How to manage diabetes in this extreme heat easily

If you are a diabetic, you know how troublesome managing diabetes in normal circumstances can be itself for many of us. But managing diabetes in extreme heat like in this summer, it can be overwhelming pretty fast.

You have to be extra careful especially if you have to use insulin or your blood sugar levels aren’t in control. There are a lot of complications which can arise due to extreme heat such as severe dehydration, sun stroke, heat stress, heat exhaustion, heat cramps etc.

So, let’s start by understanding extreme heat and it’s related terms, their cause, signs, symptoms so you can take appropriate precautions proactively and manage your diabetes easily.

manage diabetes in extreme heat

What is Extreme heat?

In summer, temperature rises a lot and to a high point normally until the rains come. But sometimes this temperature crosses from a caution level to danger level very fast, called Heat Wave.

And when humidity levels increase with these high temperatures, these caution levels change into dangerous levels where extra precautions and attention is needed to prevent any severe complication.

As per NOAA’s National Weather Service Heat Index, when temperature rises above 105° F with more than 40% humidity for two consecutive days, is called Extreme Heat.(1)

What is Heat Index and what does it tell?

Heat Index is a Temperature and Humidity index which tells us how it feels when the relative humidity is increased with the air temperature. And when exposed to full sunshine, it can increase the heat index values by 8° C or 14° F. When our body encounters prolong exposure to these levels of temperature and humidity, it can result in various heat disorders and health risks.

heat index caution level


So, what makes extreme heat so dangerous?

Exposure to extreme heat in high humidity conditions can be life threatening. Cases of illness or ultimately death rise during extreme heat conditions.

Mostly children, elderly people, heavy labor workers out in hot and humid place, people with chronic diseases like diabetes, heart conditions and obesity remain at higher risks in these extreme heat weather.

But it doesn’t mean healthy and young people shouldn’t take precautions during these times. Even your pets require extra attention to prevent any complication.

people at high risk from extreme heat

What are the dangers of Extreme Heat?

In extreme heat with high humidity conditions, evaporation gets slowed down. Which makes our body work very hard to maintain the normal body temperature as much as it can.

And when victims get overexposed to extreme heat or have been doing extreme physical activities such as over-exercising beyond the physical limit, heavy labor out in hot and humid place, they face the severe heat disorders in most cases.

CelsiusFahrenheitEffects of Extreme Heat
27–32 °C80–90 °FCaution: Dehydration and fatigue can set in with prolong exposure
and activity. Continuous activity will result in heat cramps.
32–41 °C90–105 °FExtreme Caution: You can face heat cramps. Continuous activity
will result in heat exhaustion.
41–54 °C105–130 °FDanger: You are most likely to face heat cramps and heat
exhaustion. Further exposure and activity can result in Heat stroke.
over 54 °Cover 130 °FExtreme Danger: Fatal heat stroke is imminent.

Conditions like living in a congested atmosphere with poor air quality increase the risk of exposure to extreme heat. People living in urban areas in small apartments face this heat very much because concrete stores heat to a longer time and releases that heat at night. This results in higher the temperature at night too which is known as “Urban Heat Island Effect”.

urban heat island effect

Because of this, people encounter double heat exposure during the day as well as in night too. This increases the health risks of heat disorders significantly which can be life-threatening for people who are already suffering from some health condition.

What are the effects of extreme heat on body?


1. Dehydration:

Dehydration is the very common first effect because of the extreme heat. And it can be life threatening if left untreated. In extreme heat, when the humidity rises in air, our sweat can’t evaporate and cool the body as quickly it is required. This increases body temperature and we have to replenish the body fluids frequently. Delaying in replenishing lost fluids results in dehydration. Continuous dehydration puts you on higher risk of heat related illness.

dehydration loss of fluid

Signs and symptoms of Dehydration:

Extreme thirst

Dry mouth

Dry and shriveled skin

Little to no urination

Lack of sweating

Low blood pressure

Rapid breathing

Elevated heart rate

Sunken eyes







2. Heat Rash:

Heat rash, prickly heat and also called Miliaria. Due to extreme heat when sweat evaporation gets limited, our skin pores and sweat glands gets blocked by too much sweat. When it doesn’t get cleared, it results in the rash.

heat rash, prickly heat, miliaria, red skin

Heat rash makes the skin red, dotted tiny pimples like and it stings and gets itchy when touched or makes contact with clothing. It mostly appear on the forehead, neck and shoulder area. But in diabetics, it may appear on hands, legs and feet too which makes it more uncomfortable.


3. Heat Cramps:

As the name suggests, heat cramps are the involuntary spasm of muscles which occurs when you are physically active in a hot and humid environment for long time. These can also occur after you have finished the activity.

Heat Cramps are mostly related with dehydration in extreme heat scenario. In which our body loses fluids and essential minerals such as calcium, magnesium, potassium and sodium which forms electrolytes. Thus, heat cramps are the result of muscles losing their own contraction ability to work easily.

heat cramps in muscles

Heat cramps mostly affects arm muscles, core muscles (abdominal area & back), thighs and legs. These heat cramps are intermittent, brief, involuntary painful spasms which can last for a few hours until the body replenishes the lost fluids & electrolytes and body muscles get relief from it.


4. Heat Exhaustion:

Heat Exhaustion is the next stage effect after Heat Cramps due to prolong exposure to extreme heat in high humidity. It gets worse when there is severe dehydration and fluids in the body are not getting replenished properly.

This condition results in heavy sweating and rapid pulse which means our body is overheating a lot trying to maintain the body temperature. Without prompt and proper treatment, it can lead to Heat Stroke which is a life-threatening condition.

heat exhaustion

Warning Signs and Symptoms of Heat Exhaustion:

Muscle Cramps

Heavy sweating

Shallow rapid breathing

Weak & rapid pulse

Low blood pressure





Sudden cool and moist skin with goose bumps





5. Heat Stroke :

Heat stroke is hyperthermia condition which is caused by body overheating. In this, our body temperature rises to 104° F (40° C) or higher along with severe dehydration. This is caused by prolonged exposure and physical exertion in extreme heat with high humidity environment.

From Heat Cramps and Heat Exhaustion, Heat Stroke is the worst fatal condition in which immediate proper treatment is required to save the life. Sometimes Heat stroke is also referred as Sun stroke.

heat stroke

Warning Signs and Symptoms of Heat Stroke:

High body temperature 104° F (40° C) or above

Absence of sweat

Difficulty in breathing

Weak rapid pulse

Dry and hot red skin

Strange Behavior






and can lead to Coma


Just to be clear here Heat stroke or Sun stroke aren’t same as “Stroke”.

“Stroke” is a condition in which the brain does not get enough oxygen and blood flow which results in damage to brain cells. In major critical condition brain cells dies which is fatal condition.


Extreme Heat and Summer Safety tips:


1. Drink plenty of water to prevent dehydration: Drinking plenty of water is must for everyone. And if you are a diabetic, you know when our blood sugar levels gets high, we have to urinate more than usual. In this condition, we lose body fluids very fast with every passing. And when you sweat more, it creates a rapid fluid loss which can turn into dehydration pretty fast.

drink plenty of water to prevent dehydration

On top of that if you are taking diabetes medication such as Metformin, it can also increase risk of dehydration.

•  So, don’t wait to drink water until you feel you are thirsty. It’s a sign that you are already dehydrated to a point.

•  Avoid drinking sugar-sweetened drinks like sodas, sweet tea.

•  If you like your caffeine, keep it in moderation. Over the top use can be diuretic (more urination) and increase the risk of dehydration. And in some people, caffeinated drinks can cause   headaches and insomnia as well.

•  Water is best for re-hydration. But if you don’t like drinking plain water all the time, you can opt for sugar-free lemonade and iced tea in between.

•  Seltzer may look good at first as it’s just carbonated water. But it’s not recommended for re-hydration specially if you tend to have stomach troubles. As it contains carbon dioxide gas which creates air bubbles. This can create gastric problems and other stomach irritations as well.

•  Carry small bottle of water or recommended electrolyte drink with you whenever you go out.

•  In case your doctor have instructed you to limit your liquid intake due to epilepsy, heart, kidney, liver diseases or fluid restricted diets where fluid retention is a problem. Ask them what you have to do in extreme heat conditions to stay hydrated.


2. Eat well balanced, light regular meals : Eating well balanced, light regular meals is essential specially in summer. Why? Because in hot weather digestion gets affected a lot. Simple mistakes like overeating and bad food combinations can cause food poisoning. Eating light meals ensures that you don’t put unwanted stress on digestion system. And it keeps you from feeling fatigued, tired after a meal.

balanced diet for diabetes

On top of that eating well balanced meals ensures that you get all the essential micro-nutrients like minerals, vitamins as well. These play a vital role in protection from extreme heat. Fruits and nuts are good sources of minerals and vitamins other than your regular meals based on macro-nutrients as in carbs, protein and fat.


3. Make Insulin adjustments as directed: If you are on insulin, you may have to adjust your insulin dose as needed. Consult your doctor and diabetes educator about making the right adjustments as per your routine and in case of extreme heat conditions.

insulin dose adjustment

4. Test blood sugar levels around 4 times or as needed: In hot weather specially in extreme heat conditions, our blood sugar levels can fluctuate a lot. It can go both ways High and low pretty fast. So, it’s always a good idea to frequently test your blood glucose levels. Especially when you encounter a change such as temperature rising rapidly, after a exhausting activity and before you drive. You should make a habit of checking your blood sugar levels before driving. It may save you from unwanted Hypoglycemia situation while driving. This simple habit can save your life and of others as well.

check blood sugar before driving


5. Keep snacks or prescribed items to treat hypoglycemia: If your blood sugar levels are not stable yet, it is very important to keep some snacks or prescribed glucose tablets or drinks with you all time. So, you can treat low blood sugar levels aka Hypoglycemia actively.

These can come very handy when you have to drive or doing some physical activity which can lower your blood sugar levels quickly.

If you have faced frequent low blood sugar levels before, it’s always a good idea to have Instant Glucose Gel/liquid with you all times. Check out these good options:

6. Regular foot care: Regular foot care is very important for diabetics, no matter the weather you are facing. But in summer, you should give extra attention to your feet. In hot environment, your feet get sweaty as well. And if you wear socks for long time, those will remain sweaty and wet. While wearing socks is good to protect you feet but wearing sweaty and wet socks for long time is a big no-no.

You should make sure your feet are not sweaty. If they are, dry them with soft cloth/towel and let them breath in open air for a few times a day. Apply a little talcum powder to remove sweatiness and keep them dry for long.

regular foot care - checking for cuts and sores

When going outdoors during high heat in flip-flops, apply sunscreen or wear full covering shoes to protect from direct heat.

And of course, don’t forget to check for cuts, sores and rash on feet daily. Check out these good options:


7. Protect your medical supplies: Most people tend to ignore to protect the medical supplies in changed weather conditions. Extreme heat, direct sunlight, humidity and moisture can severely affect your medical supplies, making it completely useless or degrading.

That’s why on every medical supply you see it mentioned, “Store in a cool and dry place away from direct sunlight.”

You have to take extra precautions if you have to take insulin. As Insulin must be kept in cool and dry place. It means you should not put it in freezer as well. And never in direct sunlight, in the car or it’s gloves compartment.

Regularly examine your insulin vials. Insulin (Regular, Apidra, Lantus, Levemir, Humalog, Novolog) must remain clear.

Keep your insulin in a Insulin cooler kit to keep it cool. It usually keeps it cool for a few hours and comes in handy when you have to travel.

Same goes for Glucagon kit, Testing meter, strips and other medications, all must be kept cool and dry as well to protect from direct sunlight and high temperature.

diabetes medical supplies


8. Dress appropriately: It may seem a common sense point but sometimes people tend to ignore it for various excuses and then they suffer. In hot weather, always wear light colors, lightweight and loose fitting dresses. It will keep your body cool and protect from heat absorption. When going outdoor, wear a proper covering dress with sunglasses, hat, scarf as needed to avoid direct sunlight. Use an umbrella if need be.

dress appropriately in hot summer


9. Avoid alcohol: Alcohol is a diuretic means more urination. It increases the risk of dehydration. Drinking alcohol also affects our body’s ability to adjust body temperature. On top of that, it affects our balance, judgment and coordination abilities as well which rises to the danger level in high heat.

Additional Safety Precautions to take in Extreme heat:


1. Exercise in a cool place: Exercising is a great way to keep your body active and healthy. It can reduce the health risks due to obesity and overweight especially as in heart problems and diabetes. But extreme heat and humidity can affect your exercise routine in a dangerous way. It can cause early exhaustion, dehydration and low blood sugar levels pretty fast.

That’s why you should always exercise in a cool place especially in hot and humid weather.

tired sweating man

2. Go for a walk either in early morning or later in the evening: If you like to go for a walk or jogging, do it in the early morning or later in the evening when temperature is low. Unwanted sun exposure in a hot weather can be harmful during physical activities.


3. Watch for the signs of heat exhaustion: When exercising or doing any physical activities, people tend to ignore the early signs of heat exhaustion. Don’t do that mistake, it can be dangerous.

People with diabetes, heart disease and who are overweight, are more susceptible to overheating resulting heat exhaustion.

As we discussed above these are the early warning signs of Heat Exhaustion:

Heavy sweating, Shallow rapid breathing, Muscle Cramps, Weak & rapid pulse, Low blood pressure, Weakness, Paleness, Fatigue, Sudden cool and moist skin with goose bumps, Headache, Dizziness, Fainting, Nausea

If you experience any of these signs, immediately move to a cool and airy area. Drink water, energy drink or juice whichever you have available right away. If you have anyone around you, tell them your condition and seek medical attention. If not, call emergency services right away to get help.

man having heat exhaustion

4. Avoid strenuous activities or work during warmest hours: Sometimes it’s best to avoid strenuous activities or work during peak hours in a hot weather. It can prevent unwanted heat related illness. Plan your activities strategically, so you don’t have to work in those warmest hours.


5. Stay on the lowest floor to avoid direct heat: If your don’t have proper air conditioning, it’s better to avoid rooms absorbing direct heat. If you have access to a lower level with proper airflow, away from direct sunlight, go there for the time being.


6. Go to the nearest public shelter, library, mall and other community facilities: If your place doesn’t have proper cooling or facing power cuts at the moment and you are facing extreme heat, it’s a good idea to go to a public shelter where proper cooling, water, medical attention is available. You can also go to the nearest public library, school, shopping mall, movie theaters or any other community facility in your area to avoid heat in peak hours.


Some more extra precautions when you have to go outside:

•  Wear your diabetes identification at all times: You should always wear your diabetes identification whenever you have to go outside or travel. It can be as in ID card, bracelet, wristband, locket etc. which can identify your diabetic condition immediately in case of any emergency.

diabetes identification

•  Limit sun exposure and avoid sunburn: When outside, try to avoid direct sun exposure as much as you can by staying in shades and moving along tree lines, shelters. Keep an umbrella with you in case there is no protective cover at the location.

•  Protect your head and face from direct sunlight: Wear hat, cap, sunglasses and scarf as necessary to protect your head and face from direct sunlight and hot air. Use sunscreen and lip balm to add a extra layer of protection. Wear a covering dress to avoid sunburn and hot air.

•  Don’t stay in closed vehicle for too long: Staying in closed vehicle for too long especially in a hot and humid environment is a big no-no. Even if you have air conditioning in the vehicle, in high heat and humidity, it can create suffocation pretty fast due to opposite temperature inside and outside the vehicle without a proper fresh air flow to remove exhaled carbon dioxide.

•  Keep checking weather reports for heat wave scenario and temperature variation: It’s always a good idea to keep an eye on weather reports. So, you can plan your outdoor visits and activities or avoid altogether accordingly, to avoid heat wave scenario and major temperature spikes.


So, that’s how you can manage your diabetes in the extreme heat scenario. Knowing these terms, signs, symptoms and precautions can prevent unwanted health risks and can be life saving.

On the final note, use your common sense whenever you are outside and engaging in activities. Being proactive and avoiding risks is much better than reacting after condition gets critical.

How do you manage your diabetes in such scenarios? Do you face any specific challenges? Any more thoughts on this? Feel free to share with us…


Leave a comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.