Blood sugars

Be aware that blood sugars might not be what you expect when you are out in the cold. Some people respond to low temperatures with low blood sugars, and others will see blood sugars climb higher. The only way to know what’s happening in your body is to test frequently! Watch for trends of highs or lows in the cold, and then adjust your food and insulin accordingly.

Frozen insulin

Remember that insulin, like water, freezes around 32 degrees (F). That means the insulin in the pen or vial you left in the car, in the delivery left on your door step, and in the tubing of your insulin pump will freeze when temperatures are at freezing or below.

• Keep an eye on your insulin and make sure that it is protected from the cold. If you are outside and need to store your insulin away from your body, keep it in an insulated thermos, cooler, or specially designed storage pack to make sure that it stays above 40 degrees if possible.
• Insulin stored in the refrigerator can sometimes freeze, too. Keep it closer to the door of the fridge to prevent this.
• If you think that your insulin has frozen, throw it out and start a new vial, pen or pump reservoir. The protein in frozen insulin denatures and won’t work in the same way.

Protect your electronics

Electronics don’t like to be cold (or hot!). Keep your pump or CGM receiver in an inside pocket next to your body to keep it warm. For the most part, if you can keep it above approximately 40 degrees (F), your pump or CGM receiver will work. On extremely cold days, add a hand warmer to the pocket where you keep your device to keep it warm and prevent frozen insulin.

Glucagon Emergency Kit

The instructions read: “DO NOT FREEZE!” You won’t be able to use the kit if the syringe of diluent is frozen, so try to keep it warm. 

Headed outdoors this winter? Keep the diabetes equipment you carry with you in an inside pocket close to your body. If you can leave something nearby, make sure it stays at a temperature above 40 degrees (F). Watch for warnings or error codes on your electronic devices and for freezing of your insulin. Now go out and play!