HCN News & Notes

Surviving the Winter Season with Diabetes

SPRINGFIELD — The winter season is a wonderful time to venture into the great outdoors for a refreshing walk in the pristine landscape or to enjoy a spontaneous snowball fight. But winter can be tricky for people with diabetes to navigate.

“With some advanced planning and preparation, you can enjoy the winter season without compromising your blood-sugar goals or putting your health at risk. It just takes a little forethought and common sense,” said Dr. Chelsea Gordner, director of Inpatient Diabetes at Baystate Medical Center.

Exercise is an important part of managing diabetes. “It’s easy during winter months to just want to curl up with a warm blanket and stay put,” Gordner said. “But when you exercise regularly, your cells become more sensitive to insulin, so it works more effectively.”

Gordner advises her patients to do anything to keep moving.

“Aim for 150 minutes a movement a week,” she said. “That includes doing chores, walking to get the mail, dancing, and, of course, exercise at home or at the gym. Check with your local library to see if they have exercise DVDs. It’s a fun and a free way to try out different types of exercise in the comfort and privacy of your home.”

If you choose to exercise outdoors during the winter months, Gordner said it’s important to protect your feet. “Poor circulation from diabetes can reduce the sensitivity in your feet. It’s not uncommon for diabetes patients to end up with frostbitten toes simply because they didn’t realize how cold their feet had gotten.”

She encourages patients to wear moisture-wicking socks in cotton or wool when venturing outdoors. In addition, always wear the proper footwear for the activity.

“Sneakers in snow are not a good idea. If you plan to spend extended periods of time outdoors in the winter, invest in good boots with a thick, insulating sole,” she said.

When coming in from the cold, Gordner cautions against warming feet near a radiator, close to a fire, or with a heating pad. “That same lack of sensitivity that can lead to frostbite can also lead to severe burns.”

In addition, be sure to examine your feet daily and keep them moisturized. Diabetes contributes to dry skin on the feet. Dry, cracked skin can lead to infection that can be hard to treat if circulation is poor.

If you’re traveling at any time during the winter months, be especially careful transporting insulin and glucose test strips. Insulin should never be stored below 36 degrees Fahrenheit. For that reason, don’t leave insulin in your car when temperatures drop. Similarly, glucose strips should not be kept below 45 degrees Fahrenheit. If you’re planning to ski or be outdoors for long stretches of time, keep your strips in an inside pocket where they can absorb some body heat.

Research shows that people with diabetes are two to three times more likely to have depression than people without diabetes. Things get even more complicated as some of the behaviors associated with depression — poor sleep habits, overeating or not eating enough, lack of focus, and withdrawing from activities and socialization — make managing diabetes difficult. And when diabetes management gets difficult, people tend to get depressed.

Gordner noted the situation can be even further complicated in the winter months when daylight hours are in short supply. Seasonal affective disorder (SAD) is a very real condition experienced by one in 20 people, and its symptoms mirror depression in many ways. The good news is that treatment for depression and SAD can be very effective. Speak to your primary-care provider about treatment options, including therapy, medicine, or both.

In addition, Gordner recommends pushing yourself to stay active and engaged. Exercise produces ‘happy hormones’ that can boost your mood. Make a point to spend time with other people. Confiding in a trusted family member or friend can be a good way to reduce stress and cope with the challenge of managing both diabetes and depression.

And, no matter the season, people with diabetes need to keep their alcohol in check. Alcohol immediately raises sugar levels in your blood, but it can later lower them to dangerous levels. In addition, it can interact badly with certain diabetes medications, most notably sulfonylureas.

If you choose to drink, be smart and always eat when you drink to keep sugar levels in check. Be sure to check your sugar levels frequently when drinking, and consider having a small snack before bedtime to reduce low-sugar risks while you sleep.

“It’s also important to choose your drink wisely,” Gordner said. “As a rule of thumb, light or low-carb beers are a better choice than wine, and wine is a better choice than liquor. Avoid sugary drinks, liqueurs, or any drinks mixed with sugary sodas.”