Hot Tips for Managing Diabetes in Cold Weather

Brrr … it’s cold out there! When you’re managing diabetes, there are a few extra things to keep in mind when the temperature drops. But don’t let the cold keep you indoors; getting fresh air every day is healthy and a great idea as you try to fit exercise into your daily routine.

Blood sugars

Be aware that blood sugars might not be what you expect when you are out in the cold. Some people respond to low temperatures with low blood sugars, and others will see blood sugars climb higher. The only way to know what’s happening in your body is to test frequently! Watch for trends of highs or lows in the cold, and then adjust your food and insulin accordingly.

Frozen insulin

Remember that insulin, like water, freezes around 32 degrees (F). That means the insulin in the pen or vial you left in the car, in the delivery left on your door step, and in the tubing of your insulin pump will freeze when temperatures are at freezing or below.

• Keep an eye on your insulin and make sure that it is protected from the cold. If you are outside and need to store your insulin away from your body, keep it in an insulated thermos, cooler, or specially designed storage pack to make sure that it stays above 40 degrees if possible.
• Insulin stored in the refrigerator can sometimes freeze, too. Keep it closer to the door of the fridge to prevent this.
• If you think that your insulin has frozen, throw it out and start a new vial, pen or pump reservoir. The protein in frozen insulin denatures and won’t work in the same way.

Protect your electronics

Electronics don’t like to be cold (or hot!). Keep your pump or CGM receiver in an inside pocket next to your body to keep it warm. For the most part, if you can keep it above approximately 40 degrees (F), your pump or CGM receiver will work. On extremely cold days, add a hand warmer to the pocket where you keep your device to keep it warm and prevent frozen insulin.

Pumps

• Tandem t:slim pump: This pump is equipped with a temperature alert—it will give you a warning if the pump is too cold. Watch for this warning, and try to keep your pump warm!
• Medtronic: Review safety and cold weather tips for your Medtronic pump.

Blood Glucose Meters

Most meters and strips only operate when they are kept above 40 degrees. If your device gets below that temperature it will give you a warning. Store your meter and strips in an inside pocket in your coat or pants to keep them close to your body. Or put them in a pocket with a hand warmer pack. 

CGMs

• Dexcom: The Dexcom safety information directs users to store sensors that are not in use between 36 and 77 degrees (F). Dexcom recommends you call the manufacturer if you think that your sensor was exposed to heat or cold or is not functioning properly. If you are using a Dexcom with a receiver, make sure that the receiver is kept close to the body so that it stays warm.
• Medtronic: Medtronic encourages users to make sure that they do not freeze their sensors while storing them, but says that short term exposure to the cold (as in on the day of delivery) should be okay.

Glucagon Emergency Kit

The instructions read: “DO NOT FREEZE!” You won’t be able to use the kit if the syringe of diluent is frozen, so try to keep it warm. 

Headed outdoors this winter? Keep the diabetes equipment you carry with you in an inside pocket close to your body. If you can leave something nearby, make sure it stays at a temperature above 40 degrees (F). Watch for warnings or error codes on your electronic devices and for freezing of your insulin. Now go out and play!