Special Diets

• By the TraceGains Medical Advisory

Staying Cool in the Heat

Summer can be a time for lots of outdoor activities and for relaxing with family and friends. But the warmer months also pose special challenges to people with diabetes; for example, high heat and humidity can affect your ability to control your blood sugar levels, and may require more diligence to stay hydrated. The Centers for Disease Control and Prevention (CDC) has published a set of recommendations to help people with diabetes prepare for the higher temperatures of summer.

Summer can be a time for lots of outdoor activities and for relaxing with family and friends. But the warmer months also pose special challenges to people with diabetes

Don’t get beat by the heat

High heat, especially along with high humidity, is uncomfortable for everyone, but for people with diabetes it can pose a real health threat. Fluid loss associated with high blood sugar and certain diabetes medications is compounded by extra fluid loss due to high heat conditions, making it harder to stay hydrated. In addition, both type 1 and type 2 diabetes cause changes in the body’s ability to stay cool at the core, increasing the risk of heat-related health problems like heat stroke. The risks go down if you maintain an active lifestyle and keep your blood sugar levels well controlled all year.

Some diabetes medications, like insulin, function differently in high heat, making blood sugar control more challenging. Diabetes-related medical supplies, like glucose meters, also function differently in high heat, which can cause a false glucose reading. The CDC has the following recommendations to help people with diabetes stay healthy in hot weather:

• Drink water before you get thirsty. Thirst is a sign that you are already somewhat dehydrated. Avoid sugar-sweetened soft drinks. If your healthcare provider has recommended that you restrict your water intake, talk with them about what to do if it gets hot.
• Dress to stay cool. That means choosing loose-fitting, light-colored, lightweight clothing.
• Don’t get burned. Use sunscreen and lip balm with sunscreen if you need to spend time in the sun. Look for products that will help block both UVA and UVB rays with an SPF of at least 30.
• Choose cool places. If you don’t have air-conditioning at home, try to spend time in air-conditioned public spaces.
• Exercise carefully. Choose the coolest times of day—early in the morning or later in the evening—for physical activity, or exercise in air-conditioned places.
• Learn about your medications and medical devices. One of the challenges facing people with diabetes during times of high heat is that high temperatures can change the functioning of medications and devices that help you manage your blood sugar.
  • First, be sure to ask your pharmacist about how temperature may affect your medications and options for traveling with medication.
  • Read the package inserts that come with your medications and learn whether and how high temperatures affect them.
  • If you need to carry extra medications with you while you are away from home, keep them out of the heat as much as possible.
  • Insulin in particular needs to be kept in a cooler, but not directly on ice. Never leave your insulin in a hot car or in direct sunlight.
  • Similarly, read the literature that came with your glucose meter and the package from your test strips. Don’t leave them in excessively hot places.
• Learn to recognize symptoms of heat exhaustion and heat stroke. Heat exhaustion can lead to heat stroke, a life-threatening emergency. People with diabetes are more susceptible to heat exhaustion and heat stroke, and have a higher number of heat-related emergency room visits, hospitalizations, and deaths than people without diabetes. Here are some of the possible symptoms of heat exhaustion:
  • Cool, moist skin with goosebumps
  • Heavy sweating
  • Faintness
  • Dizziness
  • Weak and rapid pulse
  • Low blood pressure on standing
  • Muscle cramps
  • Nausea
  • Headache

If you experience any of these symptoms during a time of high heat, stop any physical activity, get to a cooler place, and drink water. If your symptoms worsen or persist for more than an hour, or if you have a fever of 104°F (40°C) or higher, seek immediate medical attention.

(Plan for Diabetes Care in Heat & Emergencies. CDC. www.cdc.gov/Features/DiabetesHeatTravel/)