Major Finding: Nearly one-third of patients with diabetes who live in a hot climate (29%) did not initiate personal protective measures for self-management of their disease until temperatures reached 101°F, and 37% left their diabetes medications and supplies at home rather than risking them to heat exposure.
Data Source: A survey of 152 adult patients with diabetes at the Mayo Clinic, Scottsdale, Ariz.
Disclosures: Dr. Nassar said that she had no conflicts to disclose.
SAN DIEGO — Many adults with diabetes who live in a hot climate don't understand how hot weather 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 risking them to heat exposure.
“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 said during a press briefing at the annual meeting of the Endocrine Society.
Previous studies have shown that people with diabetes have higher rates of emergency room visits, hospitalizations, and deaths caused by heat illness during hot weather than during more temperate weather, but few published studies have assessed how patients manage their disease during extremely hot temperatures, said Dr. Nassar, a third-year resident in the department of internal medicine at Mayo Clinic, Scottsdale, Ariz.
“Furthermore, the number of diabetes cases is increasing in the Southwestern United States,” she said. “From a physiologic standpoint, 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 needed to take against the heat, as well as their knowledge of safe temperatures and exposure times.
The mean age of respondents was 64 years, 51% were female, 58% were non-Hispanic white, 83% had type 2 diabetes, and 77% used insulin.
More than half of the patients (60%) reported staying indoors to protect themselves against the heat, 56% drank fluids frequently, 45% applied sunscreen, and 45% wore protective clothing. However, 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 of patients (71%) reported spending less than 1 hour in the heat, but 29% did not initiate personal protective measures until temperatures reached 101° F. “Heat-related illness can take place at 80°-90° when you factor in the heat index,” Dr. Nassar noted.
While 73% of patients said they had received information about the harmful effects of heat on insulin, fewer indicated that they had received information 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 this information is included in the product information inserts [contained in packaging for] medications and glucose meters,” she said.
In addition, 37% of patients left their diabetes medications and supplies at home during hot days, rather than risk them to heat exposure.
Patients reported television as their primary source for weather information (89%), followed by radio, the Internet, and newspapers.
“Overall, we found that many patients expose themselves to high temperatures before initiating protective measures,” Dr. Nassar concluded.
“We would like to repeat our survey in other populations, for example, outdoor laborers [who may employ unique protective strategies], adolescents, younger adults, and different socioeconomic groups.”
The study is expected to appear in the September 2010 issue of the Journal of Diabetes Science and Technology.
We primarily cool ourselves by sweating, and diabetes patients may have an impaired ability to do so.
Source DR. NASSAR
It's important for people with diabetes to stay hydrated when temperatures rise.
Source ©Dana Heinemann/Fotolia.com