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  • With Mayo Clinic diabetes educators

    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • June 7, 2012

    Heat and diabetes

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

35 comments posted

Controlling Your Diabetes

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Diabetes research is turning up new information on diabetes and diabetes management all the time. In 2009, I wrote a blog about the effects of heat on blood glucose control if you have diabetes. I mentioned, then, that heat doesn't have a direct effect on your blood glucose, but that heat can lead to changes in your daily routine which, in turn, can affect your blood glucose.

Later research, published in September 2010 by researchers at Mayo Clinic, Scottsdale, Ariz., suggests, additionally, that some Arizonans with diabetes have considerable gaps in their "heat awareness."

This lack of awareness led to actions such as waiting until temperatures were quite high (above 101 F, or 38.3 C) before taking precautions against the heat and leaving medications and supplies at home rather than risk exposing them to the heat — meaning not having the supplies to manage diabetes while away from home.

Sweating is an important means of cooling the body in hot weather, and the ability to sweat can be affected in some people with diabetes. Other studies have shown an increase in emergency room visits, in those who have diabetes, when temperatures are high. Diabetes equipment and medications can also be affected by heat.

Tips for managing diabetes in warm temperatures remain the same:

  • Avoid sunburn, it can stress your body and can raise your blood glucose. Wear a good sunscreen, sunglasses and hat when out in the sun.
  • Drink plenty of water to avoid dehydration. Carry a bottle of water with you on walks, etc.
  • Exercise and do more strenuous activities in the early or later hours of the day when the temperatures are cooler and the sun is not at its peak.
  • Check blood sugar levels frequently, since they may fluctuate.
  • Remember, extreme temperature changes can have an effect on your diabetes supplies; insulin can break down, blood glucose meters and test strips can be damaged, and altitude can affect blood glucose meter performance. Use insulated bags protected by a cool pack to safely store your supplies, but avoid freezing.
  • Wear light colored clothing made of fabrics that can "breathe."

In extreme heat, also take these extra measures:

  • Avoid exercising outdoors; choose an indoor, air-conditioned place.
  • Never go barefoot on hot surfaces.
  • Watch for signs of possible heat exhaustion such as dizziness, fainting and, for some people, excessive sweating. Seek medical attention if you experience these symptoms.
  • Avoid caffeinated or alcoholic beverages that can be dehydrating, in addition to drinking plenty of water.

Have a good summer, and remember to take precautions for the hot weather.

Regards,

Nancy

35 comments posted

blog index

  • June 19, 2013 12:20 p.m.

    Here on Mars it gets up to 350 degrees during the day so we use mortar for sunblock

    - silly

  • June 18, 2013 8:52 p.m.

    Can you say more about how altitude affects meters? I ran a search on this and found little on the subject, and that was more than a decade old? I am 59, live at 7500 ft. and relatively new to my T2 diagnosis and want to try and keep my relatively good health.

    - Deborah

  • June 18, 2013 2:39 p.m.

    Hey, I lived in Arizona for while and it does get hot there. I never went anywhere without my water bottle when I lived in Arizona. Stress affects everyone differently, with some people blood sugars will go up and others it will drop. Often people tell me that with activity in extreme heat their insulin requirements need to be lower.

    - Nancy and Peggy

  • June 18, 2013 11:35 a.m.

    Its odd to read the comments of those upset that Nancy's article. It seems some commenters may have missed her message. She DOES recognize that diabetics have increased trouble in heat. She states that diabetics have more trouble in heat BECAUSE they "lack heat awareness"! The nerve damage of diabetes means our bodies don't realize how hot they are getting and sweat less than folks with good nerves in their skin. She also warns that heat harms insulin and test strips. What I'm reading from Nancy is good advice saying take heat seriously. I think maybe some commenters misunderstood her message.

    - Jennae

  • June 11, 2013 1:49 a.m.

    I live in southeast Arizona at a mile high but it still gets into the high 90s. What about changes in insulin dosage and extreme heat? Should it be increased to offset increased stress on the body.

    - Jim Ret. RN

  • July 17, 2012 9:54 a.m.

    I was diagnosed with diabetes at the age of 7. I am now 70. I live in Virginia where the temperatures have been very high 100+. I have been without A/C for 25 days now due to many errors of my home warranty company and the local A/C company hired to replace the bad equipment. Yesterday the temperature in my home was 91 degrees. Thank God I woke up at 3:00 am. MY BS was 42. I decreased by 50% the bolus of my insulin pump for 4 hours and I drank lots of cold water. I am alive today. My A/C is scheduled to be repaired on Thursday so I must endure 2 more days of this heat wave. I am a strong woman but this frightens me.

    - Tracy

  • July 5, 2012 6:06 a.m.

    I believe it is a geinnatroeal thing, I'm 58 but I have heard this as child from my parents and other family members and I grew in New England but I do not know the origin of using the term sugar to mean diabetes. I also have a more general comment about your website.I agree with your idea of a strong diabetic, I was diagnosed with type 2 in 2004, at the time I weighed 323 lbs and also had hypertension and high cholesterol. I lost 150 lbs in 1 1/2 years and have maintained the weight loss. When diagnosed my a1c was 10.5 and fasting blood sugar was 257 and was prescribed glyburide. I changed my diet, started to exercise lost 20 lbs the first month. My fasting level dropped to 95-100 and was able to stop taking the medication. My yearly a1c test has been 4.2 for the last 6 years, fasting levels and 2 hrs after meals levels has been normal. I don't have hypertension and cholesterol levels are low. My exercise routine is 30 mins a day 3 to 5 days a week, including both cardio and weight training. My diet though is different from yours, I don't eat anything made from white flour, white rice and very little sugar. I do eat more whole grains, including whole wheat products and brown rice. A lot more fruits, vegetables, non fat dairy and less meat and fish. Eating more whole grains and fruit does not give me any spikes in my blood sugar, after eating a large meal that included whole wheat bread, vegetables including potato, fruit, and fish. My blood sugar level

    - Try

  • June 19, 2012 8:39 a.m.

    Hi Janis, I generally don't give out brand names but there is a product available by Frio that provides insulin cooling cases and they have a pump cooling wallet. The cooling works through the process of evaporation. I have had patients traveling in tropical areas that had no access to refridgeration and it worked well for them.

    - Nancy and Peggy

  • June 14, 2012 2:19 a.m.

    Should I expect that the strength of the insulin in my pump will diminish more quickly on hot days? If so, are there ways to keep my pump cooler when I am outdoors in the heat?

    - Janis

  • June 12, 2012 12:23 p.m.

    Your blog is just common sense. Tell us something that is new, different and will work! How are they doing on checking glucose levels without puncturing the skin! Try not to let your blood glucose to ever get over 200! Do not eat full meals, for diabetics to not spike, browse. BUT the key to weight loss is to reduce your insulin injections. Insulin makes you hungry. Dont take as much insulin and browse and NOT eat big meals. Simple, eh?

    - B'wana

  • June 8, 2012 1:47 p.m.

    My husband is type 1, extreme heat lowers his blood glucose due to heat causing his body to use his insulin more quickly. We were informed of this by a certified diabetes educator and confirmed by his M.D. Extreme cold can also cause lower readings. Either way, in extreme temps. we take precautions beyond what is normally recommended for the general population.

    - jean

  • May 28, 2012 8:25 p.m.

    I HAVE CENTRAL AIR AND I STAY IN ALL THE TIME EARLY IN THE MORNINGI WATER MY FLOWERS ALSO I HAVE A DIABETIC CAT 17YRS OLD HES ON INSULIN I KEEP IT COOL FOR HIM

    - VIVIAN

  • May 24, 2012 6:54 p.m.

    Hi, Nancy and Terry I have a problem. You are telling people lies such as the heat does no effect you at all on blood sugar, but it does. It really does. This is my problem. Thanks.

    - Person with a problem

  • May 22, 2012 5:55 p.m.

    I would suggest reading this site for people with type one and two. http://www.nytimes.com/2010/06/29/health/29real.html. Because as these experts say there is no direct effect well.... There is. I'm sorry about this experts but those are suggestions all people with or with out diabetes should do, drink water, sunscreen, but if not taken extra precautions for diabetics the heat can lead to very serious consequences.

    - Type one diabetic

  • May 22, 2012 5:45 p.m.

    I know your experts and all, but sorry to say the heat does effect us. Diabetics do not sweat the same as people without diabetes. I wound know being a type one diabetic.

    - Someone

  • April 11, 2012 3:41 p.m.

    Terry, As you know there are many variables that can affect your blood glucose. Heat does not have a direct effect on your blood glucose, but stress can. Generally, stress will raise the blood glucose.

    - Nancy and Peggy

  • April 3, 2012 5:25 p.m.

    I know this is an old blog. But I have been moved to an office that has averaged 86 degrees. I am 63 and I have Diabetes 2. My blood sugar has been very high. I am miserable in this office and they are trying to fix it. Will this heat make my blood sugar higher? My blood pressure has been average. My blood sugar has been 175 sometimes a little higher. If anyone can help . I control my blood sugar with tablets. Thank you so much

    - Terry

  • September 26, 2011 4:05 p.m.

    Norman: Sorry to hear about your fiancee. We recommend that you follow closely with an endocrinologist and a certified diabetes educator. The American Association of Diabetes Educators (www.diabeteseducator.org/) website lists diabetes educators in your area.

    - Nancy and Peggy

  • September 19, 2011 8:27 p.m.

    My fiancee is recovering in hospital from a serious case of DKA, she also had an embolus in the lung during her hospital stay. We neither of us wish to hVe this happen again. Could you please give us the the dos and don'ts so we can avoid this in the future.

    - Norman

  • June 13, 2011 12:06 p.m.

    Claudia: Ask his physician for a referral to a certified diabetes educator who will instruct you on insulin dose adjustment instructions. If you are from the US search the American Association of Diabetes Educator website for a list of certified diabetes educators near you.

    - Nancy and Peggy

  • June 10, 2011 3:09 p.m.

    I am taking care of my father-in-law. He takes 3-5 injections a day for high blood sugar. But he has occasions that it drops to a dangerous low. We cannot figure out why, or what is causing it. His doctor has not given a reason, just said keep something sweet near by. It can happen in the middle of the night, or suddenly at any time in between meal time. Is there a reason it does this?

    - Claudia

  • August 20, 2010 1:48 p.m.

    OK, so I understand about keeping insulin cool -- but how do you keep insulin cool in a pump if you work outside with heat indexes over a hundred on a regular basis? I assume that insulin is affected too by the heat -- isn't it?!?

    - Alaina

  • July 5, 2010 12:12 p.m.

    Why do farmers have a lower insulin requirement in the summer when they are in the fields? Thanks for any insights.

    - Walter

  • January 4, 2010 1:29 p.m.

    hello every body my name is cory and iam 17, i want to just say i am a hog (pig) hunter one day in the hot summer heat i caught a hog in my trap it was so hot i passed out and my bg(blood glucose) was reading on my meter critacal high. and went to the hospital and went into dka and got imitted to icu

    - cory

  • December 13, 2009 6:24 p.m.

    My son has Type 1 Diabetes which he seems to control very well according to regular Dr. check ups. However, he also has Muscular Dystrophy and is in a wheelchair, so his ability to exercise is almost nil. He has had both diseases since he was bout 17, and is 45 now. The last few years, his ankles have almost continuous sores, for which he applies an antibiotic prescription. Would a heated water foot spa, about 115 degrees, be helpful to his circulation, or in some way harm him? Thanks

    - Jerry

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