Summer is here once again, and it’s the classic time for taking family trips, swimming, and outdoor activities. Your (or your child’s) schedule has most likely changed, with different daily routines and responsibilities. So how does this all affect the management of T1D? How do you enjoy your summer while keeping close tabs on T1D management? The following are some tips to help you adapt:
Insulin: When you are going to be outside in the heat and direct sunlight for extended periods of time, it’s best to keep your insulin in a cool, dark place to keep it working well. A small lunch-size bag or pack with a cooling pack (or bagged ice) works well. If you are wearing a pump, keeping the pump out of direct sunlight should be the only precaution you need, as insulin close to your body is cooler than the ambient temperature.
Pump sites: If you are using an insulin pump, you will want to change your site every two days proactively. This will help avoid site failures, help keep adhesive working properly, and keep your insulin working optimally in relation to heat, sweat, and water exposures. If you need help with keeping your sites on for an appropriate length of time, discuss optional adhesives with your diabetes care provider.
Water sports: When it comes to swimming, diving, snorkeling, SCUBA, and other water activities, dealing with a pump or CGM can be challenging. Most pump and CGM sites are water resistant and should do fine with recreational swimming. If you are going to be in the water continuously or diving to depths beyond six feet, however, it is recommended that you discuss management options with your diabetes care provider. Those who are using pumps will want to consider using injections for days they are SCUBA diving, for example.
Hydration: Water, water, water! Please keep well hydrated when you are active in the heat. Your blood glucose is a concentration, so when your body water is low, the glucose concentration rises, meaning higher BGs.
Traveling: It is generally wise to bring more insulin than what you think you might need when you are traveling more than a few hours from home. Keep in mind that getting refills on your medication may be challenging if you just filled the item within the month, or if you are traveling out of state and don’t have access to your usual pharmacy. If you are using a pump, bring some long-acting insulin (such as Lantus, Levemir, etc.) and a copy of your current pump settings, just in case your pump fails and you need to revert to injections for a few days while you await a replacement.
Summer camp: If you are attending a diabetes-specific summer camp, there is not much to worry about, as there will be detailed instructions provided with regard to preparing for the camp, what to bring, etc. Also, such camps have a focus on direct supervision of diabetes care and are well equipped to help kids and teens with T1D stay safe while they have fun. If you are attending a general summer camp, it is advisable to create a diabetes management plan (similar to a diabetes school care plan) and to have your needs discussed with the camp’s medical staff before you attend. You will most likely be responsible for bringing your own supplies to such camps. It is also wise to discuss your safety concerns with your diabetes care provider before heading to camp.
Dr. Hahnke, Rachel Calendo, and the staff of BCS Endocrinology