Summer is
here with its scorching heat. Summer brings with it, not just the hot weather,
but also mangoes and vacations. Adding to this, the holy month of Ramadan
happens to be in Summer, this year in India. Everyone needs to take appropriate
care of their general health and this applies more so, for those with Diabetes.

Mango is the
undisputed King of fruits, atleast for the vast majority of it’s fans! It is
high in nutritional value, rich in fibre, Iron and other micronutrients such as
vitamins and minerals. While a Diabetic with decent glucose control can enjoy
few slices as in-between meal snack, it is advisable to stay away from the very
ripe ones, juices and milk shakes.

Juices and
milk shakes may lack essential fibre and can cause rapid surges in blood
glucose levels, apart from the high calories and weight gain that they may
impose. The same rule applies to other natural juices such as Sugar cane juice,
which should not be consumed by Diabetics.

Whilst one
enjoys mangoes, it may be needed to cut down other Carbs. Discussing this with
one’s own doctor or dietician helps. Checking weight periodically, tracking
Glucometer readings, regular exercise and of course not overindulging in
mangoes, do help keep blood glucose and body weight under control.

And as a
word of caution, Diabetics with Kidney problems and those on Dialysis
who are supposed to be on a low-potassium diet have to discuss with their
doctor  whether they can safely consume
mangoes or not . This is because mangoes are rich in Potassium. Same applies to
drinking Coconut water which can push up blood potassium levels and also
glucose levels if consumed regularly.

Coming to
medicines, in general, one ought to store medicines in a cool and dry place
away from direct sunlight. Medicines like Insulin need to be stored in fridge
in order to ensure that their potency doesn’t get affected. If Insulin is
carried outside, for instance during travel, it may be safely carried out using
an Ice pack available in most pharmacies or the good-old Thermos flask with ice
cubes.

A common
mistake that we come across regularly is that many leave their medication in
cars due to ignorance. With temperatures soaring high day-by-day this Summer,
it is not at all safe to leave medications in the car unattended without
adequate air conditioning, lest the medicines may not work when taken.

Foot care is
an essential part of Diabetes Care. It is strongly advised that those with
Diabetes should never walk bare-footed and this is of paramount importance, in
Summer months. If one were to walk bare-footed without appropriate footwear,
the scorching heat of the ground surface is bound to result in blisters and
ulcers of the feet which may sometimes even result in amputation of the feet
due to non- healing infected ulcers. 
This is worse if the Diabetic already suffered nerve damage and has
Diabetic Neuropathy. Simple care such as not walking bare-footed can prevent
such deleterious consequences. If Diabetics were to visit religious places of
worship and supposed to removes shoes or chappals before entering such, atleast
clean thick socks should be worn in order to protect the feet.

Regular exercise
and physical activity being a recommendation for all Diabetics, needs certain
extra precautions during the Summer months. Everyone is prone to dehydration,
worse so if a Diabetic has poorly controlled blood sugar. Clean and filtered
water should be used for hydration. Drinks made with ORS should be avoided for
regular hydration purpose as ORS contains glucose.  Soft drinks and beers are not recommended for
hydration as they can cause worsening of blood glucose levels and also promote
excess urination.

It is
essential to do exercise early in the morning or late evenings once the
temperatures are less, unless one chooses to exercise in air conditioned rooms
and gyms. One has to listen to one’s own body and not overdo exercise in hot
weather. Apart from dehydration, this may lead to fatigue, muscle cramps, and
even Heat Stroke.

Vacations
are common in Summer months for kids and families. It is important to plan
holidays appropriately, carry all regular medicines, including Glucometer,
strips, lancets, Insulin and needles to cover the entire vacation. It is
advisable to carry a duly stamped medical prescription so as to avoid any
hassle at Customs and Security checks in Airports, whilst carrying these.

In case of a
sudden low blood glucose event, a Diabetic would need quick acting Carbohydrate
to treat low blood glucose and it is recommended to have some candies,
chocolates, biscuits handy. As most vacations end up with weight gain due to
the excess food consumption, one needs to keep a watch on this. Keeping active
physically, carrying one’s usual gym and jogging gear and continuing usual
exercise routine during vacation times, 
helps prevent piling up of those extra pounds.

As Ramadan
happens to be in May and June this year, Muslims with Diabetes  intending 
to fast need to take extra care by planning this few weeks ahead.
Discussing with their doctor, finding out if they can safely fast, adjusting
oral medicines and Insulin doses, regimens as appropriate, is essential.

It is
important to avoid dehydration by drinking adequate fluids during the
non-fasting part of the day. Consuming brown rice, low fat milk, millets, whole
grain Atta to make Rotis, and avoiding Biryanis, Haleem, Red meat, and limiting
consumption of dates  can not only help
control blood glucose levels but also the weight gain due to the festivities.
Frequent blood glucose checks using Glucometer can prevent low blood glucose
and also big surges of the same.

Following
certain simple precautions during these Summer months can not only allow
Diabetics to keep themselves safe but can also facilitate them to enjoy the
seasonal foods, their vacations, observe their faith and follow their beliefs,
whilst simultaneously taking  care of
their general health and Diabetes.

Dr. Ravi
Sankar Erukulapati

Senior
Endocrinologist,

Apollo Hospitals, Jubilee Hills, Hyderabad.

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(Note – This news is not a medical consultation in any case. This is a Press Not. You can not make any decision based on this
news story. Do not become a doctor yourself, consult a qualified doctor.)