Diabetes and Heat Exposure

By Dr. Saibal Chakravorty in Internal Medicine

May 24, 2024

We all know India has become diabetes capital of the world. A large number of diabetics have been exposed to heat in the ongoing season.

Primarily patients of diabetes have symptoms of increased thirst, increased urination & increased hunger.

Exposure to heat in these patients further aggravates the symptom complex and patients may get dehydrated faster as compared to normal individuals.

These patients have poor immunity, are more prone to infections and may develop fever causing significant insensible fluid loss and presenting as extreme weakness.

Increased urination may further worsen the situation leading to dehydration. Many of the patients with diabetes have co-existent renal dysfunction and are in different stages of nephropathy. Fluid & electrolyte imbalance in these patients may lead to deterioration of renal function and subsequent hospitalization. A large number of patients are on oral antihyperglycemic regimens containing a group of drugs known as SGLT-2 inhibition.

Use of these agents in patients with extreme heat exposure and dehydration may cause further worsening of the condition and can lead to euglycemic ketoacidosis even if the blood sugars are within acceptable limits.

Patients may be encouraged to increase the intake of fluid during the summer season. Care should also be taken along with opinion of the treating physician regarding the intake of fluid in those patients who have concomitant renal and cardiac dysfunction.