August 28, 2000
Daily Care
Question from Oregon, USA:
I am wondering if outside temperatures or various altitudes can cause high or low blood sugars. My eight year old daughter was diagnosed with type 1 diabetes a year ago. She has been honeymooning and still uses very little insulin (am: 5 units Ultralente and 0.5 units Humalog; pm: 2 units Lente and 0.5 units Humalog). When skiing at one area, she typically starts with and maintains unusually high blood sugars and drops later after skiing is over. At another area, which had much colder temperatures she was low every time we tested her. We had to decrease insulin for the duration of that ski adventure. Also, recently, she had daily one-half hour swim lessons at an indoor pool where it was hot and stuffy while the water temperatures felt cool and left swimmers chilled. Blood sugar levels dropped from high 200’s mg/dl [11.1 mmol/L] (pre-swimming) to below 70 mg/dl [3.9 mmol/L](post-swimming) and needed immediate double treatment to prevent dropping more. For the rest of her lessons, we treated her with extra carbohydrates prior to the swimming. She normally swims in an outdoor pool and takes frequent hot tubs. She has not had the severe blood sugar drop which this particular pool caused. Any information in this area would be helpful in preventing future lows.
Answer:
Yes, outside temperature, water temperature and altitude changes can affect blood sugars because these changes do affect metabolism. In the cold, the body has to work much harder to stay warm — thereby increasing metabolism and burning more calories. This certainly may affect blood sugars in diabetes.
While this may not be the case in all persons with diabetes, you have done an excellent job in recognizing this relationship in your daughter’s situation — extra blood sugar testing and “patterning” as you have done are key! On top of this, the 2 activities (downhill skiing and swimming) can be quite different in their direct effect on blood sugars. Despite this fact, you have done well in managing your daughter’s numbers. Bravo to you!
Just a word of note regarding hot tubs and hypoglycemia, be aware that in some situations hot tubs (like exercise itself) can increase the rate of absorption of insulin and may result in lower blood sugar. Again blood sugar monitoring and patterning is key. Search the DTeam archives for previous discussions on hot tubs.
DMW
