Winter is upon us. Depending where you live, you may have already started shoveling, snow blowing and driving on slippery roads with blinding snow — all hallmarks of wintery weather. As the seasons change, so can managing your diabetes. Cold weather, holiday gatherings and a sense of hibernation can make your diabetes a little more challenging to deal with. However, all things are possible — it’s a matter of adapting, and maybe having a few hacks up your sleeve.
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Stay healthy
Well, yeah! That’s obvious. Of course, you got your flu shot, right? If not, it’s not too late. While getting a flu shot is extremely important for everyone, especially for those with diabetes, it’s not a guarantee that you won’t get the flu. Plus, we’re all more likely to “catch” the common cold or pick up other viruses during the cold weather. That’s because cold air makes it easier for viruses to stick around longer than they would in warmer weather. And some viruses, such as the rhinovirus, thrive more in cold temperatures. In addition, when the thermometer takes a nosedive, you might be spending more time indoors where you’re surrounded by people who are also sick. So how do you stay healthy?
· Get your flu shot and talk with your healthcare provider about getting a pneumonia vaccine if you haven’t had one yet (a pneumonia vaccine is recommended for anyone with diabetes age 2 and older).
· Wash your hands often, and avoid touching your eyes, nose and mouth. If soap and water aren’t handy, use hand sanitizer.
· Keep your distance from people who are sick.
· If you get sick, follow your sick-day plan. No sick-day plan? Talk with your doctor or diabetes educator about getting one in place before you get sick.
Guard your diabetes supplies
If you’re out and about in the cold weather and you take insulin or non-insulin injectable medicine, like a GLP-1 agonist (e.g. Trulicity, Victoza, Ozempic), protect it at all costs. Like other liquids, insulin and GLP-1 agonists can freeze, causing them to become ineffective. Your diabetes equipment can be affected by cold temperatures, too.
· Don’t leave your insulin or GLP-1 agonist in a cold car. Depending on how cold it gets where you live, your injectable medication could be affected even by keeping it in your purse or coat pocket. Keep your vials or pens in an insulated case, such as the FRIO insulin case.
· If you use an insulin pump, wear it close to your body and throw on an extra layer of clothing to keep it from freezing, as well.
· CGMs, meters, test strips and control solution can be impacted by the cold, as well, so take care to keep them at room temperature.
Protect your feet
Cold, dry weather can dry out the skin anywhere on your body; your feet are especially vulnerable as they can crack, making you more susceptible to developing infections. In addition, if you have loss of sensation in your feet from neuropathy and/or poor circulation, you may not realize that your feet are cold, putting you at risk for developing frostbite, which can cause significant damage.
· Wear appropriate waterproof footwear in the cold weather. If you’re exercising outdoors, choose sneakers that are geared toward winter weather, such as trail running shoes.
· Use sweat-wicking socks that keep your feet dry. If needed, wear another layer over them, but avoid socks that are too thick to fit into your shoes or boots.
· Be extra diligent about checking your feet every day for cuts, sores, or areas of redness or warmth. Signs of frostbite include whitish or bluish-gray skin, combined with numbness, and possible blisters. Call your healthcare provider right away if you have any of these symptoms.
· Keep your feet clean and moisturized (not between your toes, though) to prevent dryness and cracking.
Be active
Try not to let the cold, snowy weather prevent you from moving! Remember that the goal is to fit in at least 150 minutes of physical activity every week. Your warm-weather physical activities may no longer work when the temperature is below freezing, so think about other options to help you meet your activity goals during the winter months.
· Skiing, snowshoeing and ice skating are ways to enjoy the outdoors and stay active (make sure to dress warmly and keep your hands and feet dry).
· If venturing outdoors in frigid temperatures isn’t your thing, choose indoor activities such as walking at the mall, joining a gym or a pool, or working out with exercise videos.
· Bring along snacks and treatment for low blood sugars if you take insulin or diabetes pills that raise the risk of hypoglycemia, and always wear or carry some form of medical ID.
· Stay hydrated! Just because it’s cold out and you don’t feel thirsty doesn’t mean you can’t become dehydrated. Make sure to drink plenty of non-caloric fluids; better yet, keep a water bottle with you to remind you to drink.
Keep an eye on the scale
If your idea of getting through the long winter months means curling up on the couch and binge-watching your favorite series, take extra precautions to make sure the pounds don’t pile on. Extra snacking, hearty comfort meals and a lack of physical activity can lead to weight gain. Come up with a plan so that this doesn’t happen.
· Reach for lower-calorie, lower-carb snacks such as cut-up raw veggies, popcorn or hard-boiled eggs. Pre-portioned snack bags of whole-grain crackers, baked tortilla chips or nuts are good choices, too.
· Make a habit of sipping on sugar-free beverages when watching TV. Try water infused with lemon, mint leaves or berries; unsweetened hot or cold tea or coffee; or flavored seltzer water.
· Keep track of your food intake. Doing so can help you be more aware of what you’re putting in your mouth. There are plenty of apps out there, including MyFitnessPal, MyNetDiary and Lose It!.
· Schedule time for exercise. You don’t have to hit the gym (unless you want to). Climbing stairs, using hand weights or marching in place while you watch TV are easy ways to stay on the move and burn calories.
Manage your mood
Some people find winter to literally be a depressing time of year. Seasonal affective disorder (SAD) is a type of depression that can emerge during the winter due to shorter days and a lack of sufficient sunlight. About 5% of people are affected by SAD, according to the American Psychiatric Association, and it’s more common in women than in men. Symptoms include feeling anxious, being irritable, difficulty concentrating, feeling fatigued and losing interest in doing usual activities. David Spero, RN, a contributor to Diabetes Self-Management, adds that “depression interferes with diabetes management.”
· If you think you might have SAD, talk with your healthcare provider. Treatment includes lightbox therapy (phototherapy) and possibly medication and counseling.
· Stay active, both physically and socially. Exercising and being with family and friends can improve your mood and reduce stress and anxiety.
· Focus on making healthy food choices rather than reaching for high-carb, high-fat comfort foods.
· Get plenty of sleep — but not too much. Aim for about 8 hours of sleep each night.
Keep on checking
Illness, cold weather, holidays and a change in food choices can all impact your blood glucose and A1C levels. Be prepared that your blood sugars may be very different in the winter compared to the summer.
· Keep up with regular blood sugar checks or what your CGM is telling you, and pay attention to trends (e.g., higher fasting or bedtime blood sugars).
· Let your healthcare team know if your glucose levels are consistently outside of your target range — apart from food and activity, you may need a medication adjustment.
Your diabetes self-care plan will likely need some adjusting when the winter winds are blowing, but don’t let the cold weather stop you in your tracks. And remember that summer is just around the corner!
Want to learn more about managing diabetes in the winter? Read “Eight Ways to Manage Diabetes in the Cold Weather” “Wintertime High Blood Sugars: Causes and Solutions.”
