Health

How to Manage Your Diabetes in Extreme Summer Heat

Published

7 months ago

September 24, 2023

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:

Drink plenty of water.Staying hydrated is important for everyone during physical activity, and it’s especially critical if you have diabetes.
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.
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.
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.
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.
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.
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.
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.
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.

Health

Dengue Getting Worst

Published

4 days ago

April 27, 2024

Shanieka

Rashaed Esson

Staff Writer

#Dengue#Caribbean#CentralandSouthAmerica, April 25, 2024 – New data from the Pan American Organisation(PAHO), indicates that dengue in the region may hit an all time high now over 4 million cases, a 260 percent increase from 2023 with over 1700 deaths registered since mid April. In fact, since April, reports say Brazil has reported the most cases. As a result of the surge in cases, the U.S. Centers for Disease Control and Prevention (CDC), reissued its Level 1 Travel Health Advisory for the Americas on April 18, 2024 and the countries listed include the Turks and Caicos, Guadeloupe and French Guiana, as they have been seeing higher than usual levels of infection.

Health

Increased cases of Chicken Pox Prompts Ministry of Health and Human Services Response

Published

4 days ago

April 27, 2024

Shanieka

PRESS RELEASE

MINISTRY OF HEALTH & HUMAN SERVICES

Providenciales, Turks and Caicos Islands, 25 April 2024 – The Ministry of Health and Human Services is issuing a public advisory regarding a recent increase in chicken pox cases, particularly within school communities in the regions of Grand Turk and Providenciales. The Ministry is actively monitoring the situation and is working closely with affected schools to provide support and education aimed at preventing further spread of the virus.

Chicken pox, caused by the varicella-zoster virus, is a highly contagious infection characterized by a distinctive rash of itchy red spots or blisters. Transmission occurs via droplets, aerosols, or direct contact with respiratory secretions, and almost always produces clinical disease in susceptible individuals. While mostly a mild disorder in childhood, varicella tends to be more severe in adults. It may be fatal, especially in neonates and in immunocompromised persons. The Ministry urges parents, teachers, and the general public to remain vigilant and familiarize themselves with the signs and symptoms of chicken pox, which may include:

Rash: The primary symptom of chicken pox is a rash that typically begins as small red spots, which then develop into fluid-filled blisters over several days.
Fever: Children with chicken pox may experience a mild to moderate fever, often preceding the appearance of the rash.
Fatigue: Some individuals may feel generally unwell, tired, or lethargic.
Loss of Appetite: A decreased desire to eat may accompany other symptoms of chicken pox.

Management aims to relieve symptoms and reduce the risk of complications and may include:

drinking plenty of fluid (try popsicles if your child is not drinking) to avoid dehydration.
taking paracetamol to help with pain and discomfort.
cut your child’s fingernails and put socks on their hands at night to stop them scratching.
use cooling creams or gels e.g. Calamine lotion
speak to your health care provider about using antihistamine medicine to help itching.
bathe in cool water and pat the skin dry (do not rub)
dress in loose clothes.

do not use ibuprofen unless advised to do so by a doctor, as it may cause serious skin infections.
do not give aspirin to children under 16.
do not go near newborn babies, or anyone who is pregnant or has a weakened immune system, as chickenpox can be dangerous for them.
do not scratch the spots, as scratching can cause scarring.

To mitigate the spread of chicken pox within schools and communities, the Ministry emphasizes the importance of practicing good hygiene habits, including frequent handwashing with soap and water, covering coughs and sneezes with a tissue or elbow, and avoiding close contact with infected individuals.

In the event that a child exhibits symptoms of chicken pox, parents and caregivers are advised to keep them at home and seek medical attention promptly. A sick leave for a period of 14 days is usually given. After the 14 day sick leave period, the individual must return to the physician or the public health nurse at one of the primary care clinics to obtain a fit for work or school certificate allowing them re-entry back into school or work. Anyone returning earlier than this time or without this certificate should not be allowed in school so as to prevent spread to other children. Additionally, it is crucial to inform school authorities to prevent further transmission among classmates and staff.

The Ministry of Health and Human Services is committed to ensuring the health and well-being of all citizens, and will continue to work diligently to address this current situation. For further information and guidance on chicken pox prevention and management, please visit Turks and Caicos Islands Ministry of Health and Human Services Facebook page at https://www.facebook.com/tciministryofhealth/.

Caribbean News

CARPHA Supports Antigua and Barbuda in Building Capacity for upcoming Mass Gathering Events

Published

6 days ago

April 24, 2024

Shanieka

St. John’s, Antigua and Barbuda. April 17^th 2024. The Caribbean Public Health Agency (CARPHA) is conducting an integrated mission to Antigua and Barbuda (ANU) during April 15-19^th to build capacity in surveillance, early warning and response systems, laboratory capacity, competence in health and food safety, and prepare for the launch of the CARPHA Regional Tourism and Health Program (THP), ahead of the 4^th International Conference of Small Developing Island States (SIDS), Sailing Week, the ICC Men’s T20 World Cup, and other major upcoming mass gathering(MG) events.

The CARPHA mission, led by Dr. Lisa Indar, Director, Surveillance, Disease Prevention and Control Division (SDPC), comprises persons from several CARPHA departments: Dr. Laura-Lee Boodram, Head, Caribbean Regional Field Epidemiology and Laboratory Training Programme, Dr. Michelle Hamilton, Head of Laboratory Services and Networks (LSN), Dr. Jarelle Branford and Ms Sheena DeSilva from Health Information Communicable Diseases and Emergency Response (HCE), Ms Neeta Oudit (LSN), Mr. Keston Daniel and Dr. Anushka Bissoon-Pustam of the Regional Tourism and Health Program (THP), and Mr Mohammed Elsherbiny, Senior Technical Advisor to the THP from the UKHSA.

Dr. Kamaria De Castro, Acting Chief Medical Officer, remarked “The partnership is timely as it helps to improve capacity as it assists in developing a sustainable future. We want to protect our local population as well as our visitors and let them know that we are aware of public health threats and we are preparing, building capacity, training and procuring resources that will be put in place to effectively prevent major spread of diseases. She extended her gratitude to CARPHA for the continued support and partnership.”

Dr. Lisa Indar indicated, “It is important to prevent public health threats to stop them from becoming emergencies as visitors are coming in from many different countries for Cricket World Cup, SIDS, Sailing Week and we want to make sure our visitors as well as our people are safe. We want to put systems in place and strengthen existing systems to be able to identify risks early and begin immediate and more timely responses to mitigate the potential spread of diseases.”

Key outcomes and activities of this mission include:

High level endorsements for the capacity building missions from the Ministers of Health, and Tourism
Formation of an Antigua and Barbuda THP Steering Committee for promoting healthier safer tourism
Communicable Diseases Surveillance workshop for Health Workers across the health sector to understand case definitions and timely reporting to the central level.
National Risk Assessment for mass gatherings, using the WHO/PAHO Mass Gathering Risk Assessment Tool, the results of which will be used to guide preparation and response for the upcoming MGs.
Desktop simulation exercises with doctors, public health nurses, Emergency Medical Services, law enforcement, National Office of Disaster Services, Red Cross and laboratory workers to assess how participants will respond to multiple public health scenarios during mass gathering events and identify gaps/challenges of the same.
Rapid response training for public health professionals, including persons from the security/defense force and the National Office of Disaster Services and partners. The training will review scenarios that necessitate mounting a response to a public health emergency by rapidly dispatching a multidisciplinary team to investigate and implement mitigating measures to contain the situation.
Mass gatherings surveillance training for surveillance team, public health nurses and other members within the health sector. An all-hands-on-deck approach will be taken to emphasize the need for daily and real-time reporting, monitoring, response, coordination, and communication. CARPHA’s regional mass gathering syndromic surveillance system (MGSS) is detailed, including national surveillance, tourism-based surveillance and the new module developed for mass gatherings . Doctors, nurses, and surveillance officers to be present at the health stations for the 4^th UN SIDS Conference will also be trained and registered on MGSS.
Engagement with the health, tourism, and port authority teams to discuss ways to bolster disease surveillance of cruise ships for Antigua and Barbuda as a large number of the transient population for the country is through cruises, especially as Antigua and Barbuda is a homeport for many cruise ships.
Conduct field visits to major hotels (including the ones hosting the players and officials for the T20 games) to get them registered on the confidential early warning THiS system.
Training on Food and Environmental Health safety during mass gatherings for food handlers and restaurants, including those who will be providing the catering services for the SIDS Conference. The training focuses on ensuring all food handlers are equipped with the appropriate knowledge and tools to prepare, cook, store and serve food to guests at the establishments and in a Mass Gathering setting.
Training in Prevention and Control of Infectious Diseases, for the hospitality sector with an additional focus on Mass Gatherings. The session aims to build capacity to quickly identify and respond to cases of infectious diseases and will include participants from the hotel, food and beverage sectors some of which will be working closely with the SIDS Conference and will be working with the upcoming Cricket World Cup.
Assessments of the laboratory network of Antigua and Barbuda for optimization of laboratory services available in-country. Training in testing for priority pathogens during an emergency response and/or mass gathering will be conducted.

As a highly tourism-dependent country, Antigua welcomes as much as 20,000 visitors daily, further highlighting the need for robust visitor-based surveillance. These workshops will provide instruments in identifying and addressing various challenges of Antigua and Barbuda in preparing for mass gatherings. This joint mission aims to strengthen Antigua and Barbuda’s surveillance and response capacity and preparedness to effectively anticipate and manage potential challenges, ensuring a seamless and secure SIDS conference, T20 CWC tournament, Sailing Week and Carnival experience for all.

CARPHA and Antigua and Barbuda continue to work toward supporting Antigua and Barbuda’s preparation for these large-scale mass gathering events and for the large number of tourists visiting the islands on a daily and weekly basis. CARPHA stands ready to continue supporting Antigua and Barbuda.