What does type 1 diabetes, happening inside our bodies, have to do with the environment around us? The intersections might not seem immediately obvious, but health is inextricably linked with our surroundings. From the air we breathe to the water we drink and the food we eat, our health is in constant interplay with the places in which we work, live, play, and learn. Diabetes is certainly involved in these interactions, and even more so while our climate is rapidly changing. In this blog series, we will explore the complex relationships between our environments and type 1 diabetes.
Extreme Heat
Due to climate change, we are experiencing unprecedented levels of extreme heat and will experience more in the future. Greenhouse gases in the atmosphere like carbon dioxide are warming the planet, making temperatures higher on average and increasing both the frequency and intensity of heat waves. This is particularly relevant for people with type 1 diabetes because heat affects blood sugar.
On hot days, you may have noticed your BG creeping up. Those pesky highs are likely due to dehydration, so it’s particularly important for people with diabetes to drink enough water in the heat. Also be aware that some diabetes complications such as nerve and blood vessel damage can also affect the body’s ability to sweat and cool properly (1).
On the other hand, heat can also increase insulin absorption, leading to low blood sugar (2, 3). People tend to be most active when the weather is nice, so pay special attention to potential lows if it is hot out.
In especially hot conditions, it is also important to keep insulin at an appropriate temperature to maintain its effectiveness. Manufacturers recommend keeping unopened insulin in the fridge at 2-8°C or 36-46°F. FRIO insulin cooling cases are also a great substitute for refrigeration that only requires water instead of ice.
Extreme heat can be particularly challenging for those who are not used to experiencing it. While air conditioning is the most effective way to stay cool on hot days, there are plenty of other strategies to use even if you don’t have AC in your home:
- Drink ice water, eat frozen treats, and avoid alcohol
- Avoid turning on the oven or stove (No-cook meals like salads are good!)
- Lay cool, wet washcloths on your skin or spray yourself with cool water
- Wear loose, light fabrics such as cotton and linen
- Close your blinds during the day to prevent sunlight from streaming in
- Open the windows at night if the air outside cools down
- Stay close to the ground (hot air rises)
- Take lukewarm showers (cold showers feel refreshing at first, but actually make you hotter!)
- Find a local community cooling center to hang out in
- Many provinces, states, and cities have online maps with cooling center locations. You can also try dialing 2-1-1 to be directed to your closest one
Disaster Preparedness
Unfortunately, heat is not the only form of extreme weather that is increasing due to climate change. Droughts, hurricanes, floods, and wildfires, for example, are also becoming more frequent and more severe. For a number of reasons, people with disabilities and chronic illnesses are more vulnerable to the impacts of such disasters. Diabetes in particular requires so many supplies that power outages or food and medicine shortages can significantly impact management.
Many diabetes organizations have put together guides for developing an emergency preparedness plan and kit. You can check some out below:
In addition to extreme weather events, infectious disease outbreaks are also predicted to increase as a result of climate change. The COVID-19 pandemic has illustrated the disproportionate impact epidemics can have on people with disabilities and chronic illnesses.
People with diabetes are not only at higher risk for adverse health outcomes from COVID-19 infection, but also for “financial, housing, food, and medical access challenges” as a result of the pandemic. A survey of Americans with diabetes conducted by the ADA found that “7.6% of respondents said they had become temporarily or permanently homeless since the start of the public health emergency—a figure 48x higher than the national average.” The high economic burden of diabetes in even non-disaster times makes unexpected emergencies that much harder to cope with.
This stark disparity highlights how important it is to look upstream for structural changes to better support disabled and chronically ill communities. Accessible and affordable healthcare and supplies, sustainable infrastructure, protective environmental policies, and comprehensive emergency preparedness strategies can all help mitigate the effects of disasters on communities.
It is vital to meaningfully involve people with diabetes in the development of these policies to protect the health and wellbeing of the diabetes community when disaster strikes. Ultimately, disaster responses that center people with diabetes and other disabilities/chronic illnesses will be beneficial for everyone.
Increasing extreme weather and natural disasters will not only affect ecosystem health, but also human health. Between the effects of temperature on blood glucose, quantity of supplies required for diabetes, and rising cost of healthcare, people with diabetes are particularly susceptible to the effects of climate on health. All the more reason to fight to mitigate climate change as much as possible! But since extreme weather and natural disasters can never be completely avoided, this must be also accompanied by disaster management and recovery plans inclusive of people with diabetes.
References
- Centers for Disease Control and Prevention. (2022, July 27). Managing diabetes in the heat. Centers for Disease Control and Prevention. Retrieved August 5, 2022, from https://www.cdc.gov/diabetes/library/features/manage-diabetes-heat.html
- Hot Weather and Diabetes – Staying Safe in the Heat. Diabetes.co.uk. (2019, January 15). Retrieved from https://www.diabetes.co.uk/diabetes-and-hot-weather.html
- Heat and type 1 diabetes. Beyond Type 1. (2020, July 5). Retrieved August 5, 2022, from https://beyondtype1.org/heat-and-type-1-diabetes/
