By Eileen B. Wyner, NP
Bulfinch Medical Group

The calendar tells us that winter begins December 21st. I’ve lived in New England all my life and am used to winter beginning anytime around Halloween, so this year I feel like I’ve already received the best Christmas gift ever…fall weather in December!  Alas, the reality is starting to set in and winter preparations are needed. Winter safety is very important for all of us, but presents challenges for people living with Diabetes. It’s better to think about these challenges now when the ground is bare and the thermostat above freezing.  I’ve listed below a few common issues that may occur and could become serious problems if not identified and dealt with sooner rather than later.

Foot protection:

Daily foot care is one of the most important principles of good Diabetes management. The first place to start is with your boots.  Make sure your shoes fit well—poorly fitting shoes (too big, too small, and too narrow) can lead to skin breakdown, blister formation, and possible infection. You also need to keep your feet warm and dry.  Leaving wet socks on can cause serious problems such as lacerations and blisters that could develop into dangerous infections.  Even waterproof shoes have their limits, so always throw an extra pair of socks in your bag or your desk drawer.  Here’s a tip:  When shopping for boots, try them on with heavier socks (since we usually wear thicker socks in the winter).

Traveling & Commuting:

Foul weather can really disrupt your daily commute to work— as well as long distance travel for work or pleasure— which can impact your schedule when you’re trying to regulate your blood sugars. If you’re commuting on public transportation, trains may be delayed or you may have to walk unexpected distances. When driving, there may be road closures, detours that take you far from your destination, traffic jams, or totally impassable roads. It’s a good idea to carry some extra snacks, water, and glucose tabs with you to prepare for unexpected situations. Severe weather or unsafe road conditions may make it too dangerous to get out of the car to open the trunk for your provisions, so keep some snacks in the backseat at all times and always have a stash of glucose tablets or gel readily accessible in the glove compartment. Take a survey of the trunk and pack it with a sturdy shovel, ice melt, jumper cables, and blankets. Also, make sure you have a working flashlight, extra batteries, flares, a cell phone charger, and a first aid kit. Take your car in for winter maintenance in the fall and always double check that you have enough wiper fluid and antifreeze (try to keep your gas tank full also). I think a great gift to give or receive is AAA membership, so consider that your tip for last minute Christmas shopping!

Frostbite & Hypothermia:

It’s important to stay as warm and dry as you can during inclement weather to prevent frostbite and hypothermia—two very serious cold weather complications.

Frostbite is an injury to the body caused by freezing. In areas affected by frostbite, loss of feeling and color can occur. The early signs include redness or pain to an area of skin—both of which indicate it’s time to protect that area immediately and get out of the cold if possible. The skin may also turn grayish yellow in color and/or feel waxy or numb. Frostbite most often affects the nose, ears, cheeks, chin, fingers, or toes and can cause permanent damage.  Severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation, Diabetes, and neuropathy and also may affect people who are not dressed properly for extremely cold temperatures.

Hypothermia is an abnormally low body temperature that may occur when you’re exposed to cold temperatures for a prolonged period of time, especially if you are underdressed or very wet from precipitation. The body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy; if the body temperature gets too low the brain starts to slow down.  Warning signs of hypothermia include shivering, exhaustion, confusion and slurred speech—not unlike some symptoms of hypoglycemia. It’s important to be sure your blood sugar is at a safe value, and then try to get as warm and dry as possible and get medical attention as soon as you can.

Miscellaneous:

There are a couple more things to keep in mind. Any of these situations that I have mentioned could cause you to have hypoglycemia:

• Winter is also the time for illness. Getting a flu vaccine, washing your hands, and getting plenty of rest are the most important steps you can take to good health.
• Remember home safety, too.  Make sure your heating system is in good working order and you have household carbon monoxide (CO), monitors. If you have a fireplace or woodstove be sure that they are vented properly to avoid fire or CO poisoning.

The most important thing to remember is to try to be prepared…then go out any enjoy all that winter in New England has to offer…the good and the bad.