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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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Bahamas News

Introducing The Bahamas Cannabis Authority; Marijuana Bill tabled by Darville

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Garfield Ekon

Staff Writer

 

#TheBahamas, May 20, 2024 – A medical marijuana industry is set for establishment in The Bahamas, following the tabling of the Cannabis Bill, 2024, in the House of Assembly, by Minister of Health and Wellness, Hon. Dr Michael Darville, May 15.

The Minister said objective of legislation is to set up a framework to establish The Bahamas Cannabis Authority, and to regulate the of importation, exportation, cultivation, processing, manufacturing, producing, sale, possession, distribution, and use of cannabis.

He told the Assembly that the law represents a thoughtful and balanced approach and was driven by a duty to act as he referenced the number of Bahamians who are battling cancer and in need of alternative treatments for pain management and other related issues.

“The legislative package, the Cannabis Bill, 2024 is designed to introduce a controlled system of cannabis use in medical treatments. The bill establishes the Bahamas Cannabis Authority.  A regulatory body overseeing all aspects of cannabis management and cultivation and distribution.  The authority’s mandate is to ensure that cannabis production and use are safe, controlled and effectively integrated into our health care system,” Minister Darville said.

Adding that the Dangerous Drugs (Amendment) Bill, 2023 that he also tabled, reclassifies cannabis by removing it from the dangerous drug list, now recognises its potential for medical use, he said the change aligns “our nations laws” with evolving global perspectives on cannabis.

The new law makes provisions for the licensing of cannabis handlers across various aspects of The Bahamas, and Dr. Darville said the licensing is structured to prioritise Bahamian ownership, with provisions ensuring that significant control remains in the hands of Bahamian nationals, fostering local entrepreneurship and economic benefits “for Bahamians across the country.

“We are here to make a difference, to enact change, remove years of stigma and transform lives by offering alternative treatments by way of medical cannabis.  The legislation before us offers a careful, considerate approach ensuring that we prioritize the wellbeing and safety of our citizens. Let us move with compassion,” he said.

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Health

National Health Sector Strategic Plan Launched 

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Dana Malcolm 

Staff Writer 

 

#TurksandCaicos, May 20, 2024 – The Turks and Caicos is attempting to optimize the tens of millions it spends on healthcare each year with a new National Health Sector Strategic Plan to guide how money is allocated and increase efficiency in healthcare and increase health equity.

Shaun Malcolm, Minister of Health presented the theme ‘Building a Strong Resilient and Sustainable Healthcare System for Future Generations Brick by Brick’.

Desiree Lewis, Permanent Secretary of Health explained that the document “identifies and prioritizes key health issues and challenges facing the population allowing resources to be allocated efficiently to address those priorities.”

In doing so the plan is also supposed to promote collaboration between the various stakeholders in the Health industry including policy makers, legislators, doctors and other healthcare professionals on the ground; giving them an outlined set of objectives to work on in their various spheres, for a specific collective outcome.

”This will facilitate a more unified approach to addressing health challenges and leveraging resources effectively,” Lewis explains.

Modeled to achieve the UN Sustainable Development Goal number 3 which is to ensure healthy lives and promote well-being for all at all ages, the plan was developed during COVID-19 and presented by Lynrod Brooks, Director of Health Policy and Planning in the Ministry of Health and Human Services.

The plan maintains that in order to attain a healthier and empowered people there are three key actions necessary: protecting health gain, already achieved in the country; addressing past deficiencies; and identifying and implementing interventions to address new health challenges.

In order to achieve the goals set out, in addition to the three key actions there are six Strategic Directions that health stakeholders will follow

  • SD1 Strengthen Leadership, Governance and Administration: ‘Ensuring entities transform resources into results,’
  • SD2 Protect and Improve Universal Health Coverage (UHC): ‘Provide people of all ages and all health needs with health services.’
  • SD3 Address Health Security: ‘Identify outbreaks and other health threats.’
  • SD4 Promote Healthy Populations: ‘Support the creation of a conducive environment to support well-being, healthy living,’
  • SD5 Invest in Health: ‘Ensure appropriate resources are available and efficiently used.’
  • SD6 Improve Data for Impact: Increase the availability, quality and use of timely and accurate health information

Some of the priority areas under the health plan that these six Strategic Directions seek to address include, pandemic prevention; increased mental and behavioral healthcare; Strengthened national capacity against health emergencies and disasters; universal access to comprehensive, quality health services; reduced risk of non-communicable diseases; and Increased equitable access to essential medicines and vaccines.

The 3 year document will also make provisions for monitoring and evaluation so policy makers can assess if the plan is actually working. It’s billed to enhance accountability with a quarterly report to be presented for the 3-year period.

Attending the event were a myriad of professionals and policy makers indicative of the many areas of the healthcare industry which the plan will affect; attendees included: Dr Rufus Ewing, Former Premier and Minister of Health; Dr. Eldonna Boisson, the Pan American Health Organization representative for the Turks and Caicos and The Bahamas; Dr Ellis Webster, Premier of Anguilla; Washington Misick, TCI Premier; Dileeni Daniel Selvaratnam, TCI Governor and others.

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Health

Cause for Alarm; 7% Diabetic, 19% Hypertensive in TCI

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Dana Malcolm

Staff Writer 

 

#TurksandCaicos, May 20, 2024 – Health numbers in the Turks and Caicos are showing a concerning increase in lifestyle diseases according to recent statistics shared by Dr. Camelia Clarke, Director of Health Promotion and Advocacy Unit, who detailed the concerns recorded by the Ministry of Health.

”In 2021– we found that 19 percent of the population was hypertensive and a significant chunk was the 55 and up age group, we are an aging population. We are victims of our success. We’ve done well in terms of communicable diseases and we are living longer, but we are getting sicker as we become older,” the director explained at the launch of the National Healthcare Sector Strategic Plan on May 14.

Globally NCDs are separated into five categories, Mental Health, Cardiovascular Diseases, Chronic Respiratory Diseases, Cancers, and Diabetes and when they occur its bad for everyone.

“There’s a heavy, economic burden, not just on individuals, but families, communities and health systems in general. While NCDs present in different ways there are five common underlying risk factors; physical inactivity, unhealthy diet, immoderate use of alcohol, tobacco use and poor air quality,” Clarke revealed.

These five factors and the resulting five categories of diseases account for over 70 percent of deaths worldwide, the Director explained, citing that 15 million of the 41 million people who die each year, are part of the working age group which she described as ‘a significant economic knock’.

The breakdown of the Turks and Caicos’ illnesses in 2021 via phone survey, found that of the 19 percent of hypertensive residents locally, 41 percent were 55 and over, 19 percent were 35 to 54 and 9 percent were between 18 and 34 years old. Additionally 7 percent of the overall population was found to be diabetic.

Between 2015 to 2019, the number one cause of death was drowning owing to freak accidents where migrant boats capsized, but next to that was NCDs which were responsible for about half of all the deaths recorded during the period with cardiovascular diseases being particularly deadly.

Instances of Breast Cancer in the Turks and Caicos were also described as ‘significantly high’ along with a notable increase in overall cancer diagnoses locally. Between 2010 and 2013 diagnoses were more than six times higher according to the TCI Hospital.

In addition to that came a significant increase in deaths, and in the Turks and Caicos between 2021 and 2023 over $2 million was spent treating cancers, and over $300,000 on cardiovascular diseases just for overseas treatment.

Children in the Turks and Caicos are at risk as well, Clarke cited a 2015 study that showed primary school age children were experiencing risks associated with diet and physical activity.

”We also found that, unacceptably, out of every 10 children, four of them were considered overweight or obese— compounding that we found that they were taking less fruits and vegetables than we wanted them to and not exercising as much as we want. The future is looking kind of bleak,” Clarke admitted.

To stave off that future the National Healthcare Sector Strategic Plan has goals such as increased health promotion, removal of barriers to early detection of NCDs, decreased mortality, and more data.

Clarke maintained that by setting ambitious goals like those included in the National Healthcare Sector Strategic Plan the country could slowly but surely decrease the concerning numbers.

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