How Will Climate Change Impact People With Type 1 Diabetes?

Climate change affects the environment in many ways: higher temperatures, more heat waves, more forest fires, longer periods of drought, heavier rainfall, worsening air quality… It can also impact human health, and particularly that of people who live with a chronic illness such as type 1 diabetes (T1D).

Extreme events related to climate change (e.g., tornadoes, heat waves, ice storms, forest fires) will become increasingly common and will bring many challenges for people with T1D. For instance, access to primary care (emergency and family care) for severe hypoglycemia can temporarily become more difficult when the system is swamped during a heat wave or ice storm. Access to insulin may also be jeopardized in the event of hurricanes, floods or major earthquakes.

Not to mention, adapting to harsh weather conditions and the resulting psychological stress can affect blood sugar levels and make it more difficult to manage diabetes. A good example is the days and weeks that followed the flooding of the Richelieu River, in 2011. A Canadian study showed that diabetes-related complications (for all types) increased after the event due to stress.

People living with T1D and other chronic diseases (e.g., kidney disease) will be the most affected by climate change, and seniors perhaps even more so. 

A higher risk of hospitalization during extreme heat episodes.

Studies have shown that extreme heat affects blood sugar levels. In people with T1D, insulin is absorbed more quickly when blood vessels dilate in response to heat, which increases the risk of hypoglycemia. However, heat-related stress can raise blood sugar levels, especially when a person is poorly hydrated.

Studies have also highlighted an increased risk of cardiovascular problems in people with type 1 and type 2 diabetes during heat waves. 

Heat could also cause a higher incidence (i.e., a higher number of diagnosed cases) of type 1 and type 2 diabetes. Researchers have observed that a 1-degree rise in average outdoor temperature could be linked to more than 100,000 new cases of diabetes every year in the United States alone. This finding will need to be further explored so that we have a better understanding of its source and so that we can determine the incidence of type 1 diabetes vs. type 2.  

Coping with extreme heat

If you or your child are living with T1D, be very careful to avoid dehydration in hot summer weather. If you don’t have air conditioning at home, you can use fans, take cold showers, or stay with a friend or family member who has air conditioning.

Avoid doing intense physical activity outdoors or in a place with no air conditioning—and this goes for the general population, too. 

Stay hydrated. Keep on chugging down that water: if you don’t drink enough in times of extreme heat, your blood sugar will spike up and you’ll urinate more often, leading to dehydration. Avoid alcohol, as it increases the risk of dehydration and hypoglycemia. Always keep a bottle of water handy!

Don’t forget that heat also affects insulin and your supplies. Keep them cool! High temperatures can alter the composition of insulin, making it less effective. If it’s over 30°C in your home, or if you’re going out, keep your insulin pen in an insulated pouch. Insulated pouches are also available for insulin pumps. Also, keep your continuous glucose monitoring (CGM) system, capillary blood glucose meter and your test strips away from direct sunlight or heat. 

Remember that unopened vials or cartridges of insulin should be stored at temperatures between 2 and 8°C, and opened vials can be kept below 30°C for up to 30 days.

Fighting climate change

You can help the fight against climate change by properly managing, and even reducing, the waste associated with DT1 management.

There’s also a list of daily actions recommended by the Quebec government.

Finally, make sure you keep an emergency kit ready so you’re always prepared, for example in the event of major flooding in your area.

Enjoy this beautiful season and your vacations! Have a great summer!

References :

• Ratter-Rieck, J.M., Roden, M. & Herder, C. Diabetes and climate change: current evidence and implications for people with diabetes, clinicians and policy stakeholders. Diabetologia 66, 1003–1015 (2023). https://doi.org/10.1007/s00125-023-05901-y
• Health of Canadians in a changing climate. Page consultée le 20 juin 2023. https://changingclimate.ca/site/assets/uploads/sites/5/2022/02/CCHA-REPORT-EN.pdf
• INSPQ (2021). Les aléas affectés par les changements climatiques : effets sur la santé, vulnérabilités et mesures d’adaptation. Page consultée le 22 juin 2023. https://www.inspq.qc.ca/sites/default/files/publications/2771-aleas-changements-climatiques-effets-sante-vulnerabilite-adaptation.pdf
• Beyond Type 1. Heat and Type 1 diabetes. Page consultée le 27 juin 2023. https://beyondtype1.org/heat-and-type-1-diabetes/