Tackling Diabetes When Surrounded by Allergens

Diabetes concerns that arise from rapidly changing weather and allergen exposure include higher than usual blood sugars from inflammation and use of certain medications like steroids and decongestants. Diabetes control can also worsen from drowsiness caused by antihistamines and changes in insulin sensitivity related to fluctuating outdoor temperatures.

Here are a few tips and resources that you might find helpful if you live with diabetes or care for someone who does.

• Recognizing triggers and ways to avoid them seems like a no-brainer. Sometimes it can be hard to differentiate between an upper respiratory infection "getting a cold every winter", reactive airway and true allergies. Allergies can be tested for in several different ways. Allergy skin testing is the gold standard and is used along with a medical history to find out exactly what things a person is allergic to. Talk to your PCP regarding testing and precautions to take before testing. You can also find an allergist in your area using this tool.
• Check your medications (prescription or over-the-counter) to see if there may be any ingredients that cause hyperglycemia. This provides a good overview of commonly used medications while this paper goes into more detail regarding the degree of hyperglycemia caused by different classes of medications and reversibility.
• Plan an insulin regimen for "allergy season" with your endocrinologist. Based on your diabetes regimen, adjustments in long acting insulin, sensitivity factor, basal rates on pump and a larger insulin prescription may be needed to sail through comfortably.
• Stock up on diabetes supplies specially blood and/or urine ketone strips to monitor regularly for ketones during periods of prolonged hyperglycemia. Children and adolescents should have some form of a Ketone Action Plan that allows parents to safely triage when ketones rise.
• Prepare for hot days, extra doses and supplies. Even though it may not feel warm enough just yet, some days have highs similar to summer-time temperatures. Insulin storage precautions apply if you're outdoors (no exposure to direct heat or sunlight) with extra supplies needed when infusion sets and CGM adhesives fall off from sweating. Look through all devices and medications for expiry dates for a "diabetes spring clean".
• Lifestyle changes include keeping an eye on your local pollen/allergen reports via this resource and air quality reports here, depending on your sensitivity. Based on this, you can plan to work out indoors when needed, or be extra careful with showering after coming in from the outdoors on allergen heavy days.

Stay positive as you navigate the next few weeks until the summer! Better days are yet to come-this study from Dartmouth found that seasonal patterns in blood sugars (CGM trends) show improved control over the warmer months (April-September).