Summer brings special challenges for people with diabetes. These tips can help you safely manage diabetes in hot weather and when you’re on vacation.
The effects of heat are more strongly felt by people with type 1 or type 2 diabetes for several reasons:
- Complications that are common for people with diabetes include damage to nerves or blood vessels. This damage means sweat glands cannot effectively cool the body. When the humidity is also high, sweat doesn’t evaporate and the body cannot cool itself. It’s easier for people with diabetes to develop heat exhaustion or heat stroke, according to the Centers for Disease Control and Prevention (CDC). Consider this to be a medical emergency and get help quickly.
- They more quickly lose water from their bodies (become dehydrated) when it’s hot, compared to people without diabetes. They need to drink more fluids to keep blood sugar levels from increasing. High blood sugar increases the need to pee, making dehydration worse. Also, “water pills” (diuretics) used to treat high blood pressure can worsen dehydration.
- Insulin use can change because hot weather changes how the body uses insulin. The CDC recommends testing your blood sugar more often, adjusting the insulin dose, and adjusting what you eat and drink.
Top tips for summer if you have diabetes:
- Drink more fluids, especially water, even if you’re not thirsty. Waiting until you’re thirsty means you’re already dehydrated. Avoid alcoholic beverages and those with caffeine, including coffee, tea, energy or sports drinks and cola drinks. They can make you lose more water and can spike your blood sugar. Drink a glass or two of water before you exercise to prevent dehydration.
- Test blood sugar more often, especially before, during and after activities. Always ask your health care provider if you need help adjusting your insulin dose.
- Stay inside in air-conditioning during the hottest part of the day (10 a.m. to 4 p.m.). Air conditioning is the most effective way to prevent heat-related illness and death. Fans are far less effective. Plan for loss of power by locating a cooling center near you and its hours of operation. If your home is not air conditioned, go to air conditioned public places such as shopping malls, theaters, libraries, churches or schools during the hottest part of the day (afternoon through early evening).
- Wear sunscreen and a hat when you’re outside and try to stay in the shade. A sunburn can increase your blood sugar level.
- Ask a family member or friends to check on you during extreme heat. Offer to do the same for them.
- Wear loose, light-colored clothing. Natural fabrics (cotton, silk, linen) or synthetic “breathable” materials are your best choice. Don’t go barefoot, even at the beach or pool. Foot injuries can be very dangerous for people with diabetes.
- Keep medicines, supplies and equipment away from high temperatures and direct sunlight. Never leave them in direct sunlight or a hot car. Heat can affect your insulin and other medicines. If you’re traveling, keep them in a cooler. Never put insulin directly on ice or a cooling gel pack because it might freeze. The package insert (or your pharmacist) can tell you how high or low temperatures can affect your insulin or oral medications. Even your equipment – glucose monitor, test strips, insulin pump, etc. – can be damaged permanently by summer’s heat.
- Get immediate medical attention for heat-related illness. Slow down and rest at the first signs of heat stress. Symptoms include fatigue, weakness, excessive sweating or no sweating at all, confusion and stomach cramps.
- Have a plan for emergencies such as losing power. Always have a go-bag ready with your meds, supplies and equipment for emergencies.
Diabetes never takes a vacation. So if you’re traveling or taking a vacation, plan ahead. Travel can disrupt even the most stable meal, activity and medication schedule. It’s important to maintain the schedule you’ve established at home while traveling or on vacation. Try these eight tips while you’re on vacation. Your body will thank you.
- Meals and snacks are likely to get off schedule when traveling. Always have healthy snacks, water and a source of quick glucose for those times when your flight is delayed or you cannot find a restaurant. Test glucose levels more frequently when eating unfamiliar food.
- Your activity level will probably change while you’re on vacation. Sightseeing can increase it, but if you plan to just lie on the beach, it may decrease. If your vacation will boost your activity level, you’ll want to plan ahead and get in shape. During the weeks or a month before you leave, gradually add more physical activity to your day. Schedule it just as you would an appointment so you’ll stick with it. As your activity level increases, adjust food, beverages, medicines and how often you test your glucose. Remember, exercise increases sensitivity to insulin and increased activity always presents a risk for low blood sugar. Plan outside activities early in the morning or evening to avoid the hottest temperatures.
- Medication and testing schedules should be maintained while on vacation. Match up your medication schedule with your travel schedule. For example, if you’re flying west, the day will lengthen and more insulin may be needed. Know when and where you can test or take insulin.
- Identification that you are a diabetic should be kept on you as you travel and visit new places.
- Always keep your meds, supplies, equipment, and snacks in the car or airplane cabin. It will be easier to maintain them at correct temperatures as well as keeping them from being lost if your luggage is delayed.
- Check with your doctor if you think changes will be needed in your treatment plan while you’re on vacation. Travel can be very stressful and stress can raise your blood sugar. Contact your health care provider as soon as you finalize vacation plans. Ask for written prescriptions for insulin and other medications. If you’re separated from your meds or supplies, you’re only a pharmacy away from replacements. Also, ask for a letter than explains your medical devices. This is not required but it can help at security checkpoints. For example, a letter from your doctor will explain that you cannot remove an insulin pump because it connects to a catheter inserted under the skin.
- Ask for a visual inspection rather than using the metal detector or being hand-wanded. Powerful X-rays used at security checkpoints can damage insulin, even if it’s in an insulin pump.
- If your child has diabetes and is going away to camp or other extended trips without you, be sure an adult is always available who knows how to manage diabetes. He or she should be able to test glucose, give insulin shots and ensure your child sticks with a food plan. The adult should know how to spot high or low glucose levels, what to do to correct them and how to give glucagon in an emergency.