When it comes to managing blood glucose (a.k.a. blood sugar), most people with diabetes focus on familiar factors like food, exercise, and medication to keep levels within range. But there are so many things that impact blood glucose—even the weather.
“Both very cold and very hot weather can change your blood sugar,” says Komal Patil-Sisodia, M.D., an endocrinologist and CEO/Founder & Physician at Eastside Menopause & Metabolism. “If you have diabetes, you need to have a strategy around how to manage both of these situations so you can stay healthy all year.”
A blood sugar spike happens when glucose levels rise higher than the body can effectively handle, either because your body isn’t producing insulin, insulin isn’t working efficiently, or because more glucose is released into the bloodstream than usual. Over time, frequent spikes may increase the risk of diabetes-related complications, so it’s important to do what you can to mitigate them.
Meet the experts: Komal Patil-Sisodia, M.D., an endocrinologist and CEO/founder and physician at Eastside Menopause & Metabolism; and Rachel Pessah-Pollack, M.D., an endocrinologist at NYU Department of Endocrinology and clinical professor of medicine at NYU Langone, Division of Endocrinology, Diabetes, and Metabolism
That starts with understanding signs your blood sugar is high (or low) and aspects that may trigger these variations, including temperature changes. Here’s how weather influences blood sugar and what people with all kinds of diabetes can do to try to stay in range year-round.
How cold weather affects blood sugar
Dealing with cold weather may trigger a stress response. One of the ways in which our bodies naturally combat this is to release stress hormones, which subsequently decrease insulin production and release stored blood sugar. On top of this, injected insulin may absorb more slowly in cold temperatures.
“Cold weather results in less insulin secretion and less insulin absorption after an injection as a result of the lower skin temperature,” says Rachel Pessah-Pollack, M.D., an endocrinologist at NYU Department of Endocrinology and clinical professor of medicine at NYU Langone, Division of Endocrinology, Diabetes, and Metabolism. “Paradoxically, there is also an increase in hypoglycemia risk (low glucose levels) during cold weather, particularly in people with type 2 diabetes and non-diabetes patients.”
This is partly because when you get too cold, your body burns more glucose. In turn, this may lower blood sugar levels, potentially risking hypoglycemia. This may be exacerbated by the fact that low temperatures can mask symptoms of low blood sugar, such as feeling cold or numbness in certain areas.
Dr. Pessah-Pollack also notes that the weather may affect our behaviors in ways that potentially create more scenarios leading to blood sugar variations; people have a tendency to exercise less and eat higher-carbohydrate foods during the winter, both of which can increase the likelihood of blood sugar rising.
“Being less active makes your body less sensitive to insulin, which can cause higher blood sugars,” Dr. Patil-Sisodia adds.
How hot weather affects blood sugar
But the weather doesn’t have to be cold and blustery to impact blood sugar. “Both extreme cold and extreme hot temperatures can affect blood glucose levels and cause fasting glucose levels to rise,” Dr. Pessah-Pollack confirms.
The Centers for Disease Control and Prevention (CDC) stresses that dehydration may raise blood sugar readings. People with diabetes are particularly susceptible to dehydration in the heat for several reasons, including the fact that complications from the disease may ultimately damage the body’s ability to cool down.
Dehydration isn’t the only obstacle, either. Hot weather can actually change how your body processes insulin. Studies show that warm temperatures can speed up insulin absorption after injection and alter how quickly it acts in the body, which may make blood sugar levels harder to predict in the heat or lead to dangerous drops. And if your supplemental insulin is exposed to high temperatures, it may degrade.
How to manage blood sugars in extreme weather
Both of our experts note that the most important thing to do when the temperature changes drastically is to monitor your glucose levels regularly, manually, and through the use of a continuous glucose monitor (CGM). This should catch any spikes early on and help you learn how the weather impacts your body, specifically, as the impact may not be the same for everyone.
During the winter, Dr. Patil-Sisodia suggests exercising indoors to stay physically active as well as wearing “warm layers to reduce your body’s stress response to the cold.” In the summer, staying hydrated, avoiding beverages that may impact your numbers (alcohol and energy drinks), and keeping cool will go a long way towards staying in range.
For people who take insulin, there’s a bit of an extra challenge. “If you are taking insulin, take care to store it carefully and avoid freezing temperatures,” says Dr. Pessah-Pollack. “Be aware that your glucometer could potentially not be accurate due to extremely cold conditions.”
The bottom line
Ultimately, weather is just one of the many variables that may influence blood sugar. Because everyone’s body responds differently, paying attention to patterns, monitoring glucose regularly, and making small adjustments to activity, hydration, and medication (if you’re taking any to treat the condition) can go a long way toward keeping levels steady. Always consult your physician before making any changes to your routine, including how you monitor and treat your blood sugar levels.
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