The weather channel has posted a winter storm warning, and you really don't need a weather forecaster to tell you that it's cold outside! Under those conditions, everyone needs to take precautions; but if you have diabetes, it's important that you know what precautions to take, and then that you, indeed, take them. We surfed the medical experts on the net, researched several well-respected diabetes treatment manuals, and discussed the subject with our own doctors.
Here's a summary of what we found out:
It has long been recognized that climate does affect diabetes; inclement weather may lead to depression and anxiety which can influence diabetic control. So it makes sense to us to explore what we need to do before and during a severe cold winter storm.
First, precautions for everyone to take BEFORE THE STORM:
1. If your home is heated by fuel oil or propane, make sure you have an adequate supply as regular fuel sources may be cut off. If you heat with natural gas or electricity, make sure your bill is paid, or make arrangements with your provider to not cut off your service. During a severe storm, your electricity may fail, which will also cut off your ability to heat your home, so you'll need to have plenty of firewood (hopefully you have a fireplace) in an accessible place and/or safe kerosine space heaters (check with your local fire department to find out if these are legal in your area and make sure you follow the manufacturer's instructions in their use). If you live in an area where there are frequent power outages, you might want to invest in a generator.
Also good to have on hand is a small well-vented wood or camp stove with fuel. Keep a supply of safety candles, flashlights (with fresh batteries), and a portable battery-operated radio (also with fresh batteries) handy. If your water is supplied by a well, have several gallons of bottled water available for drinking and cooking. If you're on a well, you're likely to be on a septic system. Filling bathtubs with water before the storm hits (you may need to tape the closed drain with duct tape to insure a tight seal) should supply your need for water to flush the toilets until electric power is restored.
When the power goes off, you may also lose your phone lines due to ice or heavy snow. If you have frequent need of medical attention or have another chronic disease such as heart disease and live in a remote area, you may wish to invest in a cellular phone or other means with which to contact emergency help.
2. Make sure your home is winterized: walls and attic insulated, doors and windows caulked and weather-stripped, and storm windows and doors installed or windows and glass doors covered with plastic. Install and check smoke detectors. Have your chimney cleaned and checked by a reputable chimney sweep.
3. To keep pipes from freezing, wrap them in insulation or layers of old newspapers, covering the newspaper with plastic to keep out moisture. Let faucets drip a little to avoid freezing. Know how to shut off water valves should a pipe freeze and burst. Also know ahead of time how to deal with a frozen pipe (your plumber would be a good source of this information).
4. Other items to have on hand include: a first aid kit, 1-week backup supply of food that does not require refrigeration or cooking in case power is lost (during a particularly bad blizzard in Connecticut, we were without power for 5 days), a non-electric can opener, extra blankets and sleeping bags (we camped out in front of the fireplace), and a charged fire extinguisher.
5. Make sure that anyone with diabetes (and anyone else on any medication) has a 1-week supply of essential prescriptions and diabetic supplies.
DURING THE STORM:
1. Stay indoors and dress warmly in layers of dry clothing.
2. To conserve fuel, set the thermostat at 65°F (18°C) during the day and 55°F (13°C) at night. Close off un-used rooms.
3. Listen to the radio or television for latest storm information. If you lose power, contact your city officials to determine if there is a shelter open to go to.
4. If you MUST go outdoors for any reason during severe winter conditions, dress warmly in thin layers of loose-fitting dry clothing. Outer clothing should be hooded and repel water. Since the body loses about 70% of its body heat through the head, make sure to wear a warm hat. Wear well-insulated, lace-up boots. Keep your skin exposure to a minimum to prevent frostbite.
5. Watch for signs of hypothermia and frostbite which are particularly threatening to the very young and the elderly.
IF ANY OF THE FOLLOWING SYMPTOMS OCCUR, CALL FOR AN AMBULANCE OR SEEK MEDICAL ADVICE IMMEDIATELY!
signs of hypothermia:
- pale, cold skin -- no capillary return when fingernails are pressed
- slow, shallow breathing
- slow, shallow pulse, sometimes skipping a beat
- blurred or double vision
- person appears asleep, difficult to arouse, or unconscious
- person experiences a sense of "well-being"
- lack of shivering
- may have non-reacting pupils and appears dead
signs of frostbite:
- loss of feeling and white or pale appearance in fingers, toes, nose, and ear lobes.
If hypothermia or frostbite is suspected, begin warming the person slowly and call for immediate medical attention. Put the person in dry clothing and wrap their entire body in dry blankets until help comes.
OF PARTICULAR CONCERN TO DIABETICS WITH HEART DISEASE AND/OR ASTHMA:
1. Blood vessels narrow when exposed to cold, forcing the heart to work harder and decreasing its oxygen supply. Some studies also suggest that exposure to cold may increase the tendency of blood to clot. If you have diabetes and heart disease, stay indoors as much as possible and avoid any stressful exercise such as shoveling snow. Be very careful when walking outside when it's icy -- broken bones in a diabetic may take longer to heal.
2. Cold weather can "trigger" asthma. The stress of an asthma attack in a diabetic, some studies suggest, may result in the release of hormones that increase blood sugars and cause resistance to insulin. If you have diabetes and asthma, stay indoors as much as possible, and increase the monitoring of your blood sugars during cold weather. If you must go outside, cover the mouth and nose with a scarf, toque, or ski face mask. Avoid any stressful exercise such as shoveling snow. Again, be careful walking where it may be icy -- you, especially, don't want to break a bone!
Take care during cold weather, and if you have concerns about your particular needs, don't hesitate to discuss the subject with your health-care team.
