November 26, 2012

Diabetes - Safety Tips for All Seasons

I agree that many people need reminding for what to do during the heat of summer and then again when winter comes around. I had intended to do one blog for summer and winter, but why not for the entire year. The suggestions and tips do vary somewhat by the season, but need to become second nature to prevent loss of diabetes supplies to nature's whims and brutal elements. Each season also has its own unique problems for your health.

In thinking this over, I am surprised at how many are applicable every day. Those with type 1 diabetes can determine when they wish to take a pump vacation. Let's not mistake that I live in the northern part of the USA and I am writing for this area. The southern part of the USA will require some modifications for hotter summers and milder winters. Others will have to adapt this for where they live.

Staying hydrated is important for all seasons. Too many people are lured into a false sense of well-being except in summer when we know we must stay hydrated. It is this false security that gets people into trouble in spring and fall when they have been working outdoors. They think that they don't need water as they have not been doing strenuous activity and have been sweating very little. Little do they realize they have been losing moisture to evaporation and because it is cooler or there is a breeze that their system hasn't needed to create sweat.

Don't think you need to worry about drinking water in the winter? That false sense of security will cause you damage and dehydration problems. Most people do not realize how hard it is to walk in snow, shovel snow, or just how much they sweat just moving around outside. With today's clothing, moisture may be wicked away from the skin and you will not feel wet until you are back inside and removing layers. When you come to the wet clothing, just realize that you may be more dehydrated than you realize.

You may not need to drink as much water in the fall, winter, and spring as you do in the summer, but dehydration is just as possible and in some ways more dangerous because you think you are not dehydrated. This article about electric fan use in the summer heat is very interesting about the dangers involved for the very young and elderly.

Analyze the feelings or symptoms is especially important in the summer when you may think you are experiencing hypoglycemia, but the symptoms might just as easily be heat exhaustion or on the verge of sunstroke. First get to an air conditioned area if one is available and have a good drink of water. If an air-conditioned building is not available, get to a shaded area and make sure that you are not constricted by heavy clothing or unable to pull the blouse or shirt out of jeans, skirt, or pants to allow for easier evaporation. Test your blood glucose to help you determine if you are low. If this is correct, definitely chew on a glucose tablet and retest in 15 minutes. Otherwise make plans to get to an air conditioned facility or hospital as soon as reasonably possible. Heat or sunstroke is a medical emergency and should be dealt with immediately.

Yes, you probably may not experience heat exhaustion during the winter, but during the spring and fall, hot days do happen. Always be prepared.

Wear appropriate footwear is very important. This means probably different footwear for the different seasons and where you will be. Because of blood glucose levels, many people must wear proper footwear to prevent injury and having the injury become infected. This is important for healing when injury could have been prevented. Too many people like to wear nothing on their feet during the summer months whether inside or outside. All it takes a shard of glass, a nail, or other sharp object to do the damage, and if you have neuropathy or numbness in your feet, you may not to notice that you have injured yourself. Then if this area becomes infected, you may not catch it in time to prevent proper healing and this can be when the fear of amputation sets in.

Keep diabetes supplies in appropriate containers is sound advice. The container that holds your test strips keeps them fresh and ready to use. Avoid exposing the container and the test strips to direct sunlight and prevent moisture from getting into the container. Depending on where you are, consider keeping the container of test strips in a zip lock bag and the bag in a cooler with ice packs or a Frio container. Also keep you meter out of direct sunlight and in the same manner as the test strips. Always store the test strips between 36° Fahrenheit and 90° F (2° Celsius to 32° C). Do not expose the test strips to heat, moisture, or humidity. Temperatures outside the required ranges, as well as moisture and humidity, can damage the test strips and lead to inaccurate results.

Insulin that is unopened should be stored in the refrigerator between 36–46°F (2–8°C). If the insulin becomes frozen, it must be destroyed. Once the vial has been opened, it may be stored at room temperature below 86°F (30°C). Keep the vial in a place away from direct sunlight and heat. Do not use after 28 days once the vile is opened. For carrying insulin vials or insulin pens outside, use a cooler with ice packs or a Frio container. In the winter, use insulated packs for carrying insulin as insulin cannot be frozen, and if frozen it must be destroyed.

Oral medications should also be protected from direct sunlight and moisture. Some oral medications have specific storage instruction. Therefore carefully read the instructions that come with your oral medications, or have a long talk with your pharmacist for specifics. Read this for safety tips on insulin and syringes.

Wear appropriate clothing for the season. Protect yourself from sunburn during the entire year. We are all aware of the late spring through early fall, but sunburn also happens in the winter when the sun reflects off the snow. If you are outside for an extended period of time, beware of sunburn. Protect yourself from frostbite during the coldest part of winter.

Rules for driving are important to know as each state is different and the doctors in each state may have different reporting requirements for people with diabetes. So learn as much as you can about the rules in your state. Many states require doctors to report hypoglycemic tendencies and evaluate your risk for doing the testing and maintaining of safe blood glucose levels while driving. Some states maintain records of accidents caused by hypoglycemia and do suspend driving privileges for these accidents. If you are a person that has hypoglycemia frequently, always be sure to test before you start driving. It is always good to test before driving if you have type 1 diabetes or are a type 2 on insulin or sulfonylureas or the other oral medications that cause hypoglycemia.

For the applicable laws of your state, please read this.

Suggestions for exercising are not something to be taken lightly. Too many people do not discuss exercising regimens with their doctor and get themselves in danger for not having routines that are safe for their health condition. Most doctors will encourage exercise and offer suggestions for safe exercise. They will also do tests to assist in determining the limits, if any, that need to be in place for the season or the location for the exercise. It is important to know your blood glucose before you exercise and I have written about this here. More safety tips for exercising may be read here.

Tips for skin care are important in any season. People with diabetes are very susceptible to many skin problems. Thirty three percent of people with diabetes can expect the have a skin disorder caused by or affected by diabetes some time in their lives. If a skin condition is caught early it can be easily treated and many skin conditions can be prevented. Read this for more information. 

Some skin conditions anyone can have, but people with diabetes get more easily. These include bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis.

Tips for foot care can be important all the time. Everyone should have good foot care, but for people with diabetes, a daily self-care routine is a must habit. If you have feet or leg nerve damage (neuropathy), you may have an injury and not realize it. This is why a daily check is so important to discover small cuts or wounds before they become infected.

Too many people ignore this advice and wonder why they develop serious problems or complications – leading to amputations. About 85% of amputations could be prevented if the patient has it treated early. For more information please read this.

Safety tips for summer – read this.

Safety tips for winter – read this.

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