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Summer Health Tips for Diabetics
Living with diabetes, you’re familiar with summer challenges. If the disease has caused nerve damage, your body may have difficulty regulating heat. Here are management strategies to help you breeze through the season.
Use the daily heat index as a guide for precautions to take. The number reflects the impact of relative humidity on air temperature. Essentially, it’s the “feel-like temperature,” combining these two weather factors. For instance, if the outdoor temperature is 84 degrees, and the relative humidity is 70 percent, the heat index is 90, meaning it feels like 90 degrees.
When you perspire, evaporating moisture removes heat from your body. However, with high humidity, when air is saturated with water, perspiration doesn’t vaporize well. So, whenever the heat index is 80 or above, be extra cautious.
1. Sip water throughout the day.
Diabetes can injure nerves that control sweat glands, so they can’t release adequate moisture to cool you. Reduced perspiration raises your risk of dehydration. Without enough fluids, blood glucose rises, causing water loss through urine. Certain medications trigger fluid release, too.
In some cases, damaged nerves over-stimulate sweat glands. In that case, you may perspire copiously, especially while eating or sleeping.
Note that when you’re dehydrated, blood flow is impaired, slowing insulin absorption.
To offset sweating and other agents of fluid loss, you must stay hydrated. Aim to drink a volume of water that’s half your body weight. For instance, a person weighing 160 pounds should drink 80 ounces or 10 cups daily.
Skin elasticity and urine color are accurate gauges of hydration. For the skin test, gently pinch the skin on your hand. Upon release, it should promptly smooth out. If your skin is slow to normalize, you’re dehydrated.
Pale yellow urine shows you’re getting enough fluids. Warning signs are urine that’s light honey, amber, or orange. These colors indicate your kidneys are retaining fluid, making urine concentrated.
2. Watch your blood sugar like a hawk.
A high body temperature can plunge blood sugar below normal levels. Most people have warning signs of this condition, termed hypoglycemia.
A mild to moderate sugar imbalance is flagged by headaches, blurry vision, shakiness, anxiety, dizziness, confusion, pallor, sweating, fatigue, or hunger. Signs of severe hypoglycemia are clumsiness, irregular heartbeat, poor concentration, irritability, and weakness. At its worst, hypoglycemia triggers seizures, convulsions, and coma.
To avoid hypoglycemia, check your blood sugar four times daily. You may need to adjust your insulin dose during summer to keep blood sugar balanced. Obtain your doctor’s advice for how to do this.
3. Protect medication and supplies.
Both hot and freezing temperatures damage insulin, test strips, and glucose meters. Therefore, never leave them in a hot car, sunlight, or your freezer.
Store insulin and medical supplies in a cool, dry place. You can refrigerate unopened insulin at 36 to 46 degrees Fahrenheit until the expiration date on its box. Keep an open, punctured vial in the fridge up to 28 days, after which you should discard it.
Do not refrigerate insulin pens. Instead, keep them at a comfortable room temperature.
If you need to use insulin and supplies while away from home, tote them in an insulated bag with a cold gel pack. Allow refrigerated insulin to reach room temperature before use.
Pump and CGM
Do you wear an insulin pump or continuous glucose monitor (CGM)? If so, keep them away from heat. Each should be stored in an insulated pouch with a cold gel pack. While wearing one outdoors on exposed skin, cover it with clothing or a towel. Alternatively, you can disconnect a pump for one hour. Beyond that time frame, you’ll need to adjust the infusion rate to compensate for missed doses.
While wearing a pump or CGM, perspiration can loosen the adhesive securing it to your body. To prevent slippage, after preparing your skin to attach the device, apply a skin barrier prep, such as Skin-Tac H. Or, affix the unit with tape or a dressing, such as Polyskin.
4. Keep cool indoors.
Use window treatments to block the sun’s heat. If you have ceiling fans, set them to spin counterclockwise, as viewed from beneath. In rooms not cooled by air conditioning, use portable fans.
Outfit your bed with breathable, lightweight sheets made with natural fibers. Skip synthetic materials and high thread counts since they trap body heat.
One cooling option is cotton. Bamboo is antibacterial, soft, and eco-friendly since it’s a renewable resource. Buy sheets with a low thread count, between 300-400.
Did you know that your head emits more heat than any other body part? Given this fact, sleep on a cooling pillow that stays cold. This type of pillow removes heat from your neck and head in one of three ways – evaporation, transfer, or absorption.
Typically, cooling pillows are filled with either buckwheat hulls, shredded latex, gel memory foam, shredded memory foam, or shredded gel. Phase-changing beads can be paired with memory foam to absorb heat from your body. A bamboo pillow case is icing on the cake!
5. Be careful outdoors.
UVA and UVB rays damage skin, and inflammation hikes blood sugar. Apply a broad-spectrum sunscreen containing zinc oxide 20 minutes before heading outside. Wear a wide-brimmed hat, sunglasses, and lightweight clothing in light colors, to reflect the sun’s rays.
It’s preferable to work out in an air-conditioned building. If this isn’t possible, stay in the shade. The heat index can soar 15 degrees higher in areas warmed by the sun. Choose the early morning or late day for strenuous activity, when temps are most benevolent.
Before exercising, check your blood sugar. Heed these glucose meter readings by Mayo Clinic:
below 100 mg/dL – Raise your level before exercising by eating food with 15 to 30 grams of carbs.
between 100 and 250 mg/dL – This is a safe range, so a pre-exercise snack isn’t necessary.
250 mg/dL and above – This level may be too high. Test your urine for ketones before working out. If present, they indicate your body lacks adequate insulin and is burning fat for energy versus carbs. If you exercise with a high level of ketones, you can become very sick.
Once your blood sugar is ideal, test it each hour since it will change while working out. Bring a nutritious snack in case your blood sugar drops.
Urine tests are available at pharmacies, without a prescription. After dipping the test strip into urine, compare its color to the chart on the test packaging. A high level is dangerous, termed ketonuria, evidenced by dry mouth, strong thirst, frequent urination, and high blood sugar.
Without immediate medical care, ketonuria can progress to ketoacidosis. Symptoms include fruity breath, stomach pain, nausea, vomiting, difficulty breathing, flushed skin, confusion, and extreme fatigue.
Hopefully, you’ll never experience this condition, but it’s wise to know the symptoms, similar to hypoglycemia. They include feeling faint, dizzy, nauseous, confused, and sweaty. Also possible are headaches and muscle cramps.
If any of these symptoms are present, move to a cool environment, and drink some juice. Then, have someone bring you to a doctor.
6. Guard your feet.
Nerve damage in your feet reduces sensation, promoting injury without your awareness. Therefore, avoid sandals, flip-flops, and walking barefoot, exposing your feet to sharp objects. Every day, examine your skin. Promptly treat cuts and sores, and keep your feet dry to avoid fungal infection. See a podiatrist monthly.
Stay healthy during summer with ample hydration, balanced blood sugar, and protection of your insulin and medical supplies. Keep your house cool, and sleep on breathable sheets and a cooling pillow.
Before exercising outdoors, test your urine and blood sugar. If within the normal ranges, apply sunscreen and wear protective clothing. Then, check your blood sugar during and after exercise.
Keep water and healthy snacks with you, and be alert to the signs of hypoglycemia and overheating. Protect your feet from injury and fungus, and see a podiatrist monthly.
With all these smart precautions, you can smile in the face of summer!