8/1/2019
Tips for Navigating a Sweltering Summer with Diabetes:
An Interview with Emily Casciano, RD, CDE

The dog days of summer are upon us. That means whether you are at the beach or strolling through the city on a hot day, safety must be top of mind. When you have diabetes, preparation is the key to a perfect summer day.  “It has been very warm out and we have been getting a lot of phone calls about how to keep our patients safe in a variety of situations,” said Emily Casciano, a pediatric dietitian and Certified Diabetes Educator (CDE) at the Naomi Berrie Diabetes Center. “People want to know how to store insulin and how to tell if it spoils. You always have to plan for what if something does go wrong.”

We asked Emily if she could give us some tips that will make these final summer days as wonderful as they can be. Here are some of her ideas:

  • Diabetes should not hold you back from doing whatever it is you want to do. You just need to be prepared before you do it.  Start by having a conversation your endocrinologist or your CDE so you can create a personalized care plan.
  • At the beach or the pool, remember to keep your insulin cool. Insulated beach bags or frio bags work well. Keep insulin out of direct sunlight. Insulin that overheats will be less effective.
  • Be prepared to treat lows. Make sure the treatments that you have with you will not melt! For example, juice might be a better choice than Starbursts in these warmer temperatures.
  • Check your blood sugars frequently. If you notice that your blood sugars are higher than normal, it is a safe idea to change out the insulin in your pump or change your Pod. Open a new bottle of insulin if you suspect that the bottle overheated. (Officially, insulin should never measure more than 86 degrees Fahrenheit.)
  • Do not leave your insulin in a hot car. The same rule applies to your test strips. Keep all of your supplies cool.
  • If you are traveling, take one of the Berrie Center’s travel letters with you (ask your doctor or educator for one). In addition to a letter, make sure you have a medical alert ID on you at all times. If you don’t want to wear a bracelet or necklace, consider setting up the medical alert on your iPhone—which is in the health application. In addition, take your medical supplies in your carry on bag—especially your insulin.
  • Pack extra supplies wherever you go! Bring extra insulin, pump supplies, sensors, batteries, test strips and quick acting sugars whenever your summer journey takes you.
  • Pack for pump failure. If you are on a pump, taking extra pump supplies may not be enough. You always want to have long acting insulin such as Lantus or Basaglar, pen needle or syringes (if you are using vials), and a copy of your most recent insulin pump settings with you. Take a picture of your settings so the information is easily accessible on your phone.
  • Plan ahead for activities.  Whether you are biking, hiking or touring a city, if your activity level is increased, your insulin doses will likely need to decrease.  Your doctor or educator can help you make new basal patterns, or temp basal regimens specific to your needs.
  • If you are going abroad, it is important to have a list of your medications with you all the time.  The Berrie Center is not able to call in prescriptions overseas, but many pharmacies and hospitals in Europe do sell insulin and supplies over the counter.
  • Be aware of all time changes. For pump users, we advise adjusting your basal rates prior to arriving at your destination. Talk to your educator about when to adjust your dosing based on the time zone.
  • If you’re going swimming and wearing a pump, make sure it is waterproof. If it’s not and if you disconnect—two hours is the limit!  If you are going to be in the water for more than two hours, you may want to take a ‘pump holiday’ and go back on Lantus with multiple daily injections. Check with your doctor or educator. Make sure your blood glucose is at a safe level (>180) before going in the water.  
  • Enjoy the rest of your summer!