From healthline.com/health
People with diabetes can have fun at pools and hot tubs. However, they may need to adjust insulin dosages, keep supplies and medications cool and dry, and closely watch blood sugars to avoid low blood sugars
It’s not all fun and games for people with diabetes when it comes to enjoying swimming pools, sunning at the beach, or relaxing in a hot tub.
Managing blood sugar spikes and dips in the summer heat can be a challenge all on its own. But people with diabetes may also be thinking about emergency treatments for medical emergencies, making sure their devices and supplies are kept at safe temperatures, and any adhesives from insulin pumps or continuous glucose monitor (CGM) sensors don’t fall off due to water, sweat, or moving around in the water.
A little advanced planning and attention in the water can make all the difference in staying on top of diabetes management and ensure you stay safe and healthy.
Before you even dip your toes in the water, you will likely want to start thinking about where your diabetes devices and any supplies you typically use will be kept.
Even if you aren’t at the beach or the pool, it’s important to remember that insulin and sunshine do not get along well.
The ideal temperature for insulin longevity and efficacy is between 36 and 46 degrees, which is generally what refrigerators are set at and how insulin is stored until the first time it’s opened and used.
The hottest temperature insulin can withstand before it starts to break down and stops lowering blood sugar effectively is 86 degrees Fahrenheit.
Note that some glucometers will also stop working if they overheat, flashing an error message if they hit a temperature outside of the acceptable range.
Your diabetes in heat and humidity
Hot and humid weather and scorching sunshine can affect glucose levels and other aspects of managing diabetes. This can include how insulin and other medications work, and possible dehydration that can lead to dangerously high and low blood sugars.
Read more about how heat and humidity can affect your diabetes management and health overall.
You can protect your insulin pens, glass vials, and insulin pumps with any of the following approaches:
- Insulin storage: Do not leave your insulin or supplies in direct sunlight or in a very hot vehicle. This might mean taking them with you and putting them under an umbrella or a towel if there’s no other shade.
- Insulin pump storage: Store your insulin pump in a cool, shady place out of direct exposure to the sun.
- Place an ice pack in your bag next to your diabetes kit. This may give you at least an hour of protection, depending on how hot it is outside. Remember not to put your insulin directly on top of an ice pack. Freezing insulin is just as destructive as overheating it.
- Cooling products: Consider buying a diabetes product designed to help protect your medication or supplies. This might include a Medicool pack or poncho to keep the ice packs in the right place or a Frio case activated by water to keep insulin temperatures at safe levels for up to several days. If you plan to keep your pump on while swimming for an extended period of time, consider using a waterproof case from sources like AquaPack.
- Adhesives: Use additional adhesive if necessary to protect your infusion site and CGM sensor site from coming off due to prolonged time in the water. Popular sources include Rock Tape, GrifGrips, Skin Tac, or Simpatch.
- Timing hot tub use: You might try to time when you get into a hot tub with when you’re planning for insulin pump infusion or CGM sensor site changes. While not always possible, timing your infusion site change around a hot tub soak can mean you don’t have to worry about the site coming loose or possible insulin damage from the hot water.
- Medical ID: Wear a diabetes medical ID bracelet or necklace when you’re in the water or nearby, to help alert other people and lifeguards or paramedics to your condition.
Yes, you can swim if you wear an insulin pump.
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Various diabetes devices have certain limitations for how they can be used in water. For example:
- iLet by Beta Bionics is waterproof up to 12 feet deep for up to 30 minutes
- Medtronic’s MiniMed 780G system is waterproof at a 12-foot depth for up to 24 hours
- Omnipod 5 by Insulet is waterproof in 25 feet for up to 60 minutes
- Tandem t:slim X2 is “water-resistant” in 3 feet deep water for up to 30 minutes (the device user guide advises that the pump not be worn while swimming or in a hot tub)
Always make sure to consult your diabetes device manufacturer’s guidelines before exposing your insulin pump to any water.
Swimming benefits for diabetes
Swimming can benefit people with diabetes in several ways. These include improved insulin sensitivity and blood sugar levels, weight management, cardiovascular health, and mental health.
Find out more about how swimming can help you, with diabetes or not.
Consult your diabetes care team about how to handle times when you’re enjoying swimming pools, hot tubs, and beach time. They can help you navigate these situations, from how to handle insulin dosing to changes you might experience from exercise and exposure to high temperatures.
One suggestion they might have for people using insulin pumps is to be mindful of how long they might be disconnected from the device. That may affect blood sugars and longer-term management over several hours or an entire day.
Your healthcare team can best guide you on taking an insulin bolus if you’ve been disconnected from the pump for more than 30 minutes, accounting for the amount of background basal insulin you might be missing during that time period. This is specific medical advice, so make sure to consult your doctor first.
They will also likely instruct you to have fast-acting carbs, such as glucose tablets, on hand in case you experience a low blood sugar while at the pool, beach, or in a hot tub.
Don’t forget that swimming is an exercise and will affect your blood sugar levels.
Yes, hot tubs are OK for people with diabetes. However, they do require some extra care and attention, just as swimming pools and beachfront experiences do.
They can affect blood sugar levels and increase the risk of hypoglycemia since the increased blood flow moves insulin faster throughout the body.
Your doctor can help guide you on insulin dosing and blood sugar management that may need adjusting with hot tub use. Some suggest that people using insulin avoid taking a full mealtime or correction bolus before getting in a hot environment, and instead take a lower amount to help accommodate any blood sugar swing.
Insulin dosing aside, the heat from the hot tub water can be dangerous for the insulin inside the pump and the infusion site’s cannula, which delivers insulin under your skin. Most hot tubs are hotter than 95 degrees, which means an insulin pump should never be submerged, regardless of whether it’s water-resistant or not.
- Traditional tubed pumps should be disconnected before you get into a hot tub
- Omnipod patch pumps can stay attached as long as they’re on the upper body and can remain above the heated water
- CGM sensors have similar guidance about not submerging and keeping them above hot water, if possible
If you accidentally immerse your pod in the hot water for too long, keep a very close eye on your blood sugars during the few hours afterward to make sure you don’t experience any unexpected hyperglycaemia. That could be a sign that the insulin is no longer effective, and you may need a new insulin set change to prevent diabetic ketoacidosis (DKA).
When you live with diabetes, you can enjoy swimming pools, beach water adventures, and hot tubs. However, this may require some extra care and planning to ensure you do not experience any serious blood sugar fluctuations other diabetes-related issues.
You can take simple steps to manage your diabetes while in the water or enjoying waterfront fun in the sun. These may include tracking blood sugars closely and properly storing insulin, medications, or diabetes devices in cooler temperatures and out of direct sunlight.
It’s important to stay hydrated and have fast-acting carbs on hand in case of low blood sugar. Your healthcare and diabetes team can help guide you on any insulin adjustments to make before or after you’re at the pool or hot tub.
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