Diabetes and cold weather: How can you keep your blood sugar levels in check?

How does cold weather affect blood sugar?

People with diabetes often need to be extra vigilant with their management routines in winter. This is mainly due to the following factors:

• Cold weather stresses the body, prompting it to release stress hormones like cortisol and adrenaline, which are meant to help the body cope with harsh conditions. This response can slow down insulin production and interfere with glucose absorption, potentially causing higher blood sugar levels.
• With shorter days and colder temperatures, people tend to stay indoors and become less active. Physical activity helps muscles use up glucose for energy, which naturally lowers blood sugar levels. This drop in activity can lead to elevated blood sugar levels, especially if diet and medication routines aren’t adjusted to account for the decreased physical exertion.
• Winter is also flu season. When the body is fighting an infection, the immune system releases stress hormones to help combat the illness. These hormones, unfortunately, raise blood sugar levels as part of the body’s defense mechanism. Moreover, fever, dehydration, and appetite changes due to illness can further complicate blood sugar control. Higher blood sugar levels during an illness may increase the risk of complications, such as diabetic ketoacidosis (DKA) in people with type 1 diabetes.

What are the best ways to manage diabetes during winter?

Monitor blood sugar regularly

Cold weather may change how your body uses insulin, so it’s important to check your blood sugar levels frequently. Pay extra attention if you’re feeling unwell or stressed, as both can affect blood sugar.

Pro tip: Cold hands can make finger-prick testing uncomfortable. Warm your hands first by holding a warm cup or placing them under warm water. If you use a continuous glucose monitor (CGM), keep it warm to avoid malfunctions.

Dress warmly but carefully

Cold weather can reduce blood flow, increasing the risk of heart issues and worsening neuropathy pain. Wear layers, use blankets, and ensure your home stays at a comfortable temperature. The NHS recommends heating rooms to at least 18 °C (64 °F) for those with chronic health conditions.

Safety tip: If you have neuropathy, avoid direct heat sources like electric blankets or heating pads on bare skin, as reduced sensation can make it hard to tell when your skin is getting too hot.

Get your annual flu shot and COVID-19 booster

People with diabetes are at a higher risk of complications from the flu and COVID-19, so getting vaccinated is essential. An annual flu shot and a COVID-19 booster reduce your chances of illness and help you avoid blood sugar spikes related to infection.

Protect your skin and feet

Cold, dry air can lead to irritated and cracked skin, which can cause infections that are harder to heal. Moisturize daily, especially on your hands and feet. Check your feet regularly for any sores, cuts, or signs of infection, and always wear warm, moisture-wicking socks and well-fitted shoes or boots.

Store medications and equipment properly

Diabetes supplies are sensitive to temperature changes. Insulin, for example, can freeze if exposed to extreme cold, rendering it ineffective. Keep insulin, CGMs, and other devices at room temperature, ideally between 36–77 °F (2–25 °C). If you’re going outdoors, carry them in insulated bags or keep them close to your body to protect them from the cold.

Stay active with indoor exercises

Though cold weather may limit outdoor activities, staying active is essential for blood sugar control. Try gentle indoor exercises like yoga, stretching, or online workout videos. Physical activity not only helps regulate blood sugar but also boosts mood and improves circulation. Aim for at least 150 minutes of physical activity each week. 

Plan for healthy eating

Winter and the holiday season bring tempting treats, many of which are high in carbs. Enjoy treats in moderation and try to balance your meals with non-starchy vegetables and lean proteins to keep blood sugar steady. Staying hydrated is necessary too; cold weather can make you feel less thirsty, but indoor heating can dehydrate you. Opt for water or herbal teas.

Take care of your mental health

The shorter days and limited sunlight in winter can lead to seasonal affective disorder (SAD) and feelings of isolation, which can contribute to depression. Depression and anxiety are more common in people with diabetes and can make blood sugar management more challenging. Physical activity, social connection, and spending time outdoors in daylight can help boost mood.

If you’re experiencing signs of depression, such as changes in appetite, energy, or concentration, consider talking to your healthcare provider.

Prepare for cold weather emergencies

Winter weather can be unpredictable, so it’s essential to prepare for emergencies. Keep an emergency diabetes kit with extra supplies, glucose tablets, batteries, and non-perishable snacks. Severe winter weather may make it difficult to reach pharmacies or healthcare services, so having extra supplies on hand is crucial.

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