Summer care for diabetics
Summer is here with its scorching heat. Summer brings with it, not just the hot weather, but also mangoes and vacations. Adding to this, the holy month of Ramadan happens to be in Summer, this year in India. Everyone needs to take appropriate care of their general health and this applies more so to those with diabetes.
Mango is the undisputed king of fruits, at least for the vast majority of its fans! It is high in nutritional value, rich in fibre, Iron and other micronutrients such as vitamins and minerals. While a diabetic with decent glucose control can enjoy a few slices as in-between meal snack, it is advisable to stay away from the very ripe ones, juices and milk shakes.
Juices and milk shakes may lack essential fibre and can cause rapid surges in blood glucose levels, apart from the high calories and weight gain that they may impose. The same rule applies to other natural juices such as sugar cane juice, which should not be consumed by diabetics.
Whilst one enjoys mangoes, it may be needed to cut down other carbs. Discussing this with one's own doctor or dietician helps. Checking weight periodically, tracking Glucometer readings, regular exercise and of course not overindulging in mangoes, do help keep blood glucose and body weight under control.
And as a word of caution, diabetics with kidney problems and those on dialysis who are supposed to be on a low-potassium diet have to discuss with their doctor whether they can safely consume mangoes or not. This is because mangoes are rich in potassium. Same applies to drinking coconut water which can push up blood potassium levels and also glucose levels if consumed regularly.
Keep medications in a cool place
Coming to medicines, in general, one ought to store medicines in a cool and dry place away from direct sunlight. Medicines like Insulin need to be stored in fridge in order to ensure that their potency doesn't get affected. If Insulin is carried outside, for instance during travel, it may be safely carried out using an ice pack available in most pharmacies or the good-old thermos flask with ice cubes.
A common mistake that we come across regularly is that many leave their medication in cars due to ignorance. With temperatures soaring high day-by-day this summer, it is not at all safe to leave medications in the car unattended without adequate air conditioning, lest the medicines may not work when taken.
Don't neglect your feet
Foot care is an essential part of diabetes care. It is strongly advised that those with Diabetes should never walk bare-footed and this is of paramount importance, in summer months. If one were to walk bare-footed without appropriate footwear, the scorching heat of the ground surface is bound to result in blisters and ulcers of the feet which may sometimes even result in amputation of the feet due to non-healing infected ulcers.
This is worse if the diabetic already suffered nerve damage and has Diabetic Neuropathy. Simple care such as not walking bare-footed can prevent such deleterious consequences. If diabetics were to visit religious places of worship and supposed to removes shoes or chappals before entering such, at least clean thick socks should be worn in order to protect the feet.
Dehydration spells danger
Diabetics need certain extra precautions during the summer months. Everyone is prone to dehydration, worse so if a diabetic has poorly controlled blood sugar. Clean and filtered water should be used for hydration. Drinks made with ORS should be avoided for regular hydration purpose as ORS contains glucose. Soft drinks and beers are not recommended for hydration as they can cause worsening of blood glucose levels and also promote excess urination.
Listen to your body
It is essential to do exercise early in the morning or late evenings once the temperatures are less, unless one chooses to exercise in air-conditioned rooms and gyms. One has to listen to one's own body and not overdo exercise in hot weather. Apart from dehydration, this may lead to fatigue, muscle cramps, and even Heat Stroke.
Vacations are common in summer months for kids and families. It is important to plan holidays appropriately, carry all regular medicines, including Glucometer, strips, lancets, Insulin and needles to cover the entire vacation. It is advisable to carry a duly stamped medical prescription so as to avoid any hassle at Customs and Security checks in airports, whilst carrying these.
Avoid low glucose levels
In case of a sudden low blood glucose event, a diabetic would need quick acting carbohydrate to treat low blood glucose and it is recommended to have some candies, chocolates, biscuits handy. As most vacations end up with weight gain due to the excess food consumption, one needs to keep a watch on this. Keeping active physically, carrying one's usual gym and jogging gear and continuing usual exercise routine during vacation times help prevent piling up of those extra pounds.
As Ramadan happens to be in May and June this year, Muslims with diabetes intending to fast need to take extra care by planning this few weeks ahead. Discussing with their doctor, finding out if they can safely fast, adjusting oral medicines and Insulin doses, regimens as appropriate, is essential. It is important to avoid dehydration by drinking adequate fluids during the non-fasting part of the day.
Limit certain intake
Consuming brown rice, low fat milk, millets, whole grain atta to make rotis, and avoiding biryani, haleem, red meat, and limiting consumption of dates can not only help control blood glucose levels but also the weight gain due to the festivities. Frequent blood glucose checks using Glucometer can prevent low blood glucose and also big surges of the same.
Following certain simple precautions during these summer months can not only allow diabetics to keep themselves safe but can also enable them to enjoy the seasonal foods, their vacations, observe their faith and follow their beliefs, whilst simultaneously taking care of their general health and diabetes.
(Writer is Senior Endocrinologist, Apollo Hospitals, Jubilee Hills)