Got diabetes? Need advice? Of course you do! And you came to the right place: Ask D'Mine, our weekly Q&A column hosted by veteran type 1 and diabetes author  in New Mexico.

With the summer months bringing out those pesky hot-weather bugs, Wil is tackling a question that many ask this time of year: Are those of us with diabetes more prone to getting bitten than others? Read on, for some D-advice that may be as good as any insect repellent on the shelves...

{Have diabetes questions of your own? Email us at [email protected]}

 

Stephanie, type 1 from Montana, writes: OK, what’s the skinny on people with diabetes and mosquitoes? This is camping season and a time when I’m always outside, and no matter how much bug spray I use, it seems that I am ALWAYS a target for these little biting buggers more than anyone else. Usually we are enjoying some adult beverages outdoors, too, so I wonder if that plays any part in it. Is there actual science behind our diabetes blood being more appealing to mosquitoes and other bugs like this, and is there anything we can actually do about it other than “keep our blood sugars from going high”?

[email protected] D’Mine answers: For years I’ve said that if it were a just universe, PWDs would be immune from mosquito bites and the common cold—we have enough to deal with just managing our diabetes! Of course, it’s not a just universe, and this is a great question. Thanks for asking! BTW, our own Mike Hoskins touched on this a while back, and tells a tale worth reading, but given the time of year the subject deserves an update on the latest science. 

Urban, rural and campfire legends have it that skeeters do prefer us D-folk, due to our unusually sweet blood. I used to think this was malarkey. Partly, it didn’t make sense based on what I knew about both diabetes and mosquitoes, and partly, as an adult-diagnosed PWD, I haven’t noticed any difference in mosquito attacks than before I had the illness. But, as I dug into the evidence for you, I’ve come to change my mind.

Short answer: No, it has nothing to do with our diabetes blood, per se. There's more going on here.

But before we dig into that, we need to better understand mosquitoes. Welcome to Uncle Wil's Mosquito U, my friends.

Mosquito facts (and funky trivia I couldn’t resist): 

  • Only the girls suck blood. It’s a fact. The males don't, only the female mosquitoes do this.
  • There are more than 3,500 species of these micro vampires.
  • The little f--ckers have been around longer than humans. They date back at least 79 million years, based on a very modern-looking specimen found in Canadian amber, hence the Jurassic Park franchise.
  • Their life cycle is fascinating: Aquatic egg, aquatic larva, aquatic pupa, and then flying menace. When I was a kid, my family captured some larva at Havilland Lake and brought them home, putting them in our fish tank. They nearly sucked us dry before we figured out we’d created a mosquito sanctuary.
  • Actually you can’t be sucked dry by mosquitos. Just for fun, Sean Kane of Business Insider that it would take 1.1 million mosquito bites to completely drain your body of blood. (Although he points out that you’d drop dead from hypovolemic shock after the first 220,000 bites.)

Those swarms of mosquitoes you see at sunset? Those are the harmless non-biting males. They swarm to attract the female mosquitoes who then fly into the swarm to mate. Kinky.

So that is a bit of trivia.

The annoying bite of the mosquito is the least of our problems. They are vectors, a fancy word for carriers, of nasty and deadly diseases like malaria, yellow fever, West Nile virus, dengue fever, Zika virus and a gazillion others, leading philanthropist Bill Gates the mosquito “the deadliest animal in the world.”

Meanwhile, the itchy, swollen reaction we get to bites come from our body’s reaction to mosquito spit, a complex anti-coagulant. The bump and itching a histamine reaction to the mosquito’s spit, a counter attack on the part of your own immune system. On the bright side, mosquito spit is as the basis for a new generation of anti-clotting drugs to fight cardiovascular disease. So maybe mosquitoes have a divine purpose after all.

Still, I’m itching all over just writing this.

You should know that mosquitoes don’t live on blood. They live on nectar from flowers. So they really aren’t vampires, but the females need blood to produce their eggs. Blood provides protein and lipids which they can’t get from plant nectar. Ah-hah! Say many readers.

There’s the smoking gun: Many people with diabetes, especially type 2s, have high cholesterol. Surely the mosquitoes would prefer us!

And they might.

But it doesn’t work that way. Just like you can’t tell looking at the cuts of meat at the supermarket whether the steaks or the lamb chops have more cholesterol, neither can the mosquito tell whether you or your Uncle Charlie has higher cholesterol when deciding which one of you to snack on.

However, blood aside, that doesn't mean diabetes isn't still a main reason for them coming after us.

So just how do mosquitoes decide whom to bite most?

It’s all in the hunt. Mosquitoes are like bloodhounds. They sniff out their meals and doggedly track them down. What are they sniffing for? Carbon dioxide (CO2), the poison gas we (and other mammals) exhale.

And guess what? Not only do PWDs exhale elevated levels of CO2, but there’s enough difference between us and sugar-normals that of researchers proposed using CO2 levels as “a new tool” for screening for diabetes!

But that’s not all.

shows that the lady mosquito deploys several targeting methods on her hunt. She uses olfactory, visual, and then thermal clues to choose her targets. She uses CO2 levels for long-range guidance. She can smell your breath from up to 50 meters away. She hones in on the plume of gas you exhale and uses it as a beacon to get in your general area.

Then, at 15 meters, she can see you. Her eyes react to high-contrast targets, so the legend that mosquitoes prefer to go after people wearing blue isn’t necessarily true. It depends on what the background colors are. If blue makes you stand out from your background, the mosquito will say, Hello! But if you are sitting on a dark-colored deck, the poor fool wearing white is more likely to be honed in on.

There’s more, too. As she closes the gap, the female mosquito can sense your body heat. And guess what? Yeah. We D-folks have higher body temps. At least those of us do.

So you can dress to blend in, but your diabetes and your meds are setting you up to trigger two of the mosquito’s three targeting methods, and there’s not much you can do to change that. 

Does bug spray work against these factors, and does it work any more or less for PWDs?

Honestly, I don’t have a well-researched answer to that.

In my cursory searches online, I couldn’t find any information that I trust about mosquito repellent and diabetes. I suppose there could be something about our physiology that defeats the spray, or it might be more simple: A group of people, like say, around a campfire, is more likely to attract mosquitoes than a single person, as there’s more CO2 being exhaled. Then once the skeeters get there, my guess as to why you get picked on more than your pals has to do with your higher insulin-fueled body heat.

Maybe that extra heat makes you sufficiently irresistible that they’ll tolerate the to get at you.

Interestingly, an looked at many different insect repellents and talked to mosquito researchers on this very topic, and analyzed study data on how effective certain products and methods truly are.

What about booze affecting how mosquitoes attack?

Well, at least one showed that 350 ml of ingested beer (which is about one can, and who drinks only one can of beer when camping?) increased mosquito attacks, although the reason why isn’t clear. Maybe the mosquitoes just like getting a buzz on. But before you give up the adult beverages, another insists that because alcohol is a depressant, it should reduce overall CO2 exhalation. So while drinking might increase the attacks once you are discovered, drinking might also reduce the number of mosquitoes that find you. I’ll drink to that.

Oh, and while we're on the topic of summertime biting buggers... let me add this: Obviously, mosquitoes aren't the only pesky insects out there pestering us. Ticks are also a nuisance during the warmer months and feed on blood to survive, flourishing and clutching on to pets and people during Spring and Fall in particular. They're  but don't have an eye for PWDs in the same ways as mosquitoes. Those tiny little pet-attacking fleas can also latch onto us humans and cause itchy bites and rashes, while some of the same characteristics that mosquitoes exhibit may apply to these other insects, too.

But the science and diabetes-specific preferences for those other insects are a topic better bitten off at another time... mostly because you didn't ask me to scratch that itch and only inquired about mosquitoes.

So in short, you are right. We PWDs are the target. The damn mosquitoes do prefer you. But it’s not your sweet blood they crave. It’s more like lust: They are attracted to your heavy breathing and the fact that you are a hottie. Literally.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.