Summer is here and we want to enjoy the fresh air and outdoors as much as we can. However, it is important to be careful when there is extreme heat in the forecast and perhaps more so for those living with diabetes. Extreme heat is a period of high heat and humidity above 35 C (95 F) for two or three days. Humidity increases the feeling of heat and during these times the body has to work much harder at trying to maintain normal body temperature. Extreme heat can happen anywhere and anytime so we must plan ahead.
There are many things we can do to help the body regulate our body temperature and therefore decrease our risk of suffering from complications caused by the heat. This is what I want to concentrate on today with particular information for people with diabetes.
Avoid dehydration by drinking plenty of fluids (even if you aren’t thirsty)
Blood sugar levels can be affected by the heat depending on what we have eaten, how much fluids we have consumed and our activity level. If we don’t drink enough, then we lose a lot of body fluids and become what is referred to as “dehydrated” and this can cause a rise in blood glucose levels. High blood glucose levels will increase our urination and lead to more dehydration and the vicious cycle begins. Dehydration can also reduce the blood supply to your skin and thus if you use insulin the ability to absorb the insulin could be reduced. Drink even when you are not thirsty and avoid alcohol, caffeine and energy drinks (these can lead to more dehydration). If you are taking an oral prescription medication labelled a SGLT-2 inhibitor dehydration may become even more serious since this class of medication can cause dehydration as a possible side effect. Ask a member of your health-care team for more information and what to do (you can check yourself for dehydration by pinching up some skin on your arm and letting it go. It should go right back into place, but if it goes more slowly, then you could be headed towards dehydration).
Dress properly
Cover up with sunglasses, wide-brim hat and loose lightweight and light-colored clothing. Apply a broad spectrum sunscreen with at least SPF 30 and apply it every two hours or after any strenuous activity, heavy sweating or swimming. My earlier blog discusses this is more detail. If you suffer from nerve damage your sweat glands may not be functioning normally and thus it becomes harder to maintain a normal body temperature. Sunburn adds stress to the body and can raise blood sugars.
Medication storage
Keep all medicines stored at the right temperature as advised by the package insert or source of information provided with the product. Heat can damage insulin, other medications, blood glucose meters and even test strips. Keep your insulin cool but do not place it directly on ice. There are many different sizes and types of storage bags available and often at the end of the season they go on sale so you could always purchase one for the following summer.
Insulin Pumps and continuous glucose monitoring (cGM)
Insulin pumps should not be exposed to direct sunlight or heat. If you take the pump off at the beach to go in the water, then store it in a well-insulated cooler. Do not leave it in the car/backpack, etc. Be careful where you place your pump on hot days. Move it to the side of the body where there is less direct sun. I know I try and do this if I am biking or walking. I searched google using the term “insulin cooling cases” or “insulin cooling pouch” and many options showed, so if you think this is a good idea for yourself or a family member take a minute to see which best suits your need(s).
Another option to protect your pump from direct sunlight exposure would be to cover it with a white towel or cloth when you are wearing it.
It may be wise to change the insulin in your pump every two days rather than the usual 3 days ( as for Medtronic devices is what I wear). Check with your team of experts on what they recommend for your device.
Perspiration can loosen adhesives on cGM and pumps. The sensor and/or infusion set might become loose. There are many types of tapes ad dressings that can be purchased and will stick much better if exposed to a bit of perspiration. This is something I have experienced, the dressing starting to come off and I have tried many different dressings. My current secret is to wear a headband around my arm to hold the sensor & dressing in place. You could also make yourself something that is stretchable and easy to put on and take off. I did make one with a wide elastic band and used velcro to hold it together and it worked pretty good.
Most companies that manufacture sensors, transmitters and cGM devices can help you with knowing what temperature is best for storing or transporting your device.
Protect your eyes
The sun has both a positive and negative impact on our vision. Solar radiation is a combination of many types of light including the ones we most often hear about being the UVA and UVB . Sustained exposure to these rays without protection can cause major damage to the eyes over time. For example: a condition called keratitis- sunburn on the eyes and causes the cornea to burn. Usually this is resolved within 48 hours but can be painful. The sun can trigger protein damage in the eye lens and thus influence the development of cataracts. Be sure to ask your eye specialist for more information when you know you will be spending a lot of time in the fresh air and remember that sun reflects off of water and sand, increasing the UV ray effect even more. Despite the negative impact mentioned above, some studies have shown that lack of direct exposure to sunlight might contribute to nearsightedness, therefore making sunlight to be beneficial. When choosing sunglasses, prescription or not, be sure they have 100% protection against UVA and UVB light and preferably wrap around your face. If you wear contacts, check with your eye specialist about UV absorbing options.
Know the signs of heat exhaustion (check this blog for further details)
Symptoms of heat exhaustion and hypoglycemia are similar such as dizziness, fainting, confusion and excessive sweating. If these symptoms are present then be sure to check your blood sugar and have treatment readily available if you are hypoglycaemic.
FAN ALERT:
Fans create air flow and a false sense of comfort, BUT they do not reduce body temperature. When indoor air temperature rises to about 35 C (95 F) fan use may cause the body to gain heat instead of losing it. On hot humid days sweat evaporates off the skin slower than normal, and fans make it even more difficult for the body to lose heat by sweating. Overall, the use of a fan on such a hot day could increase the risk of heat-related illnesses.
Take time to add these precautions to your summer safety check list. It may save you a lot of complications and unwanted interruptions in your summer fun.
There are many excellent websites for your review to gain additional information. I will list a few here for the sake of convenience.
1)5 Tips for Managing Hot Weather and Diabetes: https://www.riteaid.com/articles/5-tips-for-managing-hot-weather-and-diabetes
2)How to Manage Your Diabetes in Extreme Summer Heat https://health.clevelandclinic.org/how-to-manage-your-diabetes-in-extreme-summer-heat/
3)Diabetes in Hot Weather- 12 Things To Know https://www.diabetesselfmanagement.com/blog/diabetes-hot-weather-12-things-know/
4)Summer Vacation & Diabetes: Plan Ahead https://karenmaccurdy.wixsite.com/diabetes/post/summer-vacation-and-diabetes-plan-ahead
5)The Ripple Effect: Climcte Change, Extreme Heat & Diabetes Management https://karenmaccurdy.wixsite.com/diabetes/post/the-ripple-effect-climate-change-extreme-heat-diabetes-management
6)Summer Sun, Fun & Diabetes: Stay Safe https://karenmaccurdy.wixsite.com/diabetes/post/summer-sun-fun-diabetes-stay-safe
Wishing you all a safe and fun filled summer. Take care everyone.