and a sleepy flight home -- and I was back to reality and the work of writing another cookbook.
Traveling with diabetes is no harder than traveling without diabetes. One merely needs to do some pre-planning; take some necessary medical precautions to make sure you are well on the trip and afterwards; eating sensibly and regularly; drinking only chilled, bottled mineral water; taking advantage of opportunities to exercise and relax...and you should arrive home as I did, exhilarated from my trip, blood sugars in good control, and not an extra pound added. In fact, when I saw my endocrinologist the following week, I'd lost 3 pounds since my pre-Italy visit.
