Managing diabetes during a disaster: 6 steps to safety

Emergencies can strike at any time. A hurricane, tornado, earthquake, blizzard or flu pandemic may disrupt life as you know it for days, weeks or months on end. When Hurricane Katrina struck the Gulf Coast in August 2005, more than 200,000 people with diabetes were affected. Some lost medical services and found themselves in shelters without access to lifesaving insulin injections.

But even minor emergencies — such as a temporary power outage in your neighborhood — can present challenges when it comes to managing diabetes. Your safety depends on planning your responses now. Use the following strategies to guide your actions for any type of emergency.

1. Pack an emergency kit.

Begin by gathering enough supplies to last for at least a week. In case of emergency, you'll need:

• Medical supplies. Pack tissues, alcohol swabs, syringes, cotton balls, testing strips, blood glucose meters and any other items key to managing diabetes. Also include a pencil and pad of paper for recording blood sugar levels.
• Medications. Be prepared to store insulin, glucagon and other drugs in a cooler. Keep ice or freezer packs handy in case refrigeration fails. Remember that your needs for medication may change if your weight or stress levels change during the emergency period.
• Non-perishable drinks and snacks. Set aside bottled water, granola bars, peanut butter, crackers, cereal, orange juice, or any other snacks recommended for controlling your blood sugar. Remember that you may need to eat more at times when your activity level increases — for example, when walking long distances or lifting heavy objects.
• Routine emergency items. Include a first-aid kit, whistle, candles, matches, gloves, flashlight and radio with spare batteries.
• Medical records. Pack copies of your insurance card and prescriptions in a waterproof plastic bag. Also keep a list of your health care providers and emergency contacts. If your child has diabetes, include a copy of the health care records you've shared with your child's school.

Store your emergency kit in a place where you can easily find it. Make sure that relatives, friends and neighbors know where you keep the emergency kit. Inspect the kit at least once a year, updating medical records and replacing expired items as needed.

2. Tell others about your diabetes.

If you're evacuated to a shelter or other location, identify yourself as a person who has diabetes. If you have diabetes-related complications, mention those as well. Sharing this information immediately means that you're more likely to get appropriate attention from relief workers. It's also important to wear appropriate medical identification at all times.

3. Protect your medications.

Keep insulin as cool as possible without freezing it. Also protect it from direct heat and direct sunlight.

Remember that extremes of temperature and humidity can affect medications, blood glucose monitors and test strips. Keep the package inserts for these items and check for information on how to use them in unusual conditions. Keep your medication containers, too. As long as you have the original containers, you might be able to get medications in case of emergency without a prescription.

Discard any medications that come in contact with flood water or other contaminated water. Make a possible exception for lifesaving drugs. If pills are still dry and clean, use them until you can find replacements.

4. Avoid dehydration.

High blood sugar can lead to dehydration. If you're exposed to high temperatures, you can lose body fluids through sweating — which only compounds the risk.

During a disaster, clean drinking water may be in short supply. Ask relief workers if you can boil water for drinking. If not, turn to the water in your emergency kit. Supplement this with bottled drinks that don't include sugar or other carbohydrates.

5. Prevent wounds and infections.

Diabetes can cause problems with blood circulation and make it harder for you to recover from wounds and infections. During a disaster, do everything you can to avoid injuries. Check your feet daily for sores, cuts and blisters. Also look for signs of infection, such as swelling, redness or discharge from a cut. If you're injured or notice signs of infection, seek treatment right away. Treating open wounds immediately can help prevent potentially life-threatening infections.

6. Wash your hands.

Washing your hands is one of the most important ways to prevent illness and infection. This simple strategy is especially important in emergency conditions. Be sure to wash your hands:

• Before preparing or eating food
• After using the toilet, changing a diaper or helping a child use the toilet
• After coughing or blowing your nose
• After caring for someone who's sick
• After handling uncooked foods, especially meat and fish
• After handling animals or animal waste
• After handling garbage or storm debris

Soap and clean, fresh water work best. If these aren't available, look for alcohol-based hand wipes or gels. The steps you take to keep your hands clean can go a long way toward promoting good health during an emergency.

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