Snow Day!

Here in Colorado we got dumped on with snow last night. Nearly two feet, and still going. The kids and I have this week off from school, so there was none of the “no school snow day” excitement, but regardless, two feet in the Denver-Metro area is exciting. We don’t typically get snow here like I did growing up in Maine.

Many people don’t know this, and non T1D people would surely have little reason to know this, but here’s a tidbit of diabetes knowledge: cold weather typically drops blood sugar. Now I say “typically” because as we know, very few things are a sure thing when it comes to blood sugar. And, there’s a million different factors involved in this blood sugar drop correlation to the thermometer. But this is a trend we see, especially in our family. The only exception is when altitude changes as well (like when we go skiing at 11,000ft, we usually see bgs run much higher, but that’s a different story).

One of the reasons we see blood sugars drop is because of the body’s response to the cold. Shivering, chattering, and other involuntary survival modes take a lot of energy, and this requires glucose. Now, if the kids are fully prepared for the weather, and their body stays nice and warm, this isn’t an issue. But whenever my kids are in the snow they’re usually playing. Sledding has a way of dropping blood sugar FAST; there’s always lots of running and falling, lots of happy adrenaline, and lots of laughing. Blood sugars while skiing can go either way, depending on the day, the conditions, the excitement level of the kids, and how fast the ski lift drags us up the mountain. When we’re iceskating we always tend to be cold (I’ve NEVER had a warm iceskating experience!), and consequently blood sugars typically drop.

Just being cold in the cold can sometimes lead to lower blood sugars because it can mask the feeling of being low. When you’re cold (or having the time of your life sledding) you may not pick up on the subtle cues that your blood sugar is dropping and consequently you don’t know you’re low until you’re REALLY low. That’s what happened with Walker today. She was shoveling out a snow cave, cold but not too cold, and having fun and working hard. She told me she felt a little low, and was going to run inside to check her blood (her CGM had failed last night, and her new sensor was still in its 2-hour warm up period before it starts tracking bg again). I followed her in to find that her blood sugar was a dangerously low 48 mg/dL. Once she stopped for a moment she realized just how low she really felt. It crept up on her. At that moment I called Ollie in too, and sure enough, he had dropped over 80 points in just 15 minutes.

It’s also important to pay close attention to your insulin when you’re out in the cold. Insulin, like water, freezes at 32 degrees Fahrenheit. Pump tubing needs to be tucked safely close to the body to stay warm enough to still be effective. But don’t sit close to the fire with your insulin pump on the stove side when you come in to warm up from the cold, because if the insulin gets too hot it can start to break down too. Ineffective insulin is just that, and blood sugars will respond accordingly. Just when you’re expecting to see lower blood sugars, bad insulin can lead to high ones (or worse: ketones). Insulin is so finicky.

So on days like these we are extra vigilant with their diabetes.