Southerners are not strangers to the formidable mix of high heat and humidity, but they would do well to get reacquainted with the increased risk it poses to the more fragile members of the population: young children, the elderly, and those who suffer from diabetes. Staying hydrated, keeping cool, and avoiding over-exertion are the key concerns, but diabetics have an additional concern - their medications can be affected by heat as well.
"Heat damages glucose meters, test strips, insulin and some of the oral medications," says J. Russell Harrington, MD, of St. Joseph's/Candler's Medical Group - Islands. "If you have some of these things even for 15 minutes in a 90 degree car, the heat is starting to throw off their accuracy and their effectiveness. We don't know exactly how much damage is occurring to these medications, but there is a risk, and a person might have a month's worth of medications in their car and in direct sunlight."
Though these supplies and medications get cooked if left in a car too long in the summer, Dr. Harrington advises that leaving them at home is not a smart option.
"Diabetics need to take their meters with them, because if their temperature is going up, then blood flow is increased, and the uptake of insulin may increase," Harrington says. "There are insulated packages or coolers that can keep your meter and your medications where they need to be-at room temperature-for when you are out of the house."
A proactive approach is best for diabetics not just for their medications but also for their own body temperature.
"You want to start hydrating before you're thirsty," Harrington says. "By the time you're thirsty, you're already dehydrated. Sweating is how we cool off, but a diabetic's ability to sweat is often impaired."
Dr. Harrington also advises diabetics to know exactly what kind of weather they are heading into when they go out.
"People in this region need to know about the heat index, because our humidity is higher than many other places," Harrington says. "Don't look at only the temperature but also the relative humidity-how hot it feels. If you're in the car or in direct sunlight on a humid day, an 85 degree temperature can feel like 90 to 100 in your body."
While diabetics may also lose electrolytes from sweating, Dr. Harrington advises that the typical sports drink is not the best solution.
"There's so much sugar in those sports drinks," Harrington says. "If you want something more than water, you should move into either zero-calorie beverages or dilute those sugary beverages with water."
Finally, Dr. Harrington stresses the need for help from others to limit time in the heat and keep rehydration on a schedule.
"If someone's blood sugar is rising too high, the person may get confused and not realize how dehydrated they are," Harrington says. "Everyone needs to keep an eye on their loved ones."
Your Summer List
Dr. Harrington believes knowledge is one of the most effective tools a diabetic patient can have, and he often refers those newly diagnosed with the disease to St. Josephs's/Candler's Center for Diabetes Management. The center stays up to date on the latest diabetes treatments and technology. The staff has the following recommendations for diabetics living in hot weather:
- Try to keep insulin out of direct sunlight and maintained at least at room temperature. Store medications in an insulated bag if possible when traveling.
- Keep a list of current medications on your person at all times if away from home. Medical bracelets are also
good to wear. Waterproof braceletes are available.
- Don't go barefoot. Always wear proper foot wear.
- Use sun block to protect the skin from too much sun.
- Drink water for hydration rather than sports drinks. Choose caffeine-free beverages to avoid a high loss of urine. Calorie-free beverages are smarter choices than the sugary drinks such as lemonade, sweet tea, and some fruit juices.
To learn more about the educational resources available at the Center for Diabetes Management, call 912.819.6146 or visit http://www.sjchs.org/CenterforDiabetesManagement.