By Beth W. Orenstein
Medically Reviewed by Pat F. Bass III, MD, MPH
When temperatures start to get out of control, so can your blood sugar. Both hot and cold weather extremes can affect your testing equipment and your medications, and have a negative impact on your body’s ability to produce and use insulin.
Research shows that when it’s hot out, more people with diabetes end up in the ER and are hospitalized because of heat illness. The number of deaths in diabetes patients due to heat illness also increases in summer. Low temperatures can be an issue for people with diabetes as well.
But you don’t have to let the environment have the upper hand. Taking a few smart precautions can help you outsmart Mother Nature. Here are the adjustments to make depending on where you live and the weather forecast.
6 Tips to Survive the Summer Heat
Take these steps to keep your diabetes under control when the temperature soars:
Stay hydrated. Lori Roust, MD, an endocrinologist at the Mayo Clinic in Arizona, explains, “The problem is that in the heat, people tend to get dehydrated easily. When you’re dehydrated, you have higher concentrations of blood sugar because less blood flows through your kidneys. With less blood, your kidneys don’t work as efficiently to clear out any excess glucose (blood sugar) from your urine.” When it’s hot, be sure to drink plenty of water or sugar-free drinks. Don’t wait until you are thirsty to replenish fluids.
Store your medications properly. High summer temps can affect your diabetes medications, glucose meter, and diabetes test strips. “When it’s hot out, it’s easy for insulin and other drugs to become degraded,” Dr. Roust says. Be sure to store your medications properly — out of the extreme heat. Never leave them in your car on a sweltering summer day, for instance. “It could get up to 150 degrees inside your car,” warns Roust.
If you’re traveling, don’t forget to take your type 2 diabetes medicines with you. You may need to carry them in a cooler with an ice pack. Just be sure they’re not sitting directly on ice or the ice pack.
Stay out of the heat of the day. Exercise is an important part of diabetes management and blood sugar control. But you don’t want to be outside exercising during the hottest part of the day. “Get in your exercise first thing in the morning or once the sun goes down,” advises Angela Ginn, RD, a diabetes educator at the University of Maryland Center for Diabetes and Endocrinology and a spokeswoman for the Academy of Nutrition and Dietetics. Another option is to work out in an air-conditioned gym.
Know signs of low blood sugar. Some of the symptoms of heat exhaustion are similar to those of low blood sugar, or hypoglycemia. These include sweating, light-headedness, shakiness, and confusion. “You may think it’s the heat and not recognize that your blood sugar levels have fallen to dangerous lows,” Roust warns. Be aware of the warning signs of low blood sugar and keep some carbohydrates with you to eat if you need to raise your blood sugar. Have a plan for a medical emergency.
Test more often. You may need to test your blood sugar levels more frequently so that you can adjust your insulin and your diet as necessary. Talk with your diabetes educator about guidelines if you're unsure of the best schedule, Ginn says.
Mind your feet. People with diabetes are susceptible to problems with their feet. In the summer you face the temptation to go barefoot or wear open sandals that expose your toes … to trouble. Always wear shoes that fit well — even in warmer months — and at the end of the day, check your feet for any cuts, scrapes, blisters, or bruises. Don’t ignore injuries to your feet. Get medical treatment right away.
6 Ways to Winter-Proof Your Diabetes Care Plan
Freezing temps and inclement weather can make it more challenging to stay on top of diabetes. Here’s what to watch for during the colder months:
Keep your supplies out of the cold. Just like extreme heat, extreme cold can affect your insulin and cause your glucose monitor to stop working. Don’t leave supplies in a car when temperatures outside are below freezing.
Do your best to avoid getting sick. Winter is cold and flu season. When you’re sick, you’re stressed, and being under stress can raise your blood sugar. Also, when you don’t feel good, you’re likely to not eat properly. Wash your hands with soap and water often so that you don’t spread germs. Ginn recommends "diabetes patients have a sick-day kit at home and fill it with soup, sugar-free cough drops, tea — things that will make you feel better and that you can access easily.” Also, be sure to get vaccinated against the flu.
Avoid packing on the pounds. Managing type 2 diabetes during the holidays can be tricky. Many seasonal treats are loaded with carbohydrates that cause your blood sugar to rise. Plan your meals and pace your special treats so that you don’t greet spring a few pounds heavier. Even a small weight gain makes it more difficult to control your diabetes and blood sugar levels.
Keep an eye on your feet. Diabetes can cause a loss of feeling in your toes and feet. Protect them with the right winter footwear, especially in snow. Apply moisturizer to your feet to keep your skin healthy. Inspect them regularly, and if you notice an injury that doesn’t heal, seek medical attention. Don’t wait.
Warm your hands. “If your hands are cold, you may have to warm them up to get a good blood sugar reading,” Roust says. Wash them in warm water before testing.
Your meter will work best when it’s kept in a room where the temperature is between 50 and 104 degrees Fahrenheit.
Don’t skip your workouts. It can be hard to get motivated to exercise in winter. But exercise is an important part of keeping blood sugar in check. It helps if you dress in layers when you’re exercising outdoors in the cold. Or join a gym where you can work out indoors. Another option: Work in exercise at home by taking the stairs, lifting weights, and exercising to videos.
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