SAN DIEGO — Many adults with diabetes do not understand how living in a hot climate impacts their disease self-management, results from a survey of 152 patients demonstrated.
For example, 29% of respondents did not initiate personal protective measures until temperatures reached 101°F, and 37% left their diabetes medications and supplies at home rather than risk their exposure to heat.
“This was quite concerning, because they wouldn't have the means to check their blood sugars if they began to feel faint if they got behind the wheel to start driving; or if they needed to seek medical attention, they wouldn't have the means to know if they should,” Dr. Adrienne Nassar, a third-year resident in internal medicine at the Mayo Clinic, Scottsdale, Ariz., said at the meeting.
Studies have shown that people with diabetes have higher rates of emergency room visits, hospitalizations, and deaths caused by to heat illness during hot weather than during more temperate weather, but few published studies have assessed how patients manage their disease in extremely hot temperatures, said Dr. Nassar. “Furthermore, the number of diabetes cases is increasing in the Southwestern United States,” she said. “The primary way in which we cool ourselves is through sweating, and diabetes patients may have an impaired ability to do so.”
In collaboration with the National Weather Service and the National Oceanic and Atmospheric Administration, Dr. Nassar and her associates surveyed 152 adults who attended the diabetes clinic at Mayo between Nov. 30, 2009, and Dec. 31, 2009, to assess the types of personal protective measures they take against the heat, and their knowledge of safe temperatures and exposure times.
Respondents' mean age was 64 years, 51% were female, 58% were non-Hispanic white, 83% had type 2, and 77% used insulin. Sixty percent reported staying indoors to protect themselves against the heat, 56% drank fluids frequently, 45% applied sunscreen, and 45% wore protective clothing. But 23% reported drinking only when they became thirsty, suggesting that they “were starting to get behind on their fluid status,” Dr. Nassar said.
Nearly three-quarters (71%) reported spending less than 1 hour in the heat, but 29% did not initiate protective measures until temperatures reached 101°F. “Heat-related illness can take place at 80°–90° when you factor in the heat index,” she noted.
While 73% of patients said they knew about heat's harmful effects on insulin, fewer said they knew about extreme heat on glucose meters (41%), oral medications (39%), and glucose testing strips (38%), and 20% did not know when to begin taking precautions, although precautions are included in the product inserts, she said.
The study is expected to appear in the September 2010 issue of the Journal of Diabetes Science and Technology.
Disclosures: Dr. Nassar reported no conflicts.
We cool ourselves through sweating, 'and diabetes patients may have an impaired ability to do so.'
Source DR. NASSAR
Advise patients to stay hydrated before thirst sets in.
Source ©Dana Heinemann/Fotolia.com