Managing your diabetes during New England winters can be full of challenges such as the frigid weather, holiday stress and the cold and flu season. Taking certain precautions at this time of year can help individuals with diabetes stay safe and healthy.
Mike Cheney, NP, a nurse practitioner at the Joslin Diabetes Affiliate and Endocrine Center at Hallmark Health, offered the following tips.
Increased risks for those with diabetes
Winter-time weight gain and inactivity can be added risk factors for patients with diabetes. "There are parties and festivities with all kinds of tempting treats, and sometimes we may not pay as much attention to what we are eating and drinking as we normally do," said Cheney. "Coming off of the winter holidays we sometimes see our patients struggling with their weight."
Cheney points out that talking with your physician and working with your dietitian can help keep you on track and offers the following suggestions to keep your body moving.
• Skip the elevator and take the stairs.
• Find a walking program at a local mall or shopping center.
• Try activities you can do at home, such as stretching.
• This might be the right time to use that gym membership or even work with a personal trainer (programs such as the Hallmark Health System Center for Weight Management and Weight Loss Surgery offer discounted rates to personal trainers).
"Just remember to consult with your physician before you begin any exercise program," reminded Cheney.
Illness impacts blood sugar levels
When you are sick with flu, cold, respiratory infection and other common winter illnesses your blood sugar levels can be affected. You will need to monitor your levels more frequently, and let your provider know of any changes. Cheney suggests the following.
• Prevention is the best medicine
• Get an annual flu shot – its not too late!
• Practice good hand hygiene
• Cover your nose and mouth with a tissue or your elbow when sneezing and coughing

The cold's affect on circulation
One of the complications of diabetes is that temperature sensation in your legs and feet can be affected. "We see people trying warm up with hot water bottles or electric blankets. This can result in burns. Also, if you are stepping into a hot bath to warm up, be sure to test the water with your hands first to get a true gauge of the water temperature."
"When you're going outside, the best way to stay warm is to dress in layers and to make sure that your head, hands and feet are well protected," said Cheney. "But individuals with diabetes need to think about other important items being kept warm as well. Your insulin, glucose meter, and test strips are sensitive to the cold. Be sure not to leave them in your car or exposed to the cold for long periods of time as their effectiveness can be diminished."
Hydrate and Moisturize
Dry winter air can lead to dehydration, which can raise blood glucose levels and dry out skin. "During the cold weather months many people don't realize just how much water they lose over the course of a day," said Cheney. "Remember to drink fluids and to use a thick moisturizer regularly on your skin (thin ones tend to evaporate quickly). Take good care of your feet, but don't use moisturizer between your toes, as it could lead to fungal growth."
Final Thought
"The most important thing anyone, with or without diabetes, can do to improve their health is to quit smoking if you still smoke," added Cheney. "Beyond that, individuals with diabetes should work closely with their doctors and health team, be conscious of their food choices, and try to lead an active lifestyle."
The Joslin Diabetes Affiliate and Endocrine Program at Hallmark Health offers the latest advances for treating diabetes and its complications as well as patient education and support services. Hallmark Health is one of 47 national and two international Affiliate locations and the only Joslin Affiliate in Boston's northern suburbs.

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