Everyone looks forward to summer and outdoor activities such as swimming, sports, and get togethers. Unfortunately, summer can also make managing diabetes harder. Staying well hydrated is important for many reasons. The summer heat can cause sweating and lead to dehydration. High blood sugars can also lead to dehydration (due to the loss of water in the urine when blood sugars are abnormally high) and makes the kidneys work harder.
Increased activity levels during the warmer months increases the risk for low blood sugar (hypoglycemia). Taking insulin or diabetic medications called sulfonylureas such as glimepiride, glipizide and glyburide increases the risk of low blood sugar even more. Regular blood sugar testing prior to and during activities can help prevent these activity related low blood sugars. Changes in medications (especially insulin) may be needed more often during the summer months.
For diabetics using insulin pumps and glucose sensors, sweating can make applying these devices to the skin more difficult. Type 1 diabetics (those who need insulin to survive) can have very high blood sugars that lead to a hospital stay if their pump infusion set falls out without their knowledge of it for long periods of time. This is why testing blood sugars more often is important in order to prevent problems. There are other ways to help these devices stick to the skin better during the summer months such as using a special skin prep. Some diabetics go on “pump holidays” during the summer where they go back to insulin injections to avoid these problems. Summer sports may involve swimming or boating and many insulin pumps are not water proof- another reason that many diabetics go on “pump holidays” over the summer months. Ask your diabetes healthcare team what will work best for you.
Diabetics who use insulin to control their blood sugars must be more careful about storing their insulins when the temperatures inside and out are warmer. Insulins not in use and unopened should stay in the refrigerator until use. Insulin that is currently being used should be kept at room temperature and out of the sun to avoid breakdown of insulin which decreases its ability to lower control blood sugars. Coolers should be used to prevent insulin from being exposed to heat and sunshine. A blood sugar meter left in the heat or sun can also overheat and may not work until it cools down.
Believe it or not, sunburn and injuries that cause pain can also cause the blood sugar to be higher. Using sunscreen and avoiding injuries can help keep blood sugar well controlled during the summer months.
Finally, don’t forget to talk with your diabetes healthcare team before making any changes in your medications and for any problems you may have related to your diabetes.