By Jill L. Quarry

As winter is upon us, so is the opportunity for many people to take part in snow activities: skiing, tubing, sledding or simply playing in the snow for the young and young at heart. For others, it may be the dreaded snow shoveling that waits after every snowfall. Either way, for people with diabetes, it is important to be prepared. More episodes of hypoglycemia, when the blood sugar level dips below 70 mg/dl, are reported from winter activities than summer activities.

Activity is one of the main tools for managing blood glucose levels in people with diabetes. This can often be a challenge for those taking insulin for blood glucose control. Most increased activity uses glucose to fuel the muscles during activity and it enhances the effects of insulin. These two conditions combined provide an optimal scenario for the potential of experiencing hypoglycemia.

This is concerning, because if the blood sugar goes too low, the brain does not have the necessary glucose and the person can go unconscious.

Signs and symptoms of mild hypoglycemia include shaking, sweating, dizziness, anxiety, increased hunger, impaired vision, weakness, fatigue, headache, rapid heartbeat and irritability. It is not recommended to rely on these signs and symptoms because they may or may not be present when a person is hypoglycemic. Further, when children are playing in the snow, they are less aware of the onset of these signs.

It is always recommended to check the blood glucose levels more frequently during increased activity. The appropriate treatment for hypoglycemia is 15 grams of carbohydrate. This would include three-to-four glucose tablets, three packs of Smarties, eight Sweettarts, 15 Skittles or one tube of glucose gel. Other foods containing protein and/or fat could potentially delay the absorption of carbohydrates and contribute to more severe hypoglycemia.

Being prepared for snow:

• If the snow activity will follow a meal within two hours, reduce usual meal insulin by 10 to 30 percent.

• If the snow activity is more than two hours after a meal, eat extra snacks for the activity. For moderate intensity activity, like sledding and skiing, eat a snack with 15 grams of carbohydrates every hour during the activity.

• Carry treatment for hypoglycemia with you at all times. This means on you personally, not in someone else's pocket, in a locker room or in the house.

• Monitor blood glucose levels before the activity, after every hour and following the activity.

• If the blood glucose reading reveals hypoglycemia at any time, treat it with 15 grams of carbohydrate and retest blood glucose levels in 15 minutes. If the blood glucose level remains under 70mg/dl, retreat with 15 grams of carbohydrates.

• Because increased activity may contribute to hypoglycemia many hours following the activity, it is suggested to check blood glucose levels at midnight and 3 a.m. in order to detect hypoglycemia at night.

• Be sure to eat a bedtime snack following increased activity, regardless of the blood glucose reading at bedtime.

Share: