Editing IPCC:AR6/WGII/Chapter-7 (section)

==== 7.2.3.4 Diabetes ====

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''Individuals suffering from diabetes are at higher risk of heat-related illness and death (medium confidence).'' Extreme weather events and rising temperatures have been found to increase morbidity and mortality in patients living with diabetes, especially in those with cardiovascular complications ( [[#Méndez-Lázaro--2018|Méndez-Lázaro et al., 2018]] ; [[#Zilbermint--2020|Zilbermint, 2020]] ; [[#Hajat--2017|Hajat et al., 2017]] ). Evidence suggests that the local heat loss response of skin blood flow is affected by diabetes-related impairments, resulting in lower elevations in skin blood flow in response to a heat or pharmacological stimulus. Thermoregulatory sweating may also be diminished by type-2 diabetes, impairing the body’s ability to transfer heat from its core to the environment ( [[#Xu--2019b|Xu et al., 2019b]] ). Higher rates of doctor consultations by patients with type-2 diabetes and diabetics with cardiovascular comorbidities have been observed during hot days, but without evidence of heightened risk of renal failure or neuropathy comorbidities ( [[#Xu--2019b|Xu et al., 2019b]] ).

''People with chronic illnesses are at particular risk during and after extreme weather events due to treatment interruptions and lack of access to medication (medium confidence).'' The impacts of extreme weather events on the health of chronically ill people are due to a range of factors including disruption of transport, weakened health systems including drug supply chains, loss of power and evacuations of populations ( [[#Ryan--2015a|Ryan et al., 2015a]] ). Evacuations also pose specific health risks to older adults (especially those who are frail, medically incapacitated or residing in nursing or assisted living facilities) and may be complicated by the need for concurrent transfer of medical records, medications and medical equipment ( [[#Becquart--2018|Becquart et al., 2018]] ; [[#Quast--2019|Quast and Feng, 2019]] ; US Global Change Research Program, 2016). Emergency room visits after Hurricane Sandy rose among individuals with type-2 diabetes ( [[#Velez-Valle--2016|Velez-Valle et al., 2016]] ).

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