Hypothermia Is A Symptom Of Severe Hypoglycemia Which Can Of Course Be Life
Annette, a 47-year-old African-American female with Type 1 diabetes mellitus, was admitted to the hospital with a foot infection that was progressive despite therapy with intravenous vancomycin.
Annette had a long-standing history of type 1 diabetes. She had developed significant peripheral neuropathy and had previous diabetic foot infections, which had led to partial amputations of both feet. Her diabetes was controlled with insulin glargine , as well as a prandial insulin aspart sliding scale. Her medical history was also remarkable for a remote history of seizures, for which she took no medication.
Your Blood Sugar Knows Best
Kids out of school, vacations, get-togethers, family reunions. The summer season can throw off your routine, and possibly your diabetes management plan. Check your blood sugar more often to make sure its in your target range no matter what the summer brings. Its especially important to recognize what low blood sugar;feels like and treat it as soon as possible.
Play it safe in the sun with a hat and sunglasses.
Warm-weather wisdom:
- Drink plenty of watereven if youre not thirstyso you dont get dehydrated.
- Avoid alcohol and drinks with caffeine, like coffee and energy or sports drinks. They can lead to water loss and spike your blood sugar levels.
- Check your blood sugar before, during, and after youre active. You may need to change how much insulin you use. Ask your doctor if you would like help in adjusting your dosage.
- Wear loose-fitting, lightweight, light-colored clothing.
- Wear sunscreen and a hat when youre outside. Sunburn can raise your blood sugar levels.
- Dont go barefoot, even on the beach or at the pool.
- Use your air conditioner or go to an air-conditioned building or mall to stay cool. In very high heat, a room fan wont cool you enough.
Downside Of Exogenous Insulin
The number of Americans living with diabetes has more than tripled over the past 30 years, and by 2014, 29.1 million Americans had been diagnosed with the disease.1,2 Patients with Type 1 diabetes are entirely insulin-deficient due to a loss of insulin-producing pancreatic beta cells, usually as a result of autoimmune destruction of these cells.
For Type 1 diabetics, the standard method for lowering glucose is to inject exogenous insulin into the body. While Type 1 diabetics are a minority of the overall diabetic population, comprising only 5% of all diabetic patients, they are at the greatest risk of hypoglycemia because of their total dependence on exogenous insulin, which lowers the serum glucose regardless of its current level. In 2011, there were approximately 282,000 emergency room visits of adults ages 18 years or older with hypoglycemia as the primary diagnosis and diabetes as a secondary diagnosis.2
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Glycemic Control During Thermal Stress
It is well established that glycemia levels decrease in those with diabetes during an acute exercise bout, with more pronounced reductions observed during aerobic activities. Hot ambient conditions can also independently modulate glycemia by increasing insulin absorption and are reported to have additive effects to exercise in decreasing blood glucose levels. These findings were supported during exercise wherein 75% of participants with type 1 diabetes required glucose supplementation during 90;min of cycling as well as in type 2 diabetes by Hooper who noted that a 3 week exposure in a hot tub resulted in a rapid decrease of HbA1c by ~1% and fasting blood glucose by ~1.3;mmol·L-1 . Even local heating of the insulin injection site can lower post-prandial glycemia through increasing insulin absorption and activity, and has been suggested as a potential avenue to improve long-term glycemic control. The mechanisms for these improvements remain unclear; however, it has been postulated that increases in muscle blood flow associated with heating and/or activation of heat shock protein 70.
Managing Diabetes In The Heat
How to keep your cool during the hottest time of year.
Take steps to stay cool when the weather heats up.
Did you know that people who have diabetesboth type 1 and type 2feel the heat more than people who dont have diabetes? Some reasons why:
- Certain diabetes complications, such as damage to blood vessels and nerves, can affect your sweat glands so your body cant cool as effectively. That can lead to heat exhaustion and heat stroke, which is a medical emergency.
- People with diabetes get dehydrated more quickly. Not drinking enough liquids can raise blood sugar, and high blood sugar can make you urinate more, causing dehydration. Some commonly used medicines like diuretics can dehydrate you, too.
- High temperatures can change how your body uses insulin. You may need to test your blood sugar more often and adjust your insulin dose and what you eat and drink.
- Get medical attention for heat-related illness.
- Make a plan in case you lose power.
- Have a go-bag ready for emergencies.
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How To Fix It And Prevent It
First of all, when youre outside on particularly hot days, remember to check your blood sugar regularly. You cant anticipate dehydration and high blood sugars because taking extra insulin prior to being dehydrated could easily lead to hypoglycemia. The better approach is to try and avoid dehydration by drinking plenty of water and checking your blood sugar frequently when youre in hot conditions.
For mild to moderate dehydration, youll want to get out of the heat, chug some water, and take a carefully calculated correction dose of insulin using your correction factor.; It can be tempting to take a larger than normal correction dose of insulin, but this can lead to a rapidly plummeting low blood sugar.
Remember, part of the high blood sugar is simply concentrated glucose because there isnt enough water in your bloodstream. Part of what will bring it down in addition to insulin is simply drinking water and rehydrating. Thats why you should resist taking a rage bolus of insulin to correct the high.
In the future, when youre hanging out in hot temperatures, drinking plenty of water should be one of your diabetes management priorities!
The Effects Of Low Blood Sugar On Your Body
Every cell in your body needs energy to function. The main source of energy might come as a surprise: Its sugar, also known as glucose. Blood sugar is essential to proper brain, heart, and digestive function. It even helps keep your skin and vision healthy.
When your blood sugar levels fall below the normal range, its called hypoglycemia. There are many identifiable symptoms of low blood sugar, but the only way to know if you have low blood sugar is by taking a blood glucose test.
Learn more about the symptoms of low blood sugar, as well as the long-term effects on the body.
most common reasons for low blood sugar are some medications used to treat diabetes, such as insulin.
In type 1 diabetes, the pancreas can no longer produce insulin. In type 2 diabetes, the pancreas doesnt make enough insulin, or your body cant use it properly. Too much insulin or oral diabetic medication can lower the blood sugar level, leading to hypoglycemia.
However, contrary to popular belief, low blood sugar isnt exclusive to diabetes, though it is rare. It can also happen if your body makes more insulin than it should.
Another possible cause of low blood sugar is drinking too much alcohol, especially over long periods of time. This can interfere with the livers ability to create a buildup of glucose and then release it into your bloodstream when you need it.
Other causes include:
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Heat And Low Blood Sugars
As usual, diabetes management is never simple. Sometimes, those hot, hot summer days can enable your body to burn glucose far more quickly than usual. Much like the slow and steady burn of glucose during a steady walk, your body is burning extra glucose while trying to keep your body cool.
Exercising on a hot, humid day when you are properly hydrated can easily result in low blood sugars despite doing everything youd normally do during that work to prevent lows.;
While research has shown that your body works harder to stay warm in cold weather compared to cooling off in hot weather, theres still an increased caloric burn that could result in burning more glucose, too.;
Unfortunately, its very hard to predict what extent of hot weather might lead to a low blood sugar because of other factors like what you last ate, insulin on-board, activity level, hydration level, and current blood sugar level. Even variables like your menstrual cycle could lead to an entirely different blood sugar response while exercising in 90-degree weather one week versus another week.
What About Type 2 Diabetics
Type 2 diabetes is far more common in America than Type 1, comprising 90% to 95% of cases. In Type 2 diabetes, the patients own body tissue slowly becomes resistant to the effects of insulin. Eventually, the pancreas stops producing insulin because it cannot continually meet the great demand for it caused by the tissue-resistance to insulin. Although most Type 2 diabetics do not need insulin early in their disease course, many of these patients will eventually require insulin as part of their therapeutic regimen.
Advanced Type 2 diabetics who are using insulin, taking multiple medications for reducing serum glucose, are elderly, or who have a co-existing critical illness are at high-risk for developing hypoglycemia.15,16
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Its The Heat And The Humidity
Even when it doesnt seem very hot outside, the combination of heat and humidity can be dangerous. When sweat evaporates on your skin, it removes heat and cools you. Its harder to stay cool in high humidity because sweat cant evaporate as well.
Whether youre working out or just hanging out, its a good idea to check the heat indexexternal icona measurement that combines temperature and humidity. Take steps to stay cool when it reaches 80°F in the shade with 40% humidity or above. Important to know: The heat index can be up to 15°F higher in full sunlight, so stick to the shade when the weather warms up.
Physical activity is key to managing diabetes, but dont get active outdoors during the hottest part of the day or when the heat index is high. Get out early in the morning or in the evening when temperatures are lower, or go to an air-conditioned mall or gym to get active.
Two Common Health Conditions Experienced By Many People Are Insulin Resistance And Sleep Disturbances And It Turns Out The Two Are Related Insulin Resistance Is The Basis For Type 2 Diabetes According To The American Diabetes Association At Least 105% Of The Population Had Diabetes In 20181yet Testing Of More Than 14000 People Using An Oral Glucose Tolerance Test By Dr Joseph Kraft Has Shown People Can Have Abnormally High Insulin Levels With A Normal Glucose Response Using A Glucose Tolerance Test2he Calls This Condition Diabetes In Situ3 And Believes By Correcting High Insulin Levels Which Lead To Insulin Resistance You Can Also Directly And Indirectly Prevent Damage To Your Vascular Systemkrafts Testing Demonstrated That The Prevalence Of Insulin Resistance Is Far Higher Than Originally Thought And Greater Than The Estimates Of People With Diabetes4 By The Same Token The Number Of People Who Have Difficulty Getting Adequate Amounts Of Quality Sleep Each Night Is Also Higher Than You May Expectfor Several Years The Mattress Firm Has Commissioned A Survey To Look At Sleep Habits And The Number Of Hours People Are Sleeping Each Night The Results From 2019 Show That Americans Are Sleeping Fewer Hours And They Are Less Satisfied With The Quality Of Their Sleep5on Average 52% Of Those Answering The Survey Reported Getting Six Hours Or Less Per Night Of Sleep And 40% Rated The Quality Of Sleep As Not Very Good Or Not Good At All This May Be Related To The Activities They Routinely Do Where They Sleep Including Watching Television Eating And Playing Video Gamessleep Disturbances Or Disorders Affect Nearly 70 Million People In The Us They Include Sleep Apnea Insomnia Narcolepsy And Restless Leg Syndrome6 Yet Medical Conditions Are Not The Only Reason Your Sleep May Be Disturbed Experts Also Find Long Naps After Lunch Eating Within A Few Hours Of Bedtime And Consuming Too Much Caffeine Can All Affect Sleep Quality And Quantity7blood Glucose And Insulin Raise Core Body Temperaturethe Body Is In A Constant State Of Thermoregulation Which It Achieves Through Complex Interactions Between The Hypothalamus Muscles Nervous System And Vascular System This Process Tightly Controls Body Temperature In The Face Of Ambient Temperature In Your Surroundings And Your Internal Heat Generationyour Body Requires This For Homeostasis And To Preserve A Stable Internal Environment In Which Enzymes Proteins And Hormones Continue To Work8 Even A Shift Of A Few Degrees In Body Temperature Can Have Disastrous Results On Your Health Or Your Life9 The Balance To Maintain Core Body Temperature Is A Form Of Homeostasis Which Is Affected By Glucose Control And Insulin Levelsas Kraft Demonstrated Hyperinsulinemia Often Predates Insulin Resistance And Symptoms Of Diabetes A Team Of Researchers From The Scripps Research Institute Has Found That High Levels Of Insulin Raise Core Body Temperature In An Animal Model10this May Mean That Even People Without Insulin Resistance Can Experience A Rise In Core Temperature After Consuming A Meal High In Carbohydrates That Drives Insulin Secretion Blood Glucose Levels Can Also Reduce Your Ability To Dissipate Heat And Thus Maintain Body Temperatureyour Body Uses Sweating As One Way Of Getting Rid Of Excess Heat Produced During Metabolism From Activity Or Other External Stimuli Thermoregulatory Sweating Is Predominantly Controlled By The Hypothalamus11 As Core Body Temperature Rises It Can Have Negative Consequences On Your Cardiovascular System And Glycemic Controlresearchers Have Found People Who Have Poor Blood Sugar Control With Diabetes
Two common health conditions experienced by many people are insulin resistance and sleep disturbances, and it turns out the two are related. Insulin resistance is the basis for Type 2 diabetes. According to the American Diabetes Association, at least 10.5% of the population had diabetes in 2018.1
Yet, testing of more than 14,000 people using an oral glucose tolerance test by Dr. Joseph Kraft has shown people can have abnormally high insulin levels with a normal glucose response using a glucose tolerance test.2
He calls this condition diabetes in situ3 and believes by correcting high insulin levels, which lead to insulin resistance, you can also directly and indirectly prevent damage to your vascular system.
Krafts testing demonstrated that the prevalence of insulin resistance is far higher than originally thought and greater than the estimates of people with diabetes.4 By the same token, the number of people who have difficulty getting adequate amounts of quality sleep each night is also higher than you may expect.
For several years, The Mattress Firm has commissioned a survey to look at sleep habits and the number of hours people are sleeping each night. The results from 2019 show that Americans are sleeping fewer hours and they are less satisfied with the quality of their sleep.5
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Effects Of Physical Fitness
The effects of aerobic fitness along with short- and long-term exercise training have been widely studied in the context of glucoregulation in type 1 and 2 diabetes. Despite this, a recent meta-analysis of the randomized trials of aerobic or resistance exercise on glycemic control in individuals with type 1 diabetes by Yardley et;al. concluded that there is insufficient evidence to ascertain the effect of exercise training on HbA1c. In fact, while a positive effect of exercise training has been shown in type 1 diabetes, others have found no effect and even a negative effect on HbA1c. On the other hand, the effects of exercise training on glycemic control with type 2 diabetes is much better established. A recent meta-analysis by Umpierre et;al. reported a mean decrease in HbA1c following a structured exercise intervention >12 weeks of ~0.7%. The analysis also revealed that structured exercise training of at least 150 minutes per week yielded superior results of a ~0.9% reduction in HbA1c which have also been associated with fewer diabetes-related complications. Noteworthy is that greater benefits occurred in individuals with type 1 and type 2 diabetes with worse glycemic control prior to the exercise intervention.
Do Lemons Lower Blood Sugar
Lemons also have a low glycemic index , and a meal with a low GI promotes lower blood sugar and insulin levels after eating. Citrus fruits like lemons also contain flavonoids, naringin, and naringenin all of which can have anti-inflammatory, antioxidant effects, according to a 2014 study in Advances in Nutrition.
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How Is Cold Weather Affecting Your Blood Sugar
in Health, Lifestyle05,104 Views
Could a change in the weather make an impact on your blood sugar? Believe it or not, it can and it does! Cold winter weather brings special considerations for blood sugar that we simply dont have to worry about in the warm summer months.
The first consideration is obvious we dont want to be outside as much when its cold! Not only is the cold air and snow uncomfortable for long periods of time, just consider the effort it takes to prepare; layers of clothing, socks, boots, scarves, jackets, hats, gloves, etc. all that trouble to do something as simple as walk the dog!
Due to the elements, we tend to stay indoors far more during the winter months. This means we are negatively affecting our blood sugar levels in a few ways and arent even aware of it.
Firstly, without regular physical activity, blood sugar levels will run consistently higher. Dont let the fact that the snows a-blowing turn you into a couch potato. There are several ways to get moving while indoors from jump rope to yoga, from cleaning house to simple stretches, remind yourself to do some form of activity each day.
Secondly, while sitting around bored, we are far more likely to reach for something to eat to occupy ourselves and no one reaches for broccoli so dont even try that! In the winter, we crave warm, comforting foods like mashed potatoes, macaroni and cheese, soups and stews.