The days are getting longer, a true hint that summer is on its way. People who love the sun can’t wait while others, like myself, would rather it be a bit cooler with less intense heat and humidity. Since we have no control over the heat, we must do our best to adapt to the changing environment. Have you ever wondered if those of us with diabetes need to take any special precautions to enjoy the sun? I will attempt to answer this question in this blog.
Sunlight contains ultraviolet (UV) rays. Summer and spring are the times when these rays are the strongest. The two types of UV rays have different effects on the skin. UVA rays penetrate deeply in the skin and it is these rays that contribute to premature aging and wrinkles. UVB rays are 1000 times more powerful than UVA and these rays alter the skin cells and cause a sunburn. Both ultraviolet rays can contribute to skin cancer, but cancer is more associated with the UVB rays.
Check the temperature and UV index before going outside. Environment Canada’s UV Index gives us a measure https://www.canada.ca/home.html of the intensity of the sun’s UV rays at any given time. Your local weather forecast often includes this in their daily forecast. The maximum value of UV rays occurs around noon and its lowest value is in the early morning or later in the afternoon. This index varies from 0-11. An index of 2 would be considered low whereas an index of 6-7 or higher would be considered high. This index value will help you to determine how long you should stay outside and what protection you need to wear. Avoiding the sun as much as possible between the hours of 11AM-3 PM is also recommended. Protection is important not only for the skin but also the eyes, top of head, ears, feet, etc.
Stores have several displays of suntan lotions or creams. Their indications for use may vary from self-tanning to applying after the sun exposure or to treat a bad sunburn. Please read the labels carefully to be sure you pick the right product.
Sunscreens and SPF (sun protection factor)- The SPF is a number that refers to the product’s ability to filter or block UVB rays. Not all sunscreens are the same and NONE of them offer total protection. Sunscreens are meant to increase the amount of time you can spend in the sun without burning. They block the UV rays but several things can alter their effectiveness such as the amount of time you expose yourself to the sun and its intensity, the skin type and the amount applied and your activity level. A SPF of 30 or higher can block 97% of UVB rays but this does not mean it is twice as effective a SPF of 15.
Methods/Items to protect yourself include:
Sunscreen
Apply sunscreen 15-20 minutes before you go outside. Reapply every 2 hours or more frequently if you have been sweating or in the water. Apply generously and don’t forget the scalp, neck, ears, feet and other exposed areas not covered by glasses, a hat or clothing. The www.Canada.ca website tells us that for an adult we should probably use about 7 teaspoons of sunscreen breaking it down to 1 teaspoon (tsp) for each arm and leg, 1 tsp for the front of body, 1 tsp for back and another teaspoonful for the face and neck.
Choose a broad spectrum sunscreen to be sure it will protect you from both UVA and UVB rays.
Choose a sunscreen with SPF of at least 30.
The words “water resistant” or “sport” on the label means they are manufactured to stay on the skin longer if you are in the water or sweating. However, they still need to be reapplied after you stop your activity.
Use a lip balm with a SPF of 15. Reapply as required.
Apply the sunscreen product before applying insect repellant.
All sunscreens have an expiry date. Once the product has expired, it may not offer the same degree of protection.
Side effects to sunscreens are rare, however you could be sensitive to an ingredient in the product. Read the label where all ingredients are listed and if you have any questions, ask your pharmacist.
Clothing, hats,sunglasses,umbrellas
Loose, tightly woven clothing provides the best protection. If you can see light through the garment, then UV rays can also pass through. Cotton offers a minimal barrier and even though we like to wear cotton in the hot months we should not depend on it for UV protection. A better material would be polyester or nylon, or a fabric that might reflect the UV rays like silk.
Dark and brighter colors are preferred over light colored fabrics.
Certain clothing is now manufactured to offer UV protection. The label should carry a UV protection code (UPF). These codes start at 15 and go up to 50+. This is a good website to learn more about this type of clothing: https://www.rei.com/learn/expert-advice/sun-protection.html.
Sunglasses that have been designed specifically for UV eye protection are the best choice. A UV400 or higher means they will block 100% of both types of UV rays. Polarized lenses block the glare and are ideal for summer and winter activities. Remember that sun can reflect off of the sand, water, snow and pavement. Be wise even if you are sitting on the beach or your deck if these elements of nature are close.
Frames that are wide or wraparound the eye will help protect the delicate skin in that area of the face.
Umbrellas-black umbrellas absorb the heat faster and better than other colours. They also emit the heat in a faster manner. The color inside of these black umbrella is silver to make the inside cool.
What special precautions are there for people with Diabetes?
1) Insulin absorption can be accelerated because the sun activates the blood circulation. This increased rate of insulin absorption, increase activity or eating less on a hot day are all risks for a hypoglycemia reaction. Over my years with diabetes, I have definitely experienced this effect. Plan ahead if you can but if you can’t make sure you have supplies to treat a reaction and check your blood glucose often.
2) It’s summer and the wearing of flip-flops, sandals or going barefoot are not advised. Definitely the “barefooting” part should be skipped. Diminished ability to feel sensations in the feet and poor wound healing due to elevated blood glucose levels or poor circulation can cause problems. Always check your feet for blisters, cracks or other signs of injury all year round.
3) Sunburns that are severe release stress hormones and this could raise blood glucose levels.
4) A hot sunny day does not directly affect your blood glucose, but it could change your daily habits. Eating less or over exertion could lead to hypoglycemia just like eating the ice cream cone and being less active could cause hyperglycemia.
5) If you suffer from neuropathy (nerve damage), you may not feel the burning sensation caused by sun exposure. This nerve damage could also interfere with the activity of the sweat glands making it difficult for the body to regulate its temperature.
6) Prolonged exposure to UV absorption can contribute to the development of cataracts and increase risks for diabetic retinopathy. The risk of this could be amplified in people with diabetes due to chemical changes in the lens of the eye.
7) Drink plenty of water to avoid dehydration and rise in blood sugars. Drink before, during and after any type of activity.
Keep all diabetes supplies away from direct sun and heat. Insulin can lose strength and test strips may be inaccurate. There are many varieties of insulated storage bags that could be used when you plan a day outside.
Please be aware that some medications can increase your sensitivity to the sun. Medications include prescription, non-prescription, and over-the-counter as well as herbal products. In other words, your skin could burn more easily when exposed to the sun. Be sure to check with your pharmacist beforehand if there are any risks of being in the sun with your medication.
Summer can be enjoyed with or without diabetes, but a few extra precautions are needed. A few years ago at a local beach, a person took their insulin pump off to go in the water and someone stole it, maybe thinking it was a cell phone. Be sure to put your pump out of sight when you take it off at the beach or anywhere so it won’t be confused with another type of technological device.
References:
1)Quebec Diabetes Association- accessed on line April 27th, 2020. https://www.diabete.qc.ca
2)https://www.diabetescarecommunity.ca accessed April 27th,2020
3)www.canada.ca accessed April 27th,2020
4)https://consumermedsafety.org/medication-safety-articles - this reference gives a list of medications that are sun-sensitive (not all inclusive however)
#sun & diabetes
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