Q: My daughter has been spending long days by the pool with her friends this month. How will all that sunning and swimming affect her blood sugar management?
A: Summer fun and type 1 diabetes do mix, just as long as your daughter is willing to take a few extra sun safety steps. For starters, make sure she is staying hydrated by drinking plenty of water and other appropriate fluids when outdoors for long stretches. If blood sugar goes high over the course of a day, it can result in fluid loss. Add to that the fluid loss from being outside in hot, sticky weather and it's a recipe for dehydration -- which in turn, can lead to problems like heat exhaustion. Before your daughter heads out for the day, make sure she has enough bottled water and other carbohydrate-free drinks to keep her fluid intake steady.
Next, does she wear sunscreen? For anyone, spending too much time in the sun can result in sunburn and skin damage when skin is left unprotected. But for someone with type 1, an extensive sunburn can trigger the release of stress hormones -- and these hormones then increase risk for high blood sugar. For basic protection, look for a waterproof sunscreen with an SPF of at least 30, though children and teens with more delicate skin may need a different level. Wearing a sun hat and limiting skin exposure when the sun's rays are strongest (late morning and early afternoon) can also help protect skin from damage.
It's also important to keep all diabetes supplies away from direct sun and heat: Insulin can lose strength with heat exposure, glucose test strips may be inaccurate if stored in extreme heat, and hot meters may give inaccurate blood sugar results. Storing supplies in an insulated lunch bag tucked inside a larger tote (and then kept in a shady spot) usually works to keep supplies at sun-safe temperatures. Be sure to follow the manufacturer's storage instructions for all supplies.
Finally, swimming is a great activity to stay in shape, enjoy time with friends, and cool off on a hot summer day. But remember, swimming is exercise! Factor in this extra activity when you and your daughter plan out her carbohydrate intake and insulin needs for the day (if you aren't sure how to do this, your diabetes educator can help). To compensate for any lows that may crop up during physical activity, pack an extra snack and some fruit juice. Summer is always much more fun when you're prepared!
--Marilyn Cox, R.N., C.N.S., C.D.E., B.C.-A.D.M., is a clinical nurse specialist in endocrinology at Children's Medical Center of Dallas.
How Other Parents Deal
"We make sure that whenever we go to the beach, we bring a cooler filled with drinks, a separate bag for supplies, and a big beach umbrella for shade. It's nice to have a place to cool off and rest, and sitting under the umbrella gives us a little extra privacy when we need to test."
--Katherine, mom of Arianne
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.