rural vermont winterVermonters know that winters can be long and challenging. Unfortunately, winter can be even more challenging for people who live with diabetes.

Diabetes management can be complicated when we are ill or injured. And some people with diabetes have impaired circulation which may make them more prone to frostbite as well as delayed bone healing with fractures.

These are some guidelines to help us enjoy the winter:

Illness and Immunizations

The American Diabetes Association as well as the Centers for Disease Control recommends flu vaccines for all adults with diabetes except for those who have had previous severe reactions. Egg allergies no longer prevent most people from getting a flu shot. Speak to your health care provider about this. It is also beneficial if your family and coworkers are vaccinated as well.

Pneumonia vaccines are also recommended. Your health care provider will decide which one is best for you and if or when it needs to be repeated. This is an ideal time for you and your health care provider to discuss other important vaccines such as the Shingles vaccine. You should also be aware if you are up to date on DTaP (diphtheria,tetanus and pertussis) as well as protected against Hepatitis B.

Injury and Frostbite

Other winter woes include potential injuries due to falls on slippery surfaces and risk of frostbite to extremities.

Wear sturdy footwear with good traction. Consider using studded slip-ons such as Yak-Traks to provide better traction. Persons with unstable gait should be using assistive devices such as canes or walkers. Consider alternative indoor environments for walking such as a gym or shopping mall.

Driving in severe weather can be dangerous. Persons with diabetes should always keep a source of rapid acting carbohydrates such as candy, juice, regular soda or glucose tabs with them at all times especially while driving. You will need sharp reflexes and concentration while driving, especially in bad weather, and a low blood sugar can definitely incapacitate you.

Protect all of your extremities. You may need to wear an extra layer of socks and/or gloves to prevent your toes and fingers from getting too cold. Don’t forget that your cheeks, ears and nose can be vulnerable as well. Scarves, hats and ski masks can help to keep your face and head warm and safe. Symptoms of frostbite include discoloration of skin or a waxy appearance and blistering. If you have swelling, itching, burning and deep pain while your extremities are rewarming you should contact your doctor.

Snow shoveling is very strenuous. Consider having a paid service or ask neighbors or family for help. If you are shoveling yourself take frequent breaks and have a snack. Check your blood sugar to make sure that you are not getting too low. If you have any chest pressure or pain stop immediately and seek medical attention.

Be aware that insulin and other injectable diabetes medications need to be stored between 36 and 86 degrees. Do not leave these drugs exposed to freezing weather. If you do carry these injectables they must be protected. If you note that your clear medications have become cloudy you cannot use them and they should be discarded. Glucometers also have a temperature range. According to the FDA, “altitude, temperature, and humidity (High altitude, low and high temperatures, and humidity) can cause unpredictable effects on glucose results. Check the meter manual and test strip package insert for more information.” Insulin pumps as well cannot withstand very cold temperatures and may stop working unexpectedly. Again, make sure that the pump stays insulated under several layers of clothing.

If you have any diabetes related questions please call us at 802-847-4576.

November is Diabetes Awareness month, visit American Diabetes Association to find out more information on Diabetes.

Rhonda Lapidow, CDE, is a certified diabetic educator at the University of Vermont Medical Center.


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