Surviving the Summer Sun: Diabetes Tips for the Beach

Summer is officially here, and keeping blood sugar levels in check can be particularly challenging. Here are some vital tips for those managing Type 1 or Type 2 diabetes to help stay balanced.

Sun and Heat Precautions

If you have diabetes and plan to spend hours at the beach under the blazing sun, ensure you don't have nerve or blood vessel damage that affects your body's ability to cool down. This could lead to heat exhaustion or heatstroke, a medical emergency. Dehydration might increase your blood sugar levels and cause more frequent urination.

Summer heat can also affect how your body responds to insulin. Keep a close eye on your blood sugar levels while at the beach. If you're taking insulin, you might need to adjust your dosage and store it in a cool place. Heat can cause insulin to be absorbed faster, increasing your risk of hypoglycemia (low blood sugar). It's best to consult your doctor for tailored guidance before a beach outing.

Sunlight and heat can impact certain diabetes medications, so they should be kept cool or at room temperature for effectiveness. Sunlight and heat can reduce medication efficacy. Injectable medications need to be stored in a cooler, away from direct contact with ice or ice packs, to avoid freezing.

Never leave injectable medications other than insulin in a hot car or under direct sunlight to avoid overheating. Moreover, if your clear insulin looks cloudy, or your cloudy insulin (such as NPH) appears grainy, it could be damaged. Discard it and use a fresh vial or pen.

Heat can also damage glucose meters, test strips, continuous glucose monitors, and insulin pumps. Keep these devices out of direct sunlight to prevent overheating and don't store them in your car.

Also, it might seem obvious, but it's crucial: always wear sunscreen. Even if you're mostly under an umbrella, you'll still be exposed to harmful ultraviolet rays. The risk of painful sunburn increases, and over time, so does the risk of skin cancer. Use sunscreen with an SPF (Sun Protection Factor) of at least 30—even if you don't usually burn. Reapply every two hours, especially after swimming or sweating heavily. It's advisable to avoid midday sun from 10 a.m. to 4 p.m., and wear protective gear like a hat and sunglasses.

Beach Activities and Swimming

Swimming, surfing, volleyball, jogging, or walking on the beach are great ways to enjoy your beach day. However, increased physical activity combined with hot temperatures might affect your blood sugar levels. Here's how to help keep your blood sugar stable:

- Regularly check your blood sugar, preferably with a continuous glucose monitor that doesn't require pricking, to reflect real-time sugar levels while at the beach, especially before swimming or playing beach sports. Bring a snack and something sweet to stabilize your levels if they start to drop.

- If you take insulin, keep a hypoglycemia treatment handy. Glucose tablets are convenient, easy, and won't melt in the sun, but other good options include glucose syrup packs, juice, glucose gel, or non-chocolate candies like jelly beans or fruit gums.

Food and Beverages

Being out in the sun and sand often brings on hunger and thirst. Instead of hitting the snack bar or packing junk food, plan ahead and bring healthier (and cheaper) options.

The American Academy of Nutrition and Dietetics suggests these healthy snacks:

• Roasted or dry nuts
• Pre-cut fruits and vegetables
• Whole grain crackers
• Roasted chickpeas

Other good options include:

• Low-carb crackers
• Cheese sticks
• Hard-boiled eggs
• Hummus
• Nut butter
• Pumpkin seeds

Bring a cooler with an ice pack to keep perishable foods fresh and cool.

Make sure to drink plenty of water, between 1.5 and 2 liters daily, even if you don’t feel thirsty or aren’t sweating much. Consume water or non-carb drinks, and remember that veggies and fruits have water too (especially watermelon, which has just 12 grams of carbs per cup).

Skip the alcohol. A cold beer might seem refreshing, but alcohol has a diuretic effect, causing you to urinate more and potentially leading to dehydration, depending on your alcohol intake. Plus, drinking too much alcohol and swimming is dangerous, as your risk of drowning increases the more you drink.

Keeping up with your diabetes diet can be tricky during summer months. Whether at the beach, a picnic, a barbecue, or a campfire, food is often anticipated as much as company. But when diabetes is part of your daily life, it's best to be smart about food and portion choices to keep blood sugar levels in the target range.

Insulin Pumps and Continuous Glucose Monitors

Many insulin pumps and CGMs are waterproof (meaning you can swim with them), but it's essential to read the manual to ensure you don't need to remove them before entering the water. Also, water and sweat can cause the adhesive of pump infusion sets or continuous glucose monitor sensors to become less effective.

Foot Care

Don't forget to protect your feet while at the beach, especially if you have neuropathy or circulation issues in your legs. Hot pavement, sand, shells, rocks, and broken glass are hazards you might encounter, leading to irritation, burns, blisters, or cuts. Without care, these can escalate to more severe foot problems.

Avoid or limit time walking barefoot. Wear sturdy sandals or beach shoes, and check your feet regularly during the day and after returning home. If you notice cuts or sores that don’t heal, or any areas of redness, heat, or swelling after a day at the beach (or anytime), see a doctor immediately.

Professor Julio Weinstein is the Director of Diabetes Research at Wolfson Hospital and a senior diabetes physician at the DMC Diabetes Treatment Center.