Summertime Precautions for Active People Living with T1D

Written by Amanda S. Masters, T1D Mom with a M.S. in Exercise Science

summer time
Summer weather with its heat and humidity can pose extra dangers for people living with type 1 diabetes.  Below is a list of suggestions to help keep your T1D healthy all summer long!

  • Stay hydrated – Drink fluids throughout the day. Hot weather, exercise, and high blood sugars quickly lead to dehydration.  Remember, when you feel thirsty, you are already dehydrated.  Water is the best choice because sugary drinks will not re-hydrate you as well.  Replenishing with electrolyte-balanced liquids, such as sports drinks, is only advisable when physically active and losing fluids through excessive perspiration (don’t forget to account for the sugar content). In general, it is best to avoid beverages with added sugars and chemicals.  Another great way to hydrate is through eating fresh fruit.  Fruits, such as melons, with high water content are a great source to help quench thirst.
  • Check blood sugars regularly – Test your blood glucose levels often! You may need to check more often in extreme heat or humidity.  You should also check before swimming, playing sports or exercising.  It is unsafe to exercise with high blood sugar levels (blood glucose > 250 mg/dl).  One should never exercise if ketones are present.  For safety, especially in summer heat and when playing sports or exercising, consider wearing a medic alert bracelet or necklace.
  • Check insulin pump and CGM infusion sites – Check your sites throughout the day and suspect a bad site if blood sugar runs high. Take extra care to secure your insulin pump infusion site during hot and humid weather, especially when exercising or swimming.   You may need to prepare the site with a skin-prep wipe that leaves behind a tacky residue for better adhesion or use extra tape.  Spraying antiperspirant on the skin before inserting the infusion set may also help with adhesion.  Do not use extra sticky wipes or antiperspirant with a CGM sensor, as it may affect the device’s accuracy.
  • Keep pump covered and insulin cool – Keep insulin out of direct sunlight. Insulin becomes less effective when exposed to prolonged heat. If you are planning a day at the beach or water park, or perhaps long hours at the soccer field, then store insulin pens, vials and your blood glucose meter in a cooler (but not directly in ice).  Additionally, insulin pumps are usually safe when against the body, but if you are outside with temperatures exceeding 90° F, be sure to cover it or use a cooling device to keep the pump from malfunctioning.
  • Exercise early or late – Plan exercises and outdoor activities for the cooler parts of the day, such as early morning or late evening. Exercise in air conditioning when the temperature soars above 85°.  If exercising or participating in outdoor events, be aware of the signs of heat exhaustion, such as feelings of dizziness, sweating excessively, developing a headache, cold or clammy skin, developing muscle cramps or nausea.  Most importantly, if you do not feel well after being in the heat, move to a cooler place, drink clear fluids and contact your doctor.
  • Wear appropriate clothing – The higher the humidity, the less able your body is to cool itself by sweating. Dress to allow maximum sweat evaporation by wearing light-colored, light-weight, UV-protection clothing particularly when heat indexes reach 85°F – 90°F or higher.  Don’t forget about your shoes!  Wearing flip-flops or open-shoes (such as sandals) might not provide enough protection from injury or possible infections, especially if you have neuropathy.  Sweating makes the feet more prone to yeast or fungal infections.  Walking barefoot on hot pavement or sand may cause blisters or open sores. Select socks that wick away sweat inside running shoes or sneakers.
  • Limit alcohol – Temper alcohol consumption, especially in the sun, as it can affect the body’s ability to regulate internal temperature. Consider wine spritzers and diet mixers to limit sugars and drink two glasses of water to every one alcoholic drink to stay hydrated.
  • Stock up supplies – If you are going on summer vacation, be sure you are well stocked with insulin, devices, and extra supplies, including extra pump and CGM batteries. If you use a pump, bring back-up syringes and vials of long- and short-acting insulin.  Have a plan in place in case you run out and are not in a convenient place to obtain more.  When flying, it is advisable to have your doctor write a note stating your condition and have your pharmacy print out your prescription in the appropriate language if you’ll be visiting a foreign country.  Also, be sure to pack all supplies in your carry-on luggage. Have a list with names and numbers of your medical facility, doctors, pharmacy, and emergency contacts. List out your medications and have a copy of your insurance card.  Go over this information with a traveling companion.  If you experience a medical emergency, another adult will have the information necessary to assist you and quickly communicate to a medical team.
  • Stock up on food – When traveling a distance by car or plane, pack enough snacks and meals you can eat during transit. Often flight schedules and meal times will not coincide with a T1D’s food schedule.  Additionally, you should have necessary food to treat a low (glucose tablets, candy, gels, juice, and other carbohydrate snacks).
  • Set your watch – when taking multiple daily injections and crossing time zones, use long-acting insulin at the same time you take it at home.  For example, if you self-inject at home at 9 AM and you’ll be traveling west, losing three hours, then you would need to take your insulin at 6 AM.  Short-acting insulin can still be taken at meal-time, regardless of time changes.  If you wear a pump, change to the destination time as soon as you begin your flight.
  • Attend summer camp – A child living with type 1 diabetes should attend a summer diabetes camp! It not only helps the child, but the entire family benefits from the experience.  Find a camp near you! For many T1D children, camp may be the only place where everyone is the same…checking sugar levels, counting carbs, and administering insulin.  It may give the child additional confidence in managing their condition, perhaps confidence to attend other summer camps or other times away from mom and dad.  For the family, camp offers time to take a “vacation” from the disease, knowing their child will be well supervised.  It may also be a chance to focus on other family members without worrying about type 1 diabetes.

Works Cited

American Diabetes Association. Diabetes Forecast, The Healthy Living Magazine. Summer Fun and Safety Tips, May 2012.  http://www.diabetesforecast.org/2012/may/summer-fun-and-safety-tips.html

Chronic Conditions Team, Cleveland Clinic.  7 Critical Precautions for Summer If You Have Diabetes. https://health.clevelandclinic.org/2014/07/7-critical-precautions-for-summer-if-you-have-diabetes/

Davidson, Nancy Klobassa, R.N. and Moreland, Peggy, R.N., C.D.E. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-blog/diabetes-and-summer/bgp-20056545

Summer Safety Tips and Diabetes. Children’s Hospital of Philadelphia. http://www.chop.edu/health-resources/summer-safety-tips-and-diabetes

About the Author

Amanda S. Masters, M.S. Exercise Science, MBA, ACSM-CPT, NASM-PES, is a personal fitness trainer and has been in the fitness industry for over 15 years, teaching group exercise classes and training children through senior citizens in cardiovascular wellness, body strength, agility, sports skills and more. Additionally, she is a national fitness presenter for the International Sports Conditioning Association.  Amanda has a daughter with type 1 diabetes.