Managing diabetes in the heat: Potential issues and concerns

Objective: To review issues surrounding management of diabetes mellitus during times of extreme high temperatures. Methods: Materials used for this article were identified through a search of MEDLINE publications from 1966 to 2009. We chose English-language articles by using terms that cross-referenced diabetes mellitus, hot temperature, heat, desert, and insulin. Results: Persons with diabetes may have greater susceptibility to adverse effects from heat (ie, increased number of emergency department visits and hospitalizations, increased occurrence of dehydration and electrolyte abnormalities, and higher death rate) than persons without diabetes. Alterations in glucose homeostasis may occur, and changes in insulin kinetics and stability are possible. The impact of heat exposure on equipment performance (eg, glucometers) must be considered. Conclusions: Having diabetes places a person at risk for heat-related health problems. Physicians must be aware of possible complications that diabetic patients may encounter in summer heat to prevent problems. Patient educational materials should be developed relating to self-management skills in the heat, and the topic should be included in standard diabetes education programs when applicable.