My inspiration for today's blog is a result of the hot temperatures we had this week. Apparently we had record temperatures for our area in New Brunswick. I am not a lover of the heat and I always found it more difficult to manage my diabetes during these hot seasons. I remember several times during the years that I ran, I would start the run and after 10-15 minutes, despite my higher than normal sugar level when I started, my sugar would go low. This was in the days before I started to wear my sensor 24 hours a day but still it didn't have to be high intensity exercise to create the hypoglycemia I so often experienced. After a while running or any strenuous activity or work in my yard became a nuisance and I would get frustrated. Do this sound familiar to any of you?
Today's blog is intended for everyone as the hazards of extreme heat can have serious consequences.
There has been and continues to be much discussion on Climate Change and how it is affecting climate variables such as temperature, precipitation and humidity. A Canadian Environmental Sustainability Indicator Temperature Change Report published in May 2021 states that
"in Canada the national average temperature for the year 2020 was 1.1 degree Celsius above the 1961 to 1990 reference value. The annual average temperatures were consistently above or equal to the reference value from 1993 onward."
Information on the health-canada website suggests that over the next 3 decades, the number of extremely hot days in one year is expected to double in some parts of our country.
When I reflect on temperature changes during my lifespan, I know it has changed and I feel it has been most evident within the past five years. There has been extreme summer heat and extremely cold winters with much snowfall and high winds.
Extreme heat is sometimes referred to as a heat wave. Illnesses like heat stroke, heat exhaustion and even death could happen if you don't protect yourself. Extreme heat events involve high temperatures but can include high humidity as well.
Heat exhaustion is the milder form of heat illness and is most common. Symptoms include:
High body temperature
Anxiety, confusion, light-headness, dizziness, headache
Sweating is present, red hot skin
Nausea, vomiting, low blood pressure
Extreme thirst, dark urine and decreased urination
If left untreated, it could lead to heat stroke. If you experience any of the above symptoms, immediately move to a cool place and drink liquids with water being the best choice.
Heat Stroke is a medical emergency. It needs to be treated at the hospital. It has some overlapping symptoms with heat exhaustion but also might include:
Core body temperature greater than or equal to forty (40) degrees celsius (104 F)
Hallucinations, delirium, lack of coordination
Confusion, aggressivness, irritability
Loss of consciousness
Increased or irregular heart rate
Profuse sweating on exertion and extended periods of outdoor work /and/or physical activity
Rapid breathing, shock
Heat stroke could lead to liver and renal failure, muscle fibre breakdown, fluid in the lungs and death. Don't delay and call 911.
Certain populations are at risk such as: older adults and young children, pregnant women, athletes and outdoor workers, people with heart conditions such as high blood pressure, obese individuals, diabetes (both types), nerve disorders and mental health disorders including addictions, homeless and malnourished people, and those who are socially isolated.
Extreme heat conditions can affect our diabetes management leading to either high or low blood glucose readings. Precipitating factors might include:
If you sweat a lot during activity in the heat, then you could become dehydrated leading to a rise in blood glucose readings.
It is possible that people with both type 1 and type 2 diabetes feel the heat more because:Diabetes complications that have caused damage to the blood vessels and nerves can affect your sweat glands so your body doesn't cool as effectively. If this happens, it can lead to heat exhaustion and heat stroke which are medical emergencies.
Heat can cause the body's blood vessels to expand which in turn can speed up insulin absorption and potentially lead to hypoglycemia. This is definitely a problem for myself, so it is suggested that if you plan to exercise or engage in an physical activity inject insulin in a site that you don't intend to use as much. For example don't inject in the leg when you know you are planning soccer, likewise don't inject in the arm if you will be using it to play tennis. Always have some form of fast active glucose ready in these circumstances.
Even if it doesn't seem that hot outside, if there is humidity in the air then it becomes harder for sweat to evaporate from the skin, whereas in dry weather, the sweat evaporates quickly. A windy day will help sweat evaporate quickly. It is the evaporation of sweat from the skin that enables cooling.
Check you blood glucose more frequently during these heat waves since heat can change how the body uses insulin. Speaking of insulin, remember to keep it stored in a cool place, never in direct sunlight or left in a hot car while shopping or at the beach. There are many types of insulin coolers on the market if you do an internet search. I have a small one that I can plug into the dashboard of the car which fits between the two front seats and holds insulin supplies and there is enough room for juice so everything is handy. However, don't put your blood glucose meter strips in the cool storage device.
I wouldn't be a pharmacist if I didn't discuss medications. Ask your pharmacist if you are prescribed a new medication about any risks of sun sensitivity and if it could affect the region of the brain (hypothalamus) and the body temperature set-point. Medications that increase the risk of dehydration (cause fluid loss), affect kidney function or cardiac output could increase risk factors for heat exhaustion or stroke. Some examples of these types of medications include (but not limited to):
drugs to treat depression (antidepressants)
drugs for Parkinson's disease. (anti-parkinson's agents)
drugs that expand the blood vessels (vasodilators)
drugs for blood pressure (antihypertensives)
and many others so please check with your pharmacist/health care team about potential risks and side effects
A neat tool I found while researching this topic was that referred to as the Air Quality Health Index. This tool is a scale designed to help you understand what the air quality around you means to your health. Air pollution tends to be at higher levels during very hot days.
Ideas for prevention of heat-related illnesses include:
Drink water before becoming thirsty and increase your intake during extreme heat.
Avoid alcohol and caffeine containing drinks like coffee and energy or sport drinks. Some of these drinks can increase your urine output and lead to dehydration which couple have the ripple effect on raising your blood glucose levels.
Check blood glucose more frequently and be sure to have products close by if you become hypoglycaemic.
If you are going to a beach, before you get settled in, be sure you know where there is a canteen if you need to purchase any food or drink.
Don't forget to apply sunscreen (SPF of at least 30) 15-20 minutes before you go outside and remember to apply often. Sunscreen protects you from the ultraviolet(UV) rays, BUT not from the heat. Wear sunglasses that have UV protection as well.
Find tree shaded areas which could be several degrees cooler.
Wear loose-fitting and light coloured clothing and made of breathable fabric (cotton, linen)
Be active in cooler parts of the day.
Wear wide brimmed hats and remember to put sunscreen on the ears or any bald areas on the scalp. Sun can reflect off the sand and water so choose your spot to relax carefully.
Seek medical attention as required.
Make contact with people who live alone, are elderly or socially isolated to be sure they are safe.
Summer can be fun so you don't want to ruin it with any disasters. Be careful, plan ahead, good luck and enjoy your time.
This blog does not replace advice that you have received from your health-care team. It is meant for information purposes only.References as included in discussion from Canadian government websites.
My next blog will be on the weekend of July 3rd.2021. Happy Canada Day to all my Canadian followers.
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