Diabetes and Cold Weather: Seasonal Tips for Managing Your Health

The winter season is a wonderful time to catch up with friends and family and venture out into the pristine landscape for a refreshing walk or spontaneous snowball fight.

Punctuated by big meals, special treats, and, for some, a lot of toasting with seasonal nog, it can be tricky for people with diabetes to navigate. For some people with diabetes, colder temperatures can mean higher blood sugar. With winter weather keeping us inside, we tend to exercise less and eat more.

According to Dr. Cecilia Lozier, Chief, Division of Endocrine and Diabetes at Baystate Medical Center, “You can have a happy and healthy holiday season by planning ahead and enjoying everything in moderation!”

Be a Party Smartie

Dr. Lozier notes, “ The holidays are a time to slow down and enjoy quality time with loved ones. Central to these celebrations is coming together to share our favorite foods. If you have diabetes, here are some tips to help you ensure your blood sugar is in a healthy range while enjoying the holidays:

• Don’t arrive hungry. Eat a healthy snack in advance to keep your appetite in check.
• Bring a dish that’s low in carbs, fats, and calories. This way, if the other options are limited, you’ll still have something to eat and enjoy.
• Moderate portions of food high in sugar and carbohydrates. Don’t say “NO” to any foods, but take smaller portions of the foods that can spike your blood sugar.
• Check your sugars and bring your medication. If you are enjoying holiday treats, be sure to check your sugar often and keep your numbers in check.

When filling your plate at holiday meals, aim to fill half your plate with fruits and non-starchy vegetables. The other half should be a 50/50 combination, with one half being your protein and the other a combination of grains and starchy vegetables (potatoes, sweet potatoes, and squash).

Raise a Glass Wisely (if at all)

Toasting to the holidays is a time-honored tradition but for people with diabetes, it comes with risks.

Alcohol immediately raises sugar levels in your blood but it can later lower them to dangerous levels. In addition, it can interact badly with certain diabetes medications, most notably sulfonylureas.

Dr. Lozier notes, “Be mindful of how alcohol can impact your diabetes. Consider lower carbohydrate drinks such as light or low carb beers over wine. Liqueurs or mixed drinks can have a lot of sugar.

If you choose to drink, be smart and always eat when you drink to keep sugar levels in check. Be sure to check your sugar levels frequently when drinking and consider having a small snack before bedtime to reduce low sugar risks while you sleep. Dr. Lozier adds “Be mindful of low sugars after drinking because the alcohol can stop your liver from making sugars for your body in the fasting state.”

Stay Active, Stay Safe

Exercise is an important part of managing diabetes. “It can be hard to get exercise or be physically active in the cold weather. Consider warm places you can go to get physical activity or exercise such as a shopping mall, indoor track or if able a gym. Also, think about what you can do from home! There are great free exercise videos on the internet through sites like YouTube.”

Dr. Lozier advises patients to do anything to keep moving. “Keeping your muscles moving helps your body better metabolize sugar and keep your sugars in a health range. Try to get 150 minutes of physical activity or moderate exercise per week. Remember things like lifting laundry baskets or emptying the dishwasher count! Try to expand that to dedicated times for activity such as taking a walk or doing an exercise routine.”

Protect Your Feet

If you choose to exercise outdoors during the winter months, Dr. Lozier notes it’s important to protect your feet. “Some folks with diabetes can have less blood flow to the feet. Cold weather slows blood flow to the extremities even further. Make sure you keep your feet nice and warm during the cold season!” She adds “If you have decreased sensation to the feet because of diabetes, your feet may not send you the signals that they are cold. She encourages patients to wear moisture-wicking socks in cotton or wool when venturing outdoors. In addition, always wear the proper footwear for the activity. As she says, “Make sure you wear the right shoes for your outdoor activity. If you are going to be in the snow, invest in waterproof boots with a thick insulated sole.

“If you are coming in from outside and your feet are cold, warm them up with thick socks or rubbing them to get the blood flowing through the feet. Be cautious of any heat source like a heating pad or fire to warm them. Remember that if you have decreased sensation in the feet, you may not feel the extreme heat just as you don’t feel the extreme cold. That can put you at risk for burns just like frostbite.”

In addition, be sure to examine your feet daily and keep them moisturized. Diabetes contributes to dry skin of the feet. Dry, cracked skin can lead to infection that can be hard to knock out if your circulation is poor.

Travel Safe

If you’re traveling over the holidays or any time during the winter months, be especially careful transporting insulin and glucose test strips.

Insulin should never be stored below 36 degrees F. For that reason, don’t leave insulin your car when temperatures drop. Similarly, glucose strips should not be kept below 45 degrees F. If you’re planning to ski or outdoors for long stretches of time, keep your strips in an inside pocket where they can absorb some body heat.

Mind Your Mood

Research shows that people with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Things get even more complicated as some of the behaviors associated with depression—poor sleep habits, overeating or not eating enough, lack of focus, and withdrawing from activities and socialization—make managing diabetes difficult. And when diabetes management gets difficult, people tend to get depressed. It’s a vicious cycle in which two serious conditions fuel each other.

Things get even further complicated in the winter months when daylight hours are in short supply. Seasonal Affected Disorder (SAD) is a very real condition experienced by 1 in 20 people and its symptoms mirror depression in many ways.

The good news is that treatment for depression and SAD can be very effective. Speak to your doctor about treatment options including therapy, medicine, or both.

In addition, push yourself to stay active and engaged. Exercise actually produces “happy hormones” that can boost your mood. Make a point to spend time with other people.

Confiding in a trusted family member or friend can be a good way to reduce stress and cope with the challenge of managing both your diabetes and depression.

Talk to an Endocrinologist

If you have questions or concerns about managing your diabetes over the holidays and winter months, reach out to your doctor for advice. You may benefit from learning more about how to care for yourself while having diabetes from a certified diabetes educator. If you doctor thinks you may need to see a specialized provider in diabetes to guide your correct medication regimen, they can refer you to Baystate Endocrinology & Diabetes  at 413-794-7031.