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Diabetes Viewpoints

My Summer Diabetes Plan

Melissa Conrad Stoppler By Melissa Conrad Stöppler, M.D.

I’m fortunate, or unfortunate, depending upon your perspective, to live in a climate where hot summer weather is the norm for over six months of the year. As spring begins to arrive in other areas of the country, I’m already sitting in the 97-degree shade, planning how to heat-proof my diabetes care for the next half year.

The first and simplest step I need to take is to find a way to transport my insulin. Unless I’m planning to spend the late afternoon and evening at home, I’ll need to take my insulin (normally kept at home at room temperature in the air-conditioned house) with me wherever I go. And this can pose a problem if wherever I go happens to involve the outdoors. Insulin shouldn’t be exposed to extremely high temperatures or direct sunlight, so keeping my medications kit in the beach or pool bag isn’t a good idea. Even keeping the insulin in my purse won’t work, since I frequently carry that with me outdoors in the sun, too.

I’ve found that a cooler or refrigerator in the car is a necessity for me. That way, when it’s baking outside, my insulin (and beverages to combat dehydration; see below) will stay cool for hours, and I can leave it in the car without worry. Of course, the insulin doesn’t go directly on the ice packs in the cooler. Insulin cannot be allowed to freeze, since freezing and thawing are likely to change the chemistry of the insulin solution, leading to potential inaccuracies in dosing.

Many people find that injecting cold insulin is painful, but a quick warming of the vial in a closed fist will bring the solution to a normal room temperature.

For me, probably the most important aspect of heat-proofing my diabetes care plan in summer is remembering to stay well-hydrated. Dehydration is always a risk in extreme temperatures, particularly if you’re participating in outdoor activities. In this regard, the car cooler does double-duty. I plan to keep it stocked with plenty of water for both myself and the children along with a few diet sodas (my addiction, I admit). Plain water is fine for replenishing the fluids lost through sweating on a hot day; however, those who participate in very active sports will want to consider the need for replacement of critical electrolytes such as sodium and potassium, as well.

I know that staying well-hydrated poses extra challenges for people with diabetes, since high blood glucose levels result in excessive urination that can worsen dehydration. Since dehydration can also lead to instabilities in blood glucose levels, remembering to pack replacement fluids when out and about is essential for heat-proofing my own diabetes care plan. Another important point is limiting consumption of beverages containing alcohol or caffeine when outdoors in the heat. Both of these substances can have a diuretic effect that can increase fluid loss.

It really isn’t hard to adapt my diabetes care to summer heat. If only I could find some creative ideas for stress-proofing, mosquito-proofing, and tantrum-proofing our summer vacation…