Managing Diabetes Through Weather Extremes

August 28, 2023 | By Corinna Cornejo

It has been another year of extreme weather. Heatwaves. Flooding. Tornados. Cyclones. Often happening at unexpected times and in unexpected places.

Each month the weather seems more and more extreme. Life threatening high temperatures were recently felt throughout the Middle East and in China. In the Southwest U.S. one city (El Paso, TX) recorded temperatures above 100F/38C for 40 consecutive days.

July was recorded as the warmest month overall on record and 2023 could end up being the hottest year — they give it a 50-50 chance. 

We know that extreme weather can affect people’s health, including people living with diabetes. When weather extremes are the exception, happening occasionally and spaced wide apart, we have a chance to recover from the extra stress. But when there is no break, the effects become inescapable.

Weather extremes pose dangers for people with diabetes

When we experience the stress of weather extremes, whether it is very cold or very hot, it undoubtedly disrupts diabetes management. Extreme temperatures stress the body and put people with diabetes at risk of hypoglycemia and hyperglycemia — especially when it comes to hot weather. How can it do both of these things?

Hot weather can cause blood vessels to open up (i.e., dilate) affecting how much insulin is absorbed. As more insulin is absorbed blood glucose levels are driven down, potentially leading to a hypoglycemic episode.

Hot weather can also cause the body to sweat more in an effort to keep cool. If left unattended this can lead to dehydration, which, in turn can drive blood glucose levels up. Hyperglycemia is the result.

Tinotenda Dzikiti, diabetes advocate volunteering with a number of organizations in Africa and  fellow member of The Type patient editorial board, says he is extremely vulnerable to heat exhaustion and hot weather definitely takes a toll.

During hot summers in Africa, Tino often finds himself confused when his body begins to sweat. Is it his body cooling itself? Is the perspiration caused by a hypo? Or is he having a hyperglycemic episode? It could be any one of these. Does he need to drink some water or take some insulin? The only way for Tino to know is by checking his glucose levels. One thing for sure is he’ll probably want to change his shirt and freshen up after finding a place to cool down.

Weather extremes can disrupt the devices we use to manage diabetes

The best way to keep tabs on your blood glucose levels in extreme weather is to check more often using your glucometer or continuous glucose monitor (CGM). For these devices to remain accurate they too have to be protected from extreme temperatures. Test strips need to be stored properly in their container and within the manufacturer’s recommended temperature range. The meters themselves need to be kept away from direct sun and out of the heat.

Another example of how weather extremes are disrupting our diabetes devices is when they cause power outages. We don’t think about how dependent we’ve become on battery-powered devices and cellphone service.

Andrea Limboug, a Canadian now living in France who has been using a DIY Loop system for several years, shared her distress late one hot summer night when temperatures in her town had finally come down to the mid 90sF/30sC. The power went out and she realized her cellphone, which she uses as her CGM display, might not have enough of a charge to get her through the night. She had one charged battery pack at the ready and consciously decided to reserve it for her cellphone so that she could keep using her Loop system to manage her insulin dosing.

Afterward, Andrea admitted to feeling a little guilty of complaining about her “first world problem” when she posted about the impact this power blackout was having on her ability to manage her diabetes. But she went on to point out that this experience definitely reminded her to have backup plans for charging devices.

Weather extremes are one more thing to manage

With weather extremes becoming more common, they have become yet another thing we need to pay attention to as we manage daily life with diabetes.

The advice commonly given is familiar:

• Track blood glucose levels vigilantly
• Respond to hypos and hypers diligently
• Stay hydrated
• Minimize exposure to direct heat or cold
• Protect devices and test strips from direct heat or cold
• Make sure devices and battery packs are charged up
• Plan ahead

Dealing with extreme weather is part of our collective new normal. As we face this additional stress more regularly and for longer stretches, I cannot help but wonder what the long term impact will be on our health and quality of life. We can’t change the weather: we can only change how we prepare for it.

Diagnosed with type 2 diabetes a decade ago, Corinna Cornejo is a patient advocate and blogger who focuses is on health policy and developments in digital healthcare without losing sight of their potential impact on real people's lives. Corinna blogs at https://type2musings.com/  and can be found on Twitter and Facebook as @Type2Musings. The opinions presented in this blog post are those of the author and may not represent the opinions of Ascensia Diabetes Care. Ascensia have paid Corinna Cornejo an honorarium for her services as a contributor to this blog.