A few months back, we discussed the effects of the winter season and cold weather on blood sugar in people with diabetes, arising from various factors, such as reduced physical activity, dietary changes, increased food consumption, and the body’s response to cold temperatures. Today, we are here to explore the other end of the spectrum — the impact of intense heat during the summer season on diabetics. Yes, there lies a connection here, too. But what is it? However, before we go on to decode the link, let’s first understand what diabetes exactly is.
Diabetes is a chronic health condition that significantly impacts the body’s ability to convert food into energy. When we consume food, the body breaks it down into glucose, which is then released into the bloodstream. In response to rising blood glucose levels, the pancreas secretes insulin, acting as a key to allow sugar into the body’s cells for energy utilisation. However, in individuals with diabetes, either insufficient insulin is produced or the body’s utilisation of insulin is compromised. Consequently, leading to excess blood sugar in the bloodstream.
So what happens during summer?
According to research by Penn’s Perelman School of Medicine, which studied almost 3 million geographically diverse patients, very high or low outdoor temperatures increase the occurrence of three potentially life-threatening conditions for people with type 2 diabetes: serious hypoglycemia (low blood sugar), diabetic ketoacidosis (overly acidic blood), and sudden cardiac arrest/ventricular arrhythmia (abrupt loss of heart function/too-fast heart rate).
Agreeing with the findings, Dr Aditi Chopra, Consultant, Diabetes and Endocrinology, Manipal Hospital, Old Airport Road, Bangalore said, “The summer season can be challenging for people with diabetes as they may encounter fluctuations in their blood glucose levels due to many reasons,” adding that diabetics tend to get dehydrated more quickly, provoking an increase in blood glucose levels.
“This can result in an increased need to urinate, which can worsen dehydration and create a vicious cycle,” she told indianexpress.com.
Concurring with Dr Chopra that the summer season can significantly affect diabetics, Dr Anusha Nadig, Associate Consultant, Endocrinology, Fortis Hospital, Bannerghatta Road, Bangalore said that in summer, diabetic patients are at risk of low and high sugars, along with water and electrolyte imbalance. “People with diabetes get dehydrated very easily. If you don’t hydrate yourself properly, it can raise blood glucose and cause frequent urination, which further adds to water loss from the body,” she said.
Dehydration, however, isn’t the only reason which makes the summer season complicated for diabetics. In some people, diabetes is known to damage the nerves that supply the sweat glands, leading to decreased sweating. “This is a problem, especially in summer, as the body may not cool efficiently, increasing the risk of heat exhaustion,” Dr Chopra said.
Dr Nadig agreed by explaining that diabetic patients with neuropathy can have abnormal sweat glands, thereby making it difficult for the body to cool down as the temperature outside rises. “Complications like heat exhaustion and heat stroke are common in diabetic patients, especially in elderly people and children.”
In addition to these complications, what makes this season particularly harder for patients is the difficulty in the storage and maintenance of the efficacy of insulin. “Extreme heat can affect the storage and efficacy of insulin and other diabetes medications,” Dr Manjeeta Nath Das, Senior Consultant, Internal Medicine, Narayana Superspeciality Hospital, Gurugram said.
This was corroborated by a study, published in BMJ Journals, which said that when stored at high temperatures, insulin’s efficacy could rapidly decline. Therefore, appropriate storage of in-use insulin is necessary to achieve its maximum therapeutic effects.
Dr Das added that another significant factor to keep in mind is that blood sugar readings can also be impacted by the season. “It can be due to factors such as increased perspiration, dehydration, and changes in insulin absorption. Dehydration can lead to more concentrated blood glucose readings, while excessive sweating can affect the accuracy of glucose monitoring devices. Additionally, test strips for blood sugar are temperature-sensitive as well, Dr Chopra added.
Experts further noted that people with hypoglycemia also need to be cautious during this season as they can also get affected. “The risk of hypoglycemia also increases in summer. Higher body metabolism with increasing temperature, coupled with a rise in the absorption of insulin in the body can precipitate hypoglycemia. To make matters worse, symptoms such as sweating and tiredness may be harder to spot in hot weather,” Dr Chopra said, suggesting always keeping a fast-acting carbohydrate handy, such as glucose tablets or a sugary drink.
Finally, Dr Nadig highlighted that high temperature and heat can change how the body uses insulin. As such, insulin doses may need adjustments during summer.
Here are some essential tips diabetics must keep in mind, as per experts.
*Drink plenty of water and other hydrating fluids to prevent dehydration. Avoid sugary drinks and alcohol.
*Store insulin and other diabetes medications properly, following the manufacturer’s instructions. Keep them away from direct sunlight or excessive heat.
*Dress in lightweight, breathable fabrics and consider wearing a medical ID bracelet or necklace to alert others about your diabetes in case of emergencies.
*Physical activity should not be done during the hottest part of the day; mornings or evenings should be preferred.
*Seek air-conditioned environments when possible, use fans, and take cool showers or baths to lower body temperature.
*Always carry diabetes supplies, including glucose meters, extra test strips, fast-acting glucose sources, and a glucagon emergency kit if prescribed.
*Communicate with healthcare professionals to adjust medication and insulin doses as needed.
*Don’t ignore signs of heat exhaustion or heatstroke; seek immediate medical attention if symptoms arise.
*Check your sugars more often, also before and after your activity.
*People with diabetic neuropathy should be careful and avoid walking barefoot on hot ground as it can cause burns.
*Test your blood sugar in a cool, shaded place and keep your test strips away from direct sunlight.
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