How the Dog Days of Summer Affect Your Diabetes

Whether you are going on vacation or just spending time outdoors in the summer heat, the high temperatures and humidity are harder on people with chronic diseases such as diabetes.

People with chronic diseases like diabetes, are at higher risk of having problems and may not be aware of the danger.  People who take certain medications, including heart disease medications and diuretics (water pills), which can be used to treat complications of diabetes also need to be careful in the heat.

Tips for people with diabetes during these steamy, hot summer days and nights:

* Drink lots of nonalcoholic fluids. Dehydration, or the loss of body fluids, can happen in the summer heat whether you have diabetes or not. When your body is exposed to heat, you lose more water through sweat, which can dehydrate you. Dehydration increases blood sugar levels. High blood sugar will make you urinate (go to the bathroom) more often, which can dehydrate you even more.  Most types of insulin, especially short-acting insulin, don’t work as well when blood flow is decreased. To prevent dehydration drink plenty of caffeine-free, nonalcoholic fluids like water or sugar-free iced lemonade and juice. Limit your use of alcohol.

* Watch for signs of heat related illness, especially if you are working or exercising outdoors. People with diabetes and other chronic diseases, like heart disease, are more likely to overheat quicker. Symptoms include: feeling dizzy or fainting; sweating a lot; muscle cramps; skin that feels cold or clammy; headaches; fast heartbeat and/or nausea (feeling like you have to throw up). If you have any of these symptoms, move to a cooler place (in the shade or inside with air conditioning), drink fluids like water, sugar-free juice or sports drinks (based on your healthcare provider’s instructions) and get medical attention.

* Avoid sunburn. Sunburn damages your skin and can make diabetes control even harder. A bad sunburn causes inflammation (swelling), which raises blood sugar levels. Put on a broad-spectrum sunscreen and wear protective clothing (loose-fitting, lightweight, and light-colored clothing), sunglasses and a wide-brimmed hat whenever you go outside.

* Exercise and enjoy physical activity in a cool place,such as an air-conditioned gym, or early in the morning or later in the evening when temperatures may be a bit lower.  Physical activity is key to managing diabetes, but try not to be active outdoors during the hottest part of the day or when the heat index is high. Check your blood sugar every hour or two while you are being physically active. Watch for both high and low blood sugar levels. Your blood sugar can drop more quickly if you are on a medication that lowers your blood sugar. Being outside in hot weather and exercising can have the same symptoms, such as sweating and a fast heart rate, so it’s easy to miss the early symptoms of low blood sugar.

* Check blood glucose levels at least four times per day–more often if you are not feeling well. Remember that heat can cause blood glucose levels to change. Bring juice, glucose tablets, or glucose gel along with you wherever you go in case your blood sugar drops.

* Store your blood glucose meter, strips and insulin in a cool, dry place. Do not store insulin in too hot or too cold temperatures. Never store insulin in the freezer, direct sunlight, the car or the car’s glove compartment.  Always check your vials of insulin; clear insulin (Regular, Humalog, Novolog, Apidra, Lantus, and Levemir) should stay clear. Neutral Protamine Hagedorn (NPH) insulin should not have any clumping or “frosting” on the vials.

* Take care of your feet. Avoid walking barefoot, especially if you have nerve damage that lowers your ability to feel sharp objects and hot surfaces–you might hurt or burn yourself and not realize it. Wear protective shoes. Check your feet every day for cuts and other injuries. Also look for a scaly rash on your feet and white spots between your toes, which could be caused by a fungus or athlete’s foot. Sweaty feet make you more likely to get athlete’s foot and other fungal infections. Keep your feet dry and see your health care provider about treating athlete’s foot with an antifungal cream as soon as you see it.

Tips For Insulin Pump Users:

For insulin pump users, increased sweating can be a problem.  Sweating can loosen the glue material that holds the infusion set (the part of the device that attaches to your body) together.  If you sweat a lot, try using a spray of antiperspirant on the insertion site after your usual skin-preparation routine. Others have tried skin-barrier preparations such as Mastisol, Skin-Tac H or a compound tincture of benzoin applied to the skin.

The pump housing provides some insulation from the heat but, if you leave pump in a hot car or hot area, the insulin will start to degrade. Bring along a cooler to keep insulin at room temperature or below.  If you are spending a lot of time in the sun, cover the pump with a towel to protect it from direct sunlight.  Heat can also damage test strips, which can cause false readings. This could cause you to take too much or too little insulin and affect your blood sugar management.

If you have diabetes and have any questions about dealing with summertime heat, talk with your health care provider.

Want to know more?  Visit:

Managing Diabetes in the Heat – Centers for Disease Control and Prevention (CDC)

How to Stay Cool in Extreme Heat – CDC video

Tips For Preventing Heat-Related Illness – CDC

Extreme Heat Fact Sheet – Federal Emergency Management Agency (FEMA)

Don’t Forget About Our Pets and the Heat!  Visit:

Keep Pets Safe in the Heat (Humane Society of the United States)

Summer Pet Safety Tips – American Red Cross (ARC), scroll down the page