When temperatures start to get out of control, so can your blood sugar. Hot or cold weather extremes can affect your testing equipment and your medications, and they both have negative effects on your body’s ability to produce and use insulin.

A study published in PLOS Medicine in 2018 showed a sharp rise in hospitalizations among people with diabetes when temperatures were either extremely high or low. Other research notes that deaths attributed to heat illness also tend to increase during the warmer months, among people with diabetes.

But you don’t have to let the environment get the upper hand. Taking a few sensible precautions can help you outsmart Mother Nature. Here are the adjustments to make to stay safe, healthy, and on track with your diabetes management plan, no matter where you live and whatever the weather forecast.

6 Tips for Managing Diabetes in the Summer Heat

Take these steps to keep your blood sugar more stable when the temperature soars:

1. Stay Hydrated

High temperatures mean a greater likelihood of dehydration. That’s an issue for everybody, but it has a distinct effect on people with diabetes. “When you’re dehydrated, you have higher concentrations of blood sugar, because less blood flows through your kidneys,” says Lori Roust, MD, an endocrinologist at the Mayo Clinic in Phoenix. “With less blood flow, your kidneys don’t remove excess sugar from your blood to excrete through your urine.” So, when it’s hot, be sure to drink plenty of water or sugar-free drinks. Don’t wait until you are thirsty to replenish fluids.

2. Store Your Medications Properly

High summer temps can affect your diabetes medications, glucose meter, and diabetes test strips. “When it’s hot out, it’s easy for insulin and other drugs to become degraded,” Dr. Roust says. Be sure to store your medications properly — out of the extreme heat. Never leave them in your car on a sweltering summer day, for instance. “It could get up to 150 degrees inside your car,” warns Roust.

If you’re traveling, don’t forget to take your type 2 diabetes medicines with you. You may need to carry them in a cooler with an ice pack. Just be sure they’re not sitting directly on ice or the ice pack, per the Centers for Disease Control and Prevention (CDC).

3. Stay Out of the Heat of the Day

Exercise is an important part of diabetes management and blood sugar control. The American Diabetes Association (ADA) recommends getting 150 minutes of physical activity each week. But you don’t want to be outside exercising during the hottest part of the day, which in general is around 3 p.m., per The Old Farmer’s Almanac. Check your local weather forecast to be sure. “Get in your exercise first thing in the morning or once the sun goes down,” advises Angela Ginn, RD, CDCES, diabetes grant director at the University of Maryland Medical Center in Baltimore. Another option is to work out in an air-conditioned gym.

4. Know the Signs of Low Blood Sugar

Some of the symptoms of heat exhaustion are similar to those of low blood sugar, or hypoglycemia — including sweating, light-headedness, shakiness, and confusion, according to the ADA. “You may think it’s the heat and not recognize that your blood sugar levels have fallen to dangerous lows,” Roust cautions. Be aware of the warning signs of low blood sugar and keep some carbohydrates with you to eat if you need to raise your blood sugar. Have a plan for a medical emergency.

5. Ask Your Healthcare Team About Blood Sugar Testing Frequency

When the weather is hot, you may need to test your blood sugar levels more frequently, so that you can adjust your insulin and diet as necessary. Talk with your endocrinologist or certified diabetes care and education specialist about guidelines, if you’re unsure of the best schedule, Ginn says.

6. Mind Your Feet

People with diabetes are susceptible to problems with their feet, as the CDC notes. In the summertime, you may be tempted to go barefoot or wear open-toed sandals, but the CDC advises against it. Instead, they recommend always wearing shoes that fit, as well as socks — even in warmer months. And at the end of the day, carefully check your feet for cuts, scrapes, blisters, or bruises. Don’t ignore injuries to your feet; get medical treatment right away.

6 Ways to Winter-Proof Your Diabetes Care Plan

Freezing temps and inclement weather can make it more challenging to stay on top of your health. Here’s what to watch for during the colder months:

1. Keep Your Supplies Out of the Cold

Just like extreme heat, extreme cold can affect your insulin and cause your glucose monitor to stop working, notes the Children’s Hospital of Philadelphia (CHOP). Don’t leave supplies in the car when temperatures outside are below freezing.

2. Protect Yourself From COVID-19 and the Flu

Winter is cold and flu season, and that can be dangerous for people with diabetes. A study published in May 2022 in Open Forum Infectious Diseases found that people with diabetes were nearly 60 percent more likely to be hospitalized for flu-related symptoms than those without diabetes. Serious complications from COVID-19 are also more common in individuals who have diabetes, according to research published in the World Journal of Clinical Cases in 2021.

Wash your hands with soap and water regularly so that you don’t spread germs. The CDC recommends taking precautions such as wearing a well-fitting mask, especially when there’s high community spread of COVID-19 in your area, and practicing social distancing indoors in public settings. Ginn recommends that “diabetes patients have a sick-day kit at home and fill it with soup, sugar-free cough drops, tea — things that will make you feel better and that you can access easily.” Also, be sure you are vaccinated and boosted against COVID-19, and remember to get your annual flu shot.

3. Have a Plan for the Holidays

Managing type 2 diabetes during the holidays can be tricky. Many seasonal treats are loaded with carbohydrates that will cause your blood sugar to rise. The CDC suggests planning your meals and moderating your intake of special treats, so that you don’t greet spring a few pounds heavier. It’s also important to avoid or limit alcohol, as it can lower blood sugar and interact with diabetes medications.

4. Keep an Eye on Your Feet

Diabetes can cause a loss of feeling in your toes and feet, per the Cleveland Clinic. The ADA recommends protecting them with the right winter footwear, especially in the snow, and wearing moisture-wicking socks to keep them dry. Apply moisturizer to your feet — though not between the toes — to keep infections at bay. Inspect them regularly, and if you notice an injury that doesn’t heal, seek medical attention, according to the Mayo Clinic. Don’t wait.

5. Warm Your Hands Before Testing Blood Sugar

“If your hands are cold, you may have to warm them up to get a good blood sugar reading,” Roust says. Wash them in warm water before testing.

Most blood glucose meters only operate when they are kept at temperatures above 40 degrees F, according to CHOP.

6. Don’t Use Cold Weather as an Excuse to Skip Your Workouts

It can be hard to get motivated to exercise in the winter. But exercise is an important part of keeping blood sugar in check. It helps if you dress in layers when you’re exercising outdoors in the cold, advises the Mayo Clinic. Or join a gym where you can work out indoors. Another option: Work in exercise at home by taking the stairs, lifting weights, and exercising to videos.