Downhill and cross-country skiing, sledding, ice skating, ice hockey, snowboarding and snowshoeing are all great ways to have fun and be active this winter. While safety always needs to be a concern for anyone outdoors, taking care of your diabetes while participating in these activities requires a bit more planning.
Winter sports safety tips
Blood sugar
Check your blood sugar often while active outside and don’t let your glucose meter get cold.
- When you are active outside in the winter, you may be at greater risk of a low. You burn a lot of energy doing winter sports. Your body needs fuel (sugar) to keep warm and to help with your activity. Test every one to two hours when being active outside in the winter.
- Glucose meters are not always accurate when they are cold. The listed operating temperatures for most meters start at 40-50 degrees Fahrenheit. Think about ways to keep your glucose meter warm when you are on the slopes or outside. You can keep your meter with you under layers of clothes, or leave your meter at the ski lodge and check blood sugar every one to two hours.
Insulin
Make sure your insulin stays warm.
- Insulin needs to be kept between 40 and 86 degrees Fahrenheit.
- If you wear an insulin pump, carry it under layers of clothes, close to your body.
- If you use insulin bottles and syringes, or pens, leave your supplies at the lodge (or in a warm place) so they are available when you stop for lunch or a snack.
Strenuous activities
NEVER ski, snowboard or engage in strenuous winter activities alone.
- If you do have a low blood sugar, other people need to know. It is important to wear your medic alert necklace or bracelet. The ski patrol or medics can’t help you if they don’t know your condition.
Snacks
- Pack snacks. You don’t want to have a low blood sugar as you are going up the ski lift (or if you do, you want to be able to treat it immediately!). Glucose tablets or juice are the best — they are quick energy.
Preventing lows
- Make sure you eat breakfast and STOP for lunch. While you may want to make “just one more” run, don’t overdo it. Better to stop and eat rather than spend a chunk of the day recovering from a low blood sugar.
- Frequent checks during the day can help you catch a low during the activity. But, remember you can have a “delayed low.” This means your blood sugar can drop between four to 24 hours after you’ve been active. Your muscles need to replenish their stored energy, called glycogen.
- You can prevent a delayed low by eating extra carbs before you exercise, or reducing the amount of insulin prior to exercising (you may even have to do both!).
- It is also important to eat a snack within 30 minutes of finishing exercise to prevent delayed lows. This snack should have both carbs and protein (i.e. glass of hot cocoa made with milk, peanut butter sandwich, cheese and crackers, or a small handful of nuts with a piece of fruit).
- If you are planning an afternoon of winter activity (moderately strenuous) you may need an additional 30 grams of carb for every hour you are active.
- For those on NPH insulin: Decrease your morning NPH dose by 20 percent.
- For those on Lantus insulin: Decrease your evening dose by 20 percent the night before strenuous exercise.
- For pumpers: Use a temporary basal rate for the duration of activity. Decrease basal insulin by 20 percent to start.
- It is ALWAYS best to speak with your healthcare team about other approaches involving insulin adjustments that can help to prevent low blood glucose levels.
Enjoy the winter but do so safely and in good control of your diabetes.