Diabetes Simplified: Turning up the Heat
Can heat affect blood sugar levels?
By Wil Dubois
I had neglected to take the chicken out to thaw the night before, so I set the rock-hard breasts on my back porch in a pool of 95-degree sunshine to "quick thaw." Then I promptly forgot all about them. Until right before dinner.
The chicken went way beyond thawed, but fell far short of being cooked by the sun. The meat was hot to the touch, and the color was… well, funky.
That's what happens when you heat a protein but don't quite cook it. It gets funky. What does this have to do with diabetes? Insulin, my friends, is a protein. And that, in a nutshell, answers the question, "Can heat affect blood sugar levels?" Yes it can, because cooked insulin gets funky and won't lower your blood sugar; or at least it won't lower it as well as it should.
But how hot is too hot? When do you need to break out the ice in the summer to keep your insulin as cool as your beer? And what are your options for keeping your key medicine cold while you're out enjoying the summer heat?
Too hot to handle?
The maximum temperature insulin can reach before heat degrades it depends on the brand of insulin, so you'll have to look at that little piece of paper that comes in each and every box of insulin. You know, that one with the fine print that you always throw away without reading.
Most types of insulin have a top temperature of 86 degrees Fahrenheit, but there's at least one formulation that can handle temps as high as your body— 98.6 degrees F. Still, many summer locations can easily top either of these maximum temperatures, so you need to plan ahead for a fun and healthy summer.
On the road, over the road, beyond the road
If it's 110 degrees in the shade, and you're making a quick dash from your air-conditioned car to your air-conditioned hotel, don't worry about protecting your insulin. It will be fine. Research shows that very short exposure to high heat has no effect on the effectiveness of insulin. But on the other hand, if you're taking on the Iron Man Sahara challenge wearing your insulin pump, you need to think ahead.
A good working mantra is that short exposure to even very high heat won't harm your insulin; while long exposure to even slightly higher than recommended heat levels can. (Exception to the rule: Extreme heat. If you happened to drop your insulin vial into a pot of boiling water while making spaghetti, it's all over.)
The bottom line to remember is that heat damage to insulin is not instant. It requires both exposure and time. Exactly how much time? Well, that's the 64 million dollar question. None of the manufacturers publish data on exactly how long it takes heat to damage insulin, and I've never seen any published studies that have looked into it. Oh, wait. That's wrong. I did once read a case study about a guy who heated some insulin in a microwave and things turned out badly. But he's probably one of those guys who needs a warning label that coffee is hot.
When it comes to heat and insulin, I think some common sense goes a long way. If you're hot and sweaty, then I'm betting your insulin is, too. If I had to pick a number for the heck of it, I'd say that if your insulin is going to be exposed to temperatures higher than the manufacturer recommends for more than an hour, you need to protect it. But remember, I got that one-hour figure from a Ouija Board, not from clinical research. I'll run through your options for keeping your stash cool in a minute, but first a quick detour.
Most of us have both "active" insulin supplies, plus "inventory" insulin supplies. The active insulin is the pen or vial we are using, or for pumpers, the insulin in the reservoir. Our inventory is the rest of the pens in the box, the spare vials, or the vial the reservoir is being filled from. Active insulin should always be at room temp, because cold insulin stings; while the inventory should always be protected from heat by keeping it refrigerated. This is particularly important when taking lengthy summer vacations involving travel.
Of course, regardless of the outdoor temp, you should never leave your insulin in your car in the summer. According to research done by San Francisco State University professor Jan Null, on a 90 degree day, the temperature inside a parked car can reach 138 degrees in just an hour and a half.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...