In winter, people with diabetes experience more blood glucose fluctuations. This is mainly the result of multiple factors acting together, including reduced physical activity, hormonal changes, increased caloric intake, more infections, and seasonal decreases in insulin sensitivity.

To help you get through winter steadily, the following provides a detailed analysis from two aspects: "causes" and "coping strategies."

❄️ Why is blood glucose harder to control in winter?

Body enters “energy-saving mode”: cold stimulates the body to secrete hyperglycemic hormones such as cortisol and adrenaline, and studies show that insulin sensitivity decreases in winter, which reduces the body's efficiency in using glucose and makes blood glucose more likely to rise.

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Changes in lifestyle habits:

“Passive” overeating: to keep warm, the body instinctively increases energy demands, leading to increased appetite. In addition, winter holidays mean more gatherings, making it easier to consume high-calorie foods, increasing weight and insulin resistance.

“Less” activity by choice: Cold outdoor temperatures greatly reduce people's level of activity, decreasing glucose expenditure and making blood glucose more likely to accumulate.

Additional health risks: Winter is a high-incidence period for respiratory infections; when ill, inflammatory mediators and stress responses interfere with insulin function, causing blood glucose to become uncontrolled. In addition, be especially vigilant because the risk of nocturnal hypoglycemia also increases in winter, which may be related to high energy expenditure and insufficient replenishment.

✅ What to do to stabilize blood glucose in winter?

The core strategies can be summarized in the table below, covering five major areas: diet, exercise, monitoring, protection, and medication:

Control Dimensions

Core Objectives

Specific Action Recommendations

Dietary Management

Control total caloric intake to stabilize postprandial blood glucose

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• Order matters: Eating in the sequence "soup → vegetables → meat → staple foods" helps delay the rise in blood glucose.

• Choose wisely: Replace part of refined rice and flour with whole grains and mixed beans. Avoid consuming thick meat broths and porridge.

• Be cautious with snacks: Between meals, you may eat modest amounts of low-sugar fruits (e.g., apples, grapefruit). Sugar-free foods are not calorie-free and should not be consumed without limit.

♂️ Keep exercising

Increase energy expenditure and improve insulin sensitivity

• Mainly indoors: focus on indoor activities such as yoga, tai chi, and high-knee marching in place.

• Go outdoors selectively: when the weather is good, choose to go out for brisk walks or strolls in the afternoon, and keep warm.

• Break up prolonged sitting: every 30 minutes of sitting, get up and move for 2–3 minutes.

Enhance monitoring

Detect fluctuations promptly and prevent hypoglycemia

• Increase frequency: when the weather changes suddenly or lifestyle habits change, monitoring frequency should be increased. In addition to fasting blood glucose, postprandial and nighttime blood glucose are equally important.

• Regular follow-up: According to medical advice, regularly check glycated hemoglobin to understand the average blood glucose level over the past 3 months.

️ Special protection

Prevention of infections and complications

• Infection prevention: Keep warm, get influenza vaccination, wash hands frequently, and wear a mask in crowded places.

• Protect the feet: inspect the feet daily. Foot soak water temperature should not exceed 40°C, duration no more than 15 minutes, and dry between the toes. Do not use hot water bottles or electric blankets directly to warm the feet to prevent burns.

• Protect the skin: apply moisturizer frequently to prevent skin dryness and cracking.

Standardize medication use and seeking medical care

Treat scientifically; do not adjust medications arbitrarily

• Do not adjust medications on your own: Never increase oral hypoglycemic agents or insulin by yourself in response to higher blood glucose, as this may cause severe hypoglycemia.

• Consult your doctor promptly: If blood glucose remains persistently high or shows large fluctuations, seek medical attention promptly and adjust the regimen under professional guidance.

• Adhere to medication: Do not relax medication adherence even during holidays.

Special reminder: The "two-sided risk" in winter

In winter, blood glucose control should not only prevent hyperglycemia but also be vigilant for hypoglycemia, especially nocturnal hypoglycemia. Elderly patients with diabetes are at higher risk.

Nocturnal signs: nighttime hypoglycemia may be atypical, presenting as vivid dreams, nightmares, sweating, etc., and requires extra attention.

Carry with you: when going out, be sure to carry candies, biscuits, or other fast-acting carbohydrate foods to raise blood glucose in case of need.

In summary, the key to blood glucose control in winter is to "be more attentive than usual," implementing meticulous management in all aspects of daily life.