Be Smart and Warm

IT’S BEEN A grey and bleak transition from 2019 to 2020—with vast swathes of northern India experiencing one of the worst ever spells of cold. The bed and blanket seem to have developed a magnetic pull—even the most disciplined among us is faltering in their walks and exercise. Added to this is the variety of calorie-dense goodies floating around—and it’s a recipe for disaster for those who have diabetes. Usually, with the right guidance from the treating team, diabetics who are aware and moderately disciplined learn to live with the condition. However, the advent of a harsh winter demands some adjustments.

Typically, blood sugar control worsens during winter. This largely happens because our physical activity, especially outdoor activity, goes down. Christmas and New Year fuel the holiday mood and our food options become increasingly high in calorie content (think plum cake, carrot halwa, gajak and so on). Excessive cold can also cause stress—the ensuing release of stress hormones can worsen diabetes too. Let’s list 10 simple precautions for diabetics during winter.

1) Test blood frequently. Don’t let the holiday mood and the thought of a needle prick in the cold make you avoid testing. Gentle warming simply by rubbing hands together or holding a warm mug may do the trick and open up constricted blood vessels. Excessive direct heat can also be damaging, so be careful.

2) Move it! Don’t lapse into a totally sedentary state because of the cold. Do indoor exercises: yoga is a great option. At the very least, increase indoor activity. Do all your tasks yourself; use stairs at home and in office. Walk around: don’t sink into a chair all day and transit to the bed at night. Physical activity will not only keep you warm and benefit your heart, muscles and bones, but is also good for your brain and improves insulin sensitivity.

3) Watch what you eat. During winter, we often tend to feel hungrier. Enjoy home-cooked nutritious food and avoid sweets/refined carbohydrates. The quality and choice of vegetables in winter are significantly better and greater in winter months—take full advantage of that. Nuts in recommended amounts, especially almonds, walnuts and pistachios, are sources of good fat and protein.

4) Drink plenty of fluids. We tend to feel less thirsty during winters and often reduce fluid intake without realising it. Make sure you drink enough water.

5) Love your feet like your face. Feet deserve special attention in diabetics, particularly in winter. Diabetes impacts the feet by affecting nerves and blood flow. Blood flow to the feet can be reduced during severe cold weather leading to a greater risk of vascular complications like gangrene—in addition the feet become dry leading to greater peeling and scaling. It’s advisable to apply moisturiser after bathing and wear dry socks and shoes. Nerve involvement leads to blunting of sensations, leading to greater ulceration, infection or frostbite. Be careful while using hot water bottles or heating pads for feet as they commonly lead to burn injuries.

6) Take your vaccinations in time. Flu and pneumonia vaccinations are mandatory for diabetics, especially if over 60 years old and/or have a history of respiratory problems. While vaccines do not completely prevent these conditions, they do reduce the risk considerably. Ideally the flu vaccination should be taken every year before winter. Given the level of pollution, respiratory illnesses are common and can turn serious, necessitating hospitalisation and intravenous antibiotics, oxygen and the rest. Seek medical help at the first sign of an infection.

7) Fight that low feeling! Although winter in India is often enjoyable and pleasant during the day, with the staggering increase in pollution, it can be grey and gloomy, leading to depression, as commonly seen in colder climates. It is important to remain connected with friends and relatives.

8) Take your vitamin D supplements. Vitamin D levels drop dangerously in winter. This happens because the zenith angle of the sun changes and less UVB rays reach our skin in winter months. Add to that the effect of pollution which further limits UV ray penetration. About 2,000 international units/day (60,000 IU/month) of vitamin D is typically needed by adults during winter to avoid aches and pains and preserve our bones.

9) Take care of your heart. Our blood pressure tends to rise during winter and exposure to severe cold does increase the risk of heart attacks. Blood clotting also tends to increase in winter. It is prudent for those with cardiac issues to avoid early morning walks in extreme cold.

10) Dress warmly. Trying to prove that you are ‘hot-blooded’ or macho by wearing fewer layers is not very smart.

Follow these basics and enjoy the Indian winter!

About The Author

Dr Ambrish Mithal

•