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How to Manage Your Diabetes in Extreme Summer Heat  

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How weather can affect your blood sugar  

 

We often look forward to a change of seasons and warmer temperatures. But if you have diabetes, you may be especially sensitive to the hot weather of summer.

Extreme heat can affect your blood sugar control. If you use insulin or your blood sugars aren’t effectively controlled, you could be at higher risk during the summer months. Worsening blood sugar control is often the main concern, and depending on your level of activity, developing low blood sugars may also be a concern.

If you’ve had complications from diabetes that have damaged the nerves to sweat glands, you may be unable to sweat properly. This can become serious as outdoor temperatures rise, leading to heat exhaustion and heat stroke.

Extreme temperatures can also damage your medications and testing equipment, says Dr. Marwan Hamaty, endocrinologist at Cleveland Clinic, Ohio. “I always remind my patients to take precautions to protect themselves and their supplies during both winter and summer.”

He says it’s important to get a handle on your blood sugar control before you engage in summer fun. “If your blood sugars are mostly higher than 250 mg/dl, I recommend improving your blood sugar control before engaging in heavy physical activity — regardless of the climate and the temperature, as recommended by the American Diabetes Association.”

Dr. Hamaty also advises that the extreme heat of summer affects blood sugar levels. How the heat affects your levels depends on what you’ve eaten, whether you’re well-hydrated and your activity level.

If the heat and your activity make you sweat a lot, you may become dehydrated, leading to a rise in glucose levels. “If you become dehydrated, your blood glucose levels will rise. This can lead to frequent urination, which then leads to further dehydration and even higher blood sugar levels — a kind of vicious cycle,” he says.

Things can become even worse if the treatment includes insulin: “Dehydration reduces blood supply to your skin and, therefore, the ability of your body to absorb the insulin you’ve injected is reduced,” he says.

Most types of insulin can tolerate temperatures up to 93-95 degrees Fahrenheit. Exposing your supply to anything higher than this will make the medication quickly break down. Be careful and pay attention to any insulin you’re carrying with you in the heat.

While it’s fine to store insulin and glucagon in the refrigerator, hot temperatures (as well as freezing temperatures) will cause the medications to degrade, making them ineffective and unusable. High temperatures can have a negative effect on other medications and diabetes management supplies too. Don’t forget about the weather’s effect on things like test strips and monitoring devices. When the mercury begins to rise, these items can change in their effectiveness.

Physical activity usually causes blood sugar levels to decrease, reducing your need for insulin. The sudden addition of exercise may put you at an increased risk for low blood sugars.

Therefore, if you’re active in extreme heat, know that you’re at high risk for both low and high blood sugars. This means you should take extra precautions and monitor your sugar levels before exercising.

“I advise my patients to maintain warm skin and adjust insulin dosage prior to engaging in physical activity because insulin adjustment could vary significantly,” says Dr. Hamaty. “But don’t allow the heat to keep you indoors. It’s OK to participate in outdoor activities and enjoy all types of weather as long as you take a few precautions.”

Dr. Hamaty also suggests seeking input from your doctor regardless of the temperature before adding physical activity to your routine.

Follow these tips to help manage your diabetes while enjoying the outdoors:

  1. Drink plenty of water.Staying hydrated is important for everyone during physical activity, and it’s especially critical if you have diabetes.
  2. Avoid becoming dehydrated.Carry small bottles of water or low-calorie electrolyte-replenishing sports drinks in a backpack or on a belt while you’re hiking or playing sports.
  3. Adjust your insulin as needed.Ask your provider or diabetes educator how you should adjust your insulin (and sometimes eating extra carbohydrates) before exercising. Typically, your first few doctor’s visits focus on urgent issues, such as getting diabetes under control. Ask about how to adjust your insulin so you can prepare to be physically active.
  4. Test your blood sugar levels frequently.Since hot temperatures can cause blood sugar levels to fluctuate, it’s a good idea to test more often. That way, you can take appropriate and immediate action to keep your levels stable. You should continue frequent monitoring for several hours after you’re done with your workout or other activity. That’s because the effects of activities on blood sugars usually last for a longer period of time.
  5. Keep items to treat low blood sugar with you. This includes glucose tabs or glucose gel. If you’re at high risk for very low blood sugar (if you have frequent low blood sugar or had very low blood sugar previously), you should also have a glucagon kit available.
  6. Take some snacks with you.Some snacks can serve as a meal replacement while others help prevent low blood sugar. Discuss possible options with your dietitian.
  7. Protect your medication and supplies. Take proactive steps to protect your insulin, glucagon kit and other supplies before you head outdoors, regardless of the temperature. Consider a car cooler that plugs into a 12-volt car adapter to keep your supplies at the proper temperature. This will keep the temperature stable for some time. If you’re going away from your car for an extended period, you’ll need to take your supplies along with you. If you are on insulin pump, be sure to protect your insulin pump from high temperatures. Depending on the situation and how long your activity will be, you might simply need to monitor your glucose more often. In certain circumstances (if it’s extremely hot or you’re out for an extended amount of time) consider using a long-acting insulin temporarily along with meal insulin injection instead of an insulin pump.
  8. Avoid sunburn. You can get sunburned while skiing on the slopes or while hiking in the summer. Sunburn stresses your body and can raise blood sugar levels. Use a broad-spectrum sunscreen and wear protective eye gear.
  9. Finally, limit how much time you spend outside in extreme temperatures. “While I advise staying active during the peak winter or summer months, I also tell my patients to try to take advantage of outdoors activities when temperatures aren’t too extreme,” says Dr. Hamaty. By taking a few precautions, you can enjoy an active, healthy lifestyle in most any weather.

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Government

PDM Leader responds to National Debate question on Healthcare

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Deandrea Hamilton

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Turks and Caicos, February 3, 2025 – The PDM, if elected government, will create a treatment policy which focuses on getting residents the best possible care and ensure proper funding for treatment abroad travel, said Edwin Astwood during the live-streamed National Debate on Thursday January 30.

“On day one, I will bring a treatment abroad policy to Cabinet, to reverse what is there now.  We will ensure wherever you can get the top treatment you will be sent to.  Whether it is the USA, whether it is Canada, we will not say that you can only go into the Caribbean region.  We want the best for our people, we will put the money there in the treatment abroad policy that we can send you to places where we believe and where the data shows you can get the best treatment possible for you to fully recover and fully be healed, that is what the PDM is about.”

Astwood, who has led the PDM since 2021 and is a former Minister of Health for the TCI said medical centers will not be selected based on a limited budget and a common complaint will be no more.

“We will not send people abroad without having money in their pocket.  We will not send people abroad to be put out of hotels. We will not send people abroad to be put out of hospitals.  We will ensure that whatever allowance you need, you will get that before you go.”

In July 2022, a National Insurance Board Appeals Tribunal was established to field concerns and respond directly to contributor’s complaints, however, in the years following its set up little has been said about the effectiveness or impact of that body.

Additionally, Astwood addressed the quality of healthcare generally in the islands.

“Our people were healthier 15 years ago.  The records can show that; if you look at the birth rate compared to the death rate you will see that that ratio is higher now in ‘23-’24 than what it was in 2017, in 2015 and before.  On day one, I myself is going to push through the Cabinet a bill to ensure that primary health care is rejuvenated in all of our communities.

We know that in order to keep our people healthy, we have to look at prevention. Prevention is always better than cure, the honourable premier’s style is always to put the bandaid on the bleed.  But we (PDM) always want to go in there and stop the bleeding so that you don’t need the bandaid.  So that is what we are going to do, we are going address healthcare at its root cause and put the primary health care clinics back in every community.

He said the goal is for there to be early detection through early screenings.  Astwood said the country’s profits in recent years meant it could afford to set up an Intensive Care Unit.

“They also messed up the entire NHIP system.  Now our people cannot even get an air ambulance to come to the Turks and Caicos islands because they bankrupted the NHIP.  They made it where people are at a critical state.”

The PDM leaders shared that during a recent House of Assembly sitting, members approved $10 million dollars to pay outstanding medical bills.

Also on the PDM agenda is attention to oncology and all aspects of neonatal care due to a raised standard at the Cheshire Hall and Cockburn Town Medical Centers.

“We will get those health professionals in the hospitals.  No more will you see persons googling, to find out what your diagnosis is, we will get the proper machines for scanning.  No longer will you have those misdiagnosis and wrong diagnosis like under the honourable premier and no more will you be sent to places without money.”

He said the PDM has all of the plans to fix healthcare in the Turks and Caicos.

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Health

Premier addresses Healthcare during National Debate

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Deandrea Hamilton

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Turks and Caicos, February 3, 2025 – The Progressive National Party established  the National Health Insurance Board and the TCI Hospitals, so if there is something wrong with either of them, the PNP will fix it, explained Washington Misick during the Thursday January 30 National Debate, viewed by 38,000 people.

“We have a good infrastructure, yes we have some management issues and we are in the process of establishing a National Health Authority to deal with the whole healthcare system.  Including building poly-clinics within the various communities to take the strain off the hospitals.  We will be opening up to 10 beds in Providenciales at the hospital here, and putting in two ICU units.  We will be expanding the facilities in Grand Turk.”

April 2025 will mark 15 years since the hospitals were opened in Providenciales and Grand Turk with clinical care managed by InterHealth Canada on a contract to the tune of nearly $5 million per month.

A recent report posted on the hospital’s website explains, “Patient volumes for certain services have reached peaks 17 years earlier than expected. For example, the number of outpatient visits recorded in 2015 has surpassed the volume projected at 2033 by nearly 15,000 visits. This means a large number of persons are accessing the services far beyond what was predicted.”

Government in December informed the public that, “Under the original contract, the services delivered were to be best in class. However, for some time there have been concerns that TCIG was not receiving good value for money or the quality services it was paying for.

The Turks and Caicos Islands Government (TCIG) has redoubled efforts to hold IHC to account, including the retention of specialist PPP advisers. As a result, TCIG believes it has established areas of non-compliance that could result in TCIG being able to pursue various remedies under the contract. Whilst IHC have disputed this, the last few months have seen greater dialogue in which a settlement of outstanding issues was sought.”

The Premier was adamant that his government is a caring one and would iron out the myriad of issues, which have been well publicised, on the state of health care in the country.  That includes being more supportive of terminally ill patients, building medical professionals capacity at home and making adjustments at the NIB.

Here’s what he said during the debate:

“And we will build for those persons who need palliative care because they are terminally ill and staying in hospitals beds, restrictive visiting ability; to build a hospice first in Providenciales so that they can live out the rest of their lives in comfort with palliative medication where their relatives can visit them and spend time with them.”

Another plan was laid out.

“We will be focusing on developing expertise and competency in the country so that the level of referral abroad will be reduced and we wouldn’t be sending our patients in future to just any place, we will be sending them to centres of excellence and that doesn’t mean they will be going necessarily to the United States because there are centers of excellence all over the world some of them in our own region, so we have thought this thing through.”

Premier Washington Misick, who is leader of the Progressive National Party (PNP) and Minister of Finance, Investment and Trade said there is reform on the horizon for the National Health Insurance Plan.

“That program is being reformed so that we get value for money, “ he added, “ We are building a healthcare system where we can reduce the number of patients that are referred abroad.  We need to upskill our medical professionals here, to develop specialties and the level of referrals abroad will then come down.”

But that could take years and currently he NHIP is falling short on funding regularly, as the medical needs of contributors surge well ahead of projections, as pointed out in the TCI Hospitals report online.

“Whatever is wrong with NHIP; we are fully cognizant of it.  We have a full team working on transitioning the Hospital to the system to the public Health authority and fixing the NHIB.  Yes, we have issues with the NHIB, we established it, we appreciate that the healthcare of people is important to us so we fixed it and we will fix it again. That’s what we do.”

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Caribbean News

WRHA Investing $340M in Digital X-Ray Units

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Montego Bay, Jamaica, February 3, 2025 – Six state- of- the- art digital X-ray units valued at $340 million, are currently being installed at hospitals by the Western Regional Health Authority (WRHA).

The new units are being placed at the Cornwall Regional Hospital (CRH) in St. James, (two units); Falmouth Public General Hospital in Trelawny (two units); Savanna-la-mar Public General Hospital in Westmoreland (one unit) and the Noel Holmes Hospital in Hanover (one unit).

In an interview with JIS News, Clinical Coordinator at CRH, Dr. Delroy Fray welcomed the acquisitions, noting that they will vastly improve the delivery of service at the facility.

“We are working towards zero downtime in terms of these services, so we are one step ahead. For some time, we have been having some problems, we have had breakdowns, and so forth. We are aiming to minimize all the outsourcing that we have been doing,” Dr. Fray said.

He informed that the new machines will be in place in the next two to three weeks, and that a 160 slice CT (computed tomography) machine will also be installed at the facility.

For his part, Manager of Radiology at CRH, Stewart Lawrence, outlined that the X-ray machines will be “the highest specification of machines you can get.”

“They are not the first of their kind, but this is the first area where we are putting in two at the same time and doing a mammography imaging suite with a mammogram machine, and we will be doing biopsies there. [We] also plan to commission a CT machine very soon,” he said.

“We will be moving away from the outsourcing; we are hoping to have everything done here. So, we don’t want to give patients any far appointments, which is a thing of the past. We want patients to come in and get through in reasonable time, so they can go back to their clinics and get their diagnosis, so we have better patient management,” Mr. Lawrence stated.

The manager also outlined that the machines would come with service contracts to ensure that they are properly serviced and maintained.

“I will be following up and ensuring that everything works to the best that they can. We will ensure that one person is in charge of each machine. They should do all the scheduled servicing, follow up everything on the machine, all the error logs will be reported on, so we will keep a good audit trail of each machine to ensure that the government’s money is well spent,” Mr. Lawrence assured.

 

Release: JIS

Contact: Serena Grant

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