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Summer means freedom, play, and fun! For families living with type 1 diabetes, a little extra planning can help ensure that the season remains fun and safe. The heat, increased activity, and changes in routine bring new challenges, but also opportunities.

Q: How does summer heat affect blood sugar and insulin levels?

A: Heat can have a variety of effects. For one, it can increase insulin absorption from the injection site or pump, increasing the risk of hypoglycemia. For another, dehydration, which is more common in the summer, can lead to high blood sugar levels. Also, heavy sweating can affect the adhesion of continuous glucose monitoring (CGM) sensors or pump infusion sets. Therefore, more frequent blood sugar monitoring and good hydration are recommended.

Q: How should we adjust insulin for increased physical activity in the summer (e.g. swimming, playing)?

A: Increased physical activity usually reduces insulin needs. It may be necessary to reduce basal insulin (e.g. temporary reduced basal rate on the pump) or insulin doses before meals (bolus). It is important to measure your child’s blood sugar before, during (if possible for prolonged activity) and after exercise. Any adjustment should always be made in consultation with your child’s pediatric diabetologist, as needs are individualized.

Q: What are the best ways to store insulin in the heat, especially when traveling or at the beach?

A: Insulin should be kept cool and away from extreme temperatures and sunlight. Use special water-activated coolers or bags. Never leave insulin in a hot car or exposed to the sun at the beach. Always check the manufacturer’s instructions for storage conditions.

Q: What additional precautions do children with insulin pumps need in the summer?

A: Swimming: Check the manufacturer’s instructions for how water-resistant the pump is and how long it can be left disconnected. Test your blood sugar frequently when the pump is disconnected.

Medtronic MiniMed 780G: Although the pump is waterproof, many users prefer to disconnect their pump when swimming for added safety and to avoid accidental damage or loss of CGM signal. If you choose to swim with the pump attached, make sure it is securely attached.

Omnipod DASH System: Your child can wear the Pod while swimming. There is no need to disconnect it. However, the PDM should be kept in a safe, dry place.

Sweat: Sweat can loosen infusion sets. Use additional skin protection membranes (barrier wipes) or special adhesive tapes for better fixation. Protect the pump from sand and water if it is not fully waterproof.

Q: How to manage hypoglycemia (low blood sugar) during summer activities where routines change?

A: Always carry fast-acting carbohydrates (e.g. glucose tablets, glucose gel, juice, candy). Heat and intense activity can increase the risk of hypoglycemia or make it difficult to recognize its symptoms. More frequent blood sugar checks are essential. Make sure friends, family, or activity leaders know how to treat a hypo.

Q: What about hyperglycemia (high blood sugar) and dehydration in the heat?

A: Dehydration can make hyperglycemia worse. Encourage your child to drink plenty of water throughout the day, especially when it’s hot or exercising. If blood sugar levels are high, check for ketones, especially if your child feels unwell, as the risk of diabetic ketoacidosis can increase with dehydration.

Q: Tips for packing diabetes supplies for vacations or day trips?

A: Always pack double the amount of all necessary supplies: insulin, blood glucose test strips, needles, pump supplies (infusion sets, reservoirs), CGM sensors, glucagon, hypoglycemia treatment. If you are traveling by air, keep everything in your carry-on luggage. A letter from your doctor (in English if traveling internationally) explaining the condition and the need to carry these supplies is helpful.

Q: How to manage snacking or different meal times on vacation?

A: Vacations often mean more flexible schedules and different food choices. Try to match insulin to carbohydrates consumed. Encourage healthy snack choices. Frequent blood sugar checks are key. Adapting timing of insulin before meals may need to be modified.

Q: What should we tell camp leaders or other caregivers about managing T1D in the summer?

A: Provide a clear, written management plan that includes: emergency contact information, instructions for treating hypoglycemia and hyperglycemia, information about meals/snacks, and instructions for physical activity. Train them on how to use their glucose meter and glucagon. Make sure they know when and how to contact you or their doctor.

Q: Are there any special concerns about using a CGM in the summer?

A: Sweat and water can affect sensor adhesion. Use skin prep wipes and additional adhesive retention tapes (e.g., Skin Tac, especially overpatches). Some CGM sensors

are water resistant, but always check the manufacturer’s water resistance limits. Keep in mind that extreme heat can sometimes temporarily affect sensor accuracy.

Summer with Type 1 Diabetes can be just as enjoyable and active, as long as you plan ahead and take precautions. Don’t hesitate to discuss any concerns or seek personalized advice from your pediatric diabetes educator. With the right preparation, summer adventures can be safe and fun!