Oren Liebermann was four months into an ambitious yearlong backpacking trip around the world in 2013 when he fell seriously ill.
A former CBS3 reporter who grew up near Asbury Park in Wayside, N.J., Liebermann was steadily losing weight through the first leg of a trip that took him and his wife, Cassie, through Europe, Israel, and Kenya and eventually to Nepal, where they planned to do volunteer work for several weeks.
Then, stuck halfway around the world in the Himalayas, he all but collapsed.
That's when he learned for the first time that he had type 1 diabetes. After a brief respite back home in the States, Liebermann and Cassie, who grew up in Allentown, picked up where they left off and finished their journey.
Liebermann, 34, currently the Jerusalem correspondent for CNN, writes about his adventures in a new memoir, The Insulin Express: One Backpack, Five Continents, and the Diabetes Diagnosis that Changed Everything.
Released this month, the book also contains detailed information about diabetes and how to manage the condition.
What inspired you and your wife to go on the road?
It was a way to celebrate our first anniversary. We got married in September 2012, and we could have done what is quote-unquote the normal thing to do and buy a house and a car and start a family. Instead, we decided to sell just about everything we owned and buy a backpack and start backpacking around the world.
How did you plan the trip?
We only had a rough itinerary. We didn't make any reservations or anything like that. We had a rough idea of what countries we wanted to see in Europe. ... But Nepal always was a big stop for us because we wanted to volunteer there for six weeks. Then the plan was to go to Southeast Asia and end the trip in South America.
So you arrive at Nepal and you're not feeling so hot.
Actually, I started feeling the symptoms earlier, about two months earlier, when we were in Israel. I just didn't know they were symptoms.
What are the early signs of type 1 diabetes?
I distinctly remember one night when I couldn't sleep because I had to keep getting up to go to the bathroom.
You were having trouble with your entire hydration system, right?
Exactly. And I was incredibly thirsty all the time. I also started losing weight, but very gradually at first.
You weren't worried?
I always was able to make excuses. Israel is in a desert, so of course I'm thirsty. In Thailand, it was 95 degrees every day, so of course I was thirsty. I was in Nepal during their dry season, so of course I'm thirsty.
When did you suspect you might actually be sick?
It was the weight loss. We decided I should step on a scale, so we found a pharmacy which had one. … So I'm on the scale and I look down and everything is in kilograms so I'm staring at the numbers and I'm doing the math in my head and it just didn't make any sense to me. I did the math and I realized I had lost 40 to 45 pounds.
In the course of seven weeks?
In less than two months.
You sound so calm as you recount this. You're halfway around the world and you're sick. Weren't you terrified?
Absolutely, it was terrifying. But I knew we could see a doctor [at a local clinic] and I had a feeling we'd be OK.
Most people link diabetes with weight gain, not weight loss.
That's type 2 diabetes, which sometimes can be reversed with diet and changes in lifestyle. But not type 1. Type 1 means my pancreas no longer produces insulin, which helps control blood sugar. And that will never change.
Does one catch type 1 diabetes like you catch a cold? What causes it? Is it genetic?
There's so much we still don't know about it. ... There's a genetic component, even though no one in my family had it …. My doctor put it this way: He said I probably had a genetic predisposition to diabetes but I could have gone my whole life and never encountered the trigger that turned on the genetic marker.
Like an on-off switch?
Exactly like that.
Type 1 diabetes can't be cured?
It can be managed. I spent a month [after flying back to America] learning what diabetes is and learning how to manage it, learning how to control blood sugar. In a sense, it's very simple: If your blood sugar is high, you take insulin or if it's low, you take sugar.
Why did you decide to fly right back out and complete the last six months of the trip? It could not have been an easy decision.
I consider it to be the most important decision of my life.
Did your parents think you were crazy?
Absolutely! ... I said it was the most important decision of my life, I did not say it was the most responsible. My family and I screamed at each other. … They were scared of diabetes because they weren't familiar with it.