(Summer) Safety First

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen W

Summer has arrived in a fashion that will be hard to forget. That’s what life in New England is all about:  blink and the weather will change.  I really love summer, weather and all. It’s a time where I slow down the daily pace, enjoy the long hours of daylight, and remember being a kid where my only responsibility was reading the 7 books required from the Boston Latin School Summer Reading List. Well, adulthood has a few more responsibilities and I want to give you some pointers that will hopefully keep this summer healthy and happy for you and yours. 

 Managing your Diabetes can get a little tricky with the advent of heat and humidity, so a little pre-planning can help ensure you’re able to enjoy this magical season completely.  Remember, extreme heat can lead to heat exhaustion and heat stroke, both of which can be serious medical conditions requiring urgent medical attention.  Symptoms of heat exhaustion include dizziness, extreme sweating, muscle cramps, and clammy skin. This is best treated with cool fluids in a cool location and close monitoring of your glucose levels. Heat stroke is much more serious and characterized by a dangerous rise in your body temperature along with decreased ability to perspire. This potentially life threatening condition always requires urgent medical attention. 

  • It’s so important to stay well hydrated. The best choices are water and sugar free liquids.  Caffeinated beverages can actually cause dehydration so drink those sparingly. It’s also a good idea to use caution when drinking alcohol. Small amounts of diluted sports drink may be necessary if you’re exercising in the heat. It’s best to develop a plan with your health care provider to determine if you need additional fluids.
  • Exercise is important to maintain all year round, but extra caution is required with the heat, humidity, and bright sun. Outdoor exercise is best done before and after the high sun and heat of the day. However, with very hot temperatures and elevated heat indexes, outdoor exercise may need to be postponed. Indoor activity should be done in air conditioned facilities.  If you don’t have access to a gym you can try walking around the mall, or up and down all of the aisles of the store while doing your food shopping.
  • The sun isn’t always your friend. ALWAYS wear sunscreen during any outside activity, not just when you’re at the beach. The sun’s rays are strong and present, even when the sky is hazy, and you have to protect your skin. It’s also important to use the sunscreen correctly. Dermatologists recommend using a shot glass worth of lotion for the whole body. Reapplication is needed every 3 hours or so, especially after swimming or sweating. Another way to help to protect you from the sun and heat is to wear a wide brimmed hat and light colored, light weight loose clothes that will help to deflect the sun.
  • Your blood sugar control may be affected by the heat. Your appetite may fall off or you may be eating those special treats of summer: corn on the cob, potato salad, and lots of berries. All these things are fine in moderation, but may make your blood sugars a little erratic. You also have to be really careful about your supplies and medications. Your glucometer, test strips, oral medications, and insulin are all extremely heat and sunlight sensitive. Prolonged exposure to extremes of weather will cause malfunction and possible inactivation of your medications. This could be life threatening. Always store these things in moderate temperatures and use a well insulated gel pack for travel or any weather related storage. NEVER use a freeze pack for your insulin: it will freeze, not cool, your insulin and it will be deactivated.
  • NO bare feet. EVER. Good foot care is always in season. Always wear socks when doing heavy exercise, walking, and hiking as they will help to absorb moisture and protect the skin from breaking down. Change your socks frequently if they get too sweaty and always make sure your shoes fit well. Wear closed toe shoes with outdoor work like lawn mowing or painting to provide extra protection in the event of an accident. I ask all my patients, regardless of their medical conditions, to always wear water shoes or beach shoes when at the beach, in the ocean, and even poolside. It is very common to get a cut or abrasion from debris in the water or on the shoreline and this could be very serious for anyone, and especially so for people with Diabetes.  Avoid flip flops as the rubber piece that separates the toes can cause friction and lead to skin breakdown.

I hope that this list will help you and your families have a wonderful summer.  Now if you’ll excuse me, I have to go and start working on my self-appointed summer reading list.  Happy summer to all!



Truths and Myths About Diabetes

By Eileen B. Wyner, NP
Bulfinch Medical Group

The Internet is a wonderful thing. We have all hopped on and traveled the information highway, but like all road trips, it’s easy to make a few wrong turns. There is so much information available and it can be overwhelming to decide what is really true or might be true. I thought I would look at 5 common topics about Diabetes that my patients have brought to me over the years and sort out what is myth and what is truth.

True, False, Question MarkI don’t want to start taking insulin. My uncle went blind /started dialysis/lost his leg after he started insulin— Blindness, dialysis, and amputation are serious complications of poorly controlled Diabetes. Years of hyperglycemia may lead to retinopathy, renal failure, and lower extremity wounds resulting in amputation. Starting to use insulin doesn’t cause these complications to happen. In fact, starting insulin may help to prevent these types of complications.

I don’t want to be on insulin. I don’t need it—We all need insulin. It’s a hormone that is produced by the pancreas and it allows the body to convert food into energy for activity. If you don’t have Diabetes your pancreas makes and utilizes insulin automatically. If you do have Diabetes your pancreas isn’t working as efficiently as it should. It may not be making and releasing enough insulin into the system as effectively as the body requires. If you have Type 1 Diabetes, your pancreas isn’t making any insulin and you need to inject insulin to survive.

I have to start insulin because my Diabetes is really bad and I didn’t try hard enough to take care of it— Insulin is just one of many medicines used for treating Diabetes. If your health care provider determines that you need to start taking insulin, it doesn’t necessarily mean that your Diabetes is getting worse. Diabetes is a chronic and progressive disease that we do not yet have a cure for, and ultimately a large percentage of people with Type 2 Diabetes need to self inject insulin over time. Far from being “the beginning of the end” for most people, starting insulin is the beginning of better health. You will have better blood-sugar control, which translates into feeling better, and possibly halting or reversing complications.

I don’t want to start insulin because I will gain weight and I am already overweight—Now, there is some truth to this one. Some people with Type 2 Diabetes may gain weight after starting insulin therapy. It’s important to know, however, that the insulin itself does not increase your weight. Your body begins to process blood glucose more efficiently when the insulin starts to work and the result can be weight gain. This is one reason unexplained weight loss can be an early symptom of Diabetes. It is important to realize that any weight gain usually levels out as your blood sugar gets under better control, and not everyone gains weight when they begin taking insulin.

I am afraid of the artificial sweeteners because they are bad for you—There is no definitive research to show that there are any health dangers to using acesulfame potassium (Sunett), aspartame (Nutrasweet, Equal), saccharin (Sweet’N Low), or sucralose (Splenda) according to the U.S. Food and Drug Administration (FDA). All these agents have been approved for use.

The truth is, whenever you have a question about your health, check with your health care provider so you know what myth is and what truth is.