For those with diabetes, Central Texas heat could be especially worrisome

Nicole Villalpando, Austin American-Statesman
·4 min read

Anyone spending an extended amount of time outside in Central Texas right now knows one thing: It's hot.

With no end in sight to our summer of triple-digit temperatures, everyone needs to take precautions to avoid heat exhaustion and heat stroke.

People with diabetes, though, need to be extra careful, as their bodies don't dissipate heat as well, said Dr. Jean Chen from Texas Diabetes and Endocrinology.

Diabetes interferes with some of our natural responses to heat. Normally, heat causes blood vessels to vasodilate, or expand, to help release heat through the skin. "That's why the skin gets red and hot," Chen said.

When someone has diabetes that is not well-regulated by medication, their blood vessels don't do that as well, making it hard for them to release the heat. Their sweat glands also can be affected by diabetes, Chen said. Sweat is important to help cool the body through evaporation.

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Know the signs of heat illnesses

The symptoms of heat illnesses can mimic the symptoms of low blood sugar. A person with diabetes might try to treat themselves for low blood sugar instead of heat exhaustion. With low-blood sugar they might drink a sugary drink like orange juice, but with heat illnesses, they need to rehydrate with water.

Heat illnesses have three levels that increase in seriousness:

Heat cramps: Noticeable sweating; muscle aches; prickly heat rash especially in areas where clothing meets the skin such as the waistband; and dizziness. Move the person to a cooler area, hydrate, remove excess clothing and put cold compresses (a wet towel or shirt or icepack) on hands, feet, armpits, neck, forehead to cool them down. Call a doctor to get an assessment.

Heat exhaustion: Flushed skin; sweating even more heavily; cold or clammy skin; nausea; not wanting to eat; and a shallow heartbeat. Move the person to a cooler area, hydrate with water or an electrolyte drink, remove excess clothing and use cold compresses or spray them with water to cool them down. Call the doctor to see if you need to go to the emergency room or a doctor's office.

Heat stroke: No sweating; fast heartbeat; confusion; fainting or feeling faint; breathing quickly; confusion or delirium; loss of consciousness; and a high temperature. This is a medical emergency. If you can quickly drive them to the emergency room, great. If not, call an ambulance. While driving or waiting for the ambulance, try to do all the same interventions as for less serious heat illnesses: hydration, cooler area, less clothing, and cold compresses.

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Be prepared with proper supplies

If you're heading out to an outdoor event, make sure you have your diabetic supplies to both test your blood sugar as well as to give yourself additional insulin should you need it.

Those supplies, including the testing strips and the insulin, need to be kept in a cooler out of the heat. If you use a pump or a glucose monitor, have extra pump or monitor supplies.

"Always try to be smart, to be proactive," Chen said.

In addition, being proactive means following the advice for all people going outside in Texas heat:

  • Drink plenty of water, not alcohol or caffeinated drinks. "Hydrate, hydrate, hydrate and please, when I say 'hydrate,' it's water," Chen said. The rule of thumb is 8 ounces of water every 20 minutes. Your urine should be clear, not dark.

  • Find the shade or create your own shade with a canopy.

  • Wear lightweight, light-colored breathable clothing to reflect the sunlight rather than absorb it.

  • Avoid being outside in the heat of the day ― 2 p.m. to 6 p.m.

  • Don't leave pets or kids in cars for any length of time.

  • Wear sunscreen and reapply it every hour or two.

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Know your numbers

In the United States, 1 in 5 people with diabetes don't know they have it, according to the Centers for Disease Control and Prevention. Annual checkups with blood work are important.

Diabetes warning signs include fatigue, weight loss, extra thirst and urinating frequently (almost every hour).

When you have diabetes, Chen says, you want to have an A1C, which is an average of your blood sugar levels over a three month period, of below 7%. Between 7% and 8.9% means that your diabetes is not at goal or well-regulated. When it is 9.0% or more, that means your diabetes is considered critical.

A normal A1C would be below 5.7% and having prediabetes would be 5.7% to 6.4%, according to the CDC.

Doctors also worry when a snap-shot blood glucose reading is above 250.

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This article originally appeared on Austin American-Statesman: For those with diabetes, Central Texas heat could be especially worrisome