Diabetes and dehydration

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helli

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Relationship to Diabetes
Type 1
As the temperatures rise, diabetes fora start discussing the annual question "can the weather affect our blood sugars?"
Responses seem to vary between those who say their levels go up and those who say their levels go down intermingled with explanations - stress from one side and more active from the other.
This year, I have seen a new explanation - dehydration. Yep, after 20 years, there seem to be a new explanation for why blood sugar levels rise in the heat (although it doesn't explain why they fall for others).
I completely agree that probably need to drink more in hot weather. But do we need to drink more than someone without diabetes?
My understanding is that we can become thirsty if our levels are high which may have a slight connection with dehydration (as we are peeing more) but that is not a heat thing.
I have also seen mention that we get dehydrated because we sweat more than those without diabetes. Is this true or is it another point of sweating more if your levels are high (or, in my case, low)?

I am curious about other people's experience and where this link between diabetes and dehydration has come from. Is it all the same source which has been tweaked as it repeated or is it just something I missed along the years?
 
It is probably also good to remember that dehydration will very likely cause CGM sensors to read false lows or, in some severe cases, fail entirely if they become overly starved of interstitial fluid. To my mind, this alone is a good reason to stay well hydrated during hot weather.
 
helli said:
As the temperatures rise, diabetes fora start discussing the annual question "can the weather affect our blood sugars?"
Responses seem to vary between those who say their levels go up and those who say their levels go down intermingled with explanations - stress from one side and more active from the other.
This year, I have seen a new explanation - dehydration. Yep, after 20 years, there seem to be a new explanation for why blood sugar levels rise in the heat (although it doesn't explain why they fall for others).
I completely agree that probably need to drink more in hot weather. But do we need to drink more than someone without diabetes?
My understanding is that we can become thirsty if our levels are high which may have a slight connection with dehydration (as we are peeing more) but that is not a heat thing.
I have also seen mention that we get dehydrated because we sweat more than those without diabetes. Is this true or is it another point of sweating more if your levels are high (or, in my case, low)?

I am curious about other people's experience and where this link between diabetes and dehydration has come from. Is it all the same source which has been tweaked as it repeated or is it just something I missed along the years?
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I'm one of those folks whose numbers go down in the heat.

Personally, I detest the cold. Cold and winter is not my happy place and time. Heat and summer I am so much more comfortable.

As you probably realise, my preference is to overwinter in the Tropics. Going from UK temperatures of sub-zero to the thirties, as we did this year means we do drink more, and in particular over the early days to combat jetlag too.

Maybe those of us, whose numbers trim down just happen to drink more anyway?
 
AndBreathe said:
Going from UK temperatures of sub-zero to the thirties, as we did this year means we do drink more, and in particular over the early days to combat jetlag too.
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I would assume you would do that regardless of diabetes.
The thing that has surprised me recently is the repeated assertion that people with diabetes are more likely to become dehydrated.
 
Perhaps, we don't, but suffer the consequences of dehydration more than non-diabetics, so it's easier to state we're 'more likely' rather than explain it properly? (If so, someone needs slapping, 😉 )
 
helli said:
I would assume you would do that regardless of diabetes.
The thing that has surprised me recently is the repeated assertion that people with diabetes are more likely to become dehydrated.
Click to expand...
Perhaps it’s assumed that people don’t have their blood glucose under control. When I was misdiagnosed as Type 2 and really struggling with my BGs, I was certainly prone to dehydration in the heat, because I was dehydrated to start with, from peeing out excess glucose, and heat exacerbated it. Since I got my BG steady, I’ve not noticed dehydration being a worse problem than it was pre-D.
 
I guess it’s one of those general rules @helli but it something I’ve seen said before. I think it’s because we can get dehydrated more quickly eg if our blood sugar is a bit high, and then that becomes a vicious circle in that we can’t pee out the excess glucose properly because we’re dehydrated and those higher sugars then lead to more dehydration. I read that we’re also at greater risk of heat exhaustion and the like. Again, possibly due to dehydration and also the fact that we maybe don’t sweat 100% as we should due to small amounts of nerve damage over the years. Lots of tiny indiscernible things can add up.

I’m not a fan of the heat, but I’ve never had problems before but last Summer I felt awful in the severe heat, despite having previously coped ok, so maybe it’s an ongoing thing or can be triggered by slight changes that wouldn’t affect anyone without diabetes. I also wonder if the stress to the body of heat/dehydration can also worsen things.

People with other medical conditions are more at risk too.
 
Don't think we need to drink anymore or less than those without diabetes.

Only time notice that dehydration effects levels is with libre sensor, example if don't drink water through night & sleep right through then libre graph can be way out, once awake & drinking that night graph looks fine after scanning after.
 
helli said:
I would assume you would do that regardless of diabetes.
The thing that has surprised me recently is the repeated assertion that people with diabetes are more likely to become dehydrated.
Click to expand...
Of course, and my partner does the same.

I think it's the assumption that those living with diabetes are living with persistently elevated blood sugar levels.
 
AndBreathe said:
I think it's the assumption that those living with diabetes are living with persistently elevated blood sugar levels.
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Shame the advice is not to manage our diabetes and keep a close eye on our numbers when it is hotter rather than assuming we don't.

Maybe my view of "us" is warped because I think of those of us on the fora who have an interest in managing our condition.
 
helli said:
Shame the advice is not to manage our diabetes and keep a close eye on our numbers when it is hotter rather than assuming we don't.

Maybe my view of "us" is warped because I think of those of us on the fora who have an interest in managing our condition.
Click to expand...

In the outside world, many T2s aren't given any tools, or anything to raise an interest in managing their condition. At diagnosis, the nurse said I shouldn't worry about my diabetes, they (meaning the surgery) would look after it for me.

One of the most powerful things said to me in the early days of living with diabetes was not ever to ignore my diabetes, because I could be utterly certain it would not be ignoring me.

Never a truer word.
 
littlevoice359 said:
It is probably also good to remember that dehydration will very likely cause CGM sensors to read false lows or, in some severe cases, fail entirely if they become overly starved of interstitial fluid. To my mind, this alone is a good reason to stay well hydrated during hot weather.
Click to expand...
I find that my Libre reads higher and in fact my BG goes up when I am dehydrated, presumably because the concentration of glucose in my blood increases if there is less water in my blood and interstitial fluid due to dehydration. In these situations when I get the opportunity to have a nice long drink my BG and Libre readings go down, sometimes quite noticeably.
Having just spent 2 full days out in the heat with very little opportunity for fluids or shade, my levels have stayed quite stable through the day, but plummeted later when I suddenly really felt the thirst and had the opportunity to fully quench it. I didn't have the opportunity for toilet visits either so probably didn't drink as much as I normally would earlier in the day in order to limit that need.

I don't think I sweat any more or less now than I did before.

I think this concern about us being more prone to dehydration probably stems from people with less well managed diabetes, where their kidneys will be removing fluid at a faster rate than Jo Public. If we don't drink more then it becomes a self perpetuating downward spiral as @Inka describes. I think this is probably less of an issue for those of us with insulin and CGM who can just jab some extra insulin to help regulate it, but might be more challenging for people who are less confident of using their insulin or don't have insulin.
 
I would imagine severe dehydration may well raise blood glucose levels due to a stress response - when I was only fairly newly diagnosed we had to abort a trip to Spain (come back early) as I'd become dehydrated (I never liked to drink water as a child) and my blood sugar readings were rather high. It was early days of course, many many years ago.

I do quite a lot of exercise these days and have never noticed a link between dehydration and blood glucose levels, though perhaps I'm just habituated to it. e.g. I never drink the requisite 1 bottle (750ml) per hour (e.g. I drank a total of 2 bottles and a few cups of coffee on a 100 mile ride a couple of weeks ago - it was only low 20C's, but I will certainly have had quite a hydration imbalance - Garmin reckons 2000ml)
 
Reading through this thread, once again shows the variations in ‘us’.

The increase in BG with the heat could be because of lack of fluid causing higher concentration of glucose, or lack of interstitial fluid.The drops in BG could be because of higher sensitivity to insulin in the heat.

As I so rarely do a BG now (only need once a week for my calibration of my sensor) I think I am less aware of any discrepancies between BG and SG. I do know that in the last few days I have had far more hypos than usual, and have made adjustments to basal (by upping my target for the looping) to counter this.
 
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