January 24, 2003
Daily Care
Question from Brisbane, Queensland, Australia:
I’ve been getting a lot of higher-than-expected readings in the revolting heat this week (averaging around 34 C), and, in the past, warm weather has brought my blood sugars down. I have had diabetes for 33 years and have been on the pump for 25 years, with a three year break about five years ago. Although I accept that bodies change in their responses over time, I’m just wondering what is going on.
My cannula is fine (only put in two days ago), and while I have been in early peri-menopause for two years, I can usually tell if strange readings are due to hormonal imbalance, and it doesn’t appear to be the case here. The readings aren’t massive (just 1-3 mmol/L [18-54 mg/dl] higher than I would expect), and my diet and exercise regimens haven’t changed.
My endocrinologist has just retired, and I will be seeing my new one in a few months, but I feel uncomfortable calling the new guy out of the blue when I have never met him! Any ideas gratefully accepted!
Answer:
It will be difficult to say exactly what is wrong. Rather, I can give you a checklist I use to review potential aggravating issues.These are just a few things you may want to think about as you try to troubleshoot your results:
Is the insulin stable in the warm weather?
Do you have any issues related to lipohypertrophy over the infusion sites?
Is your diet really similar or are there real differences?
Is your exercise really different?
Have you gained weight and are more insulin resistant?
Are you properly hydrated in the warm weather?
Do you have an intercurrent health problem?
Is your insulin pump performing well?
Is your meter performing well?
What is your recent hemoglobin A1c? Does it correspond to the blood sugars you are getting when you monitor?
JTL
