Ahhh, winter… The season of freshness. The season when everything is covered in a cleansing blanket of white that seem to invigorate… And take one’s breath away! Of all the things that affect people who live with Type-1 Diabetes, cold is one of the least considered, though it should not be forgotten.
Last Monday, I had my usual bimonthly eye injection appointment in the neighbouring city. As is my habit, I checked into my hotel a bit early so that I could park my vehicle in the relative safety of their parking structure and walk for approximately fifteen minutes across a public park to reach the hospital. This is usually done due to the lack of availability of the hotel’s shuttle and the fact that I’m too cheap to pay for a taxi.
Once I checked in, I took my first few steps in the cold, -40 degrees celsius of Saskatchewan winter. That first breath caught in my lungs and caused me to choke. But the first few steps were bearable. Then, as I continued, my limbs and face started to object to my being outside. They almost seemed to form a linch mob hell-bent on making me regret every step I took in the “great” outdoors.
By the time I had reached the hospital, two things happened: I was frozen to my core despite wearing appropriate winter apparel, and the battery on my insulin pump died on me. It shouldn’t have, since it was barely half used. But exposure to the intense cold caused the battery to bottom out.
This leads us to an important reminder about the cold. First and foremost, extreme cold forces the body into a fight-or-flight state, which can cause the release of adrenaline and similar hormones, which will cause the release of glycol for further energy, thereby affecting blood sugar levels.
There are a score of other problems that spending too much time in the cold will cause. The most important thing to remember is that although insulin is meant to be kept cool and/or cold through refrigeration, it can’t be allowed to freeze. Insulin is a protein, and if it is allowed to freeze it’ll break down and won’t function the way it should. Once broken down, it won’t lower blood sugar the way it’s intended.
As far as equipment goes, the manufacturer’s information for all things Diabetes-related, such as your blood glucose monitor and insulin pump, will indicate that you shouldn’t expose them to extreme cold. The problem I faced, in regards to my pump’s battery, is that the freezing temperature will cause the composition of the battery to become ineffective and possibly even rupture. I was lucky that my battery didn’t pop inside the pump.
If you find yourself having to venture out in the freezing, Saskatchewan winter, be sure to dress for the weather. Dress in layers, stay hydrated to prevent dehydration and cover up to prevent frostbite. But most of all, keep your equipment and insulin shielded from sub-zero temperatures and freezing as much as possible. And certainly not least, trust your blood sugars frequently to ensure you’re staying on top of it. ☯