Guidelines for Diabetes Care during Disaster Conditions
A disaster is a sudden occurrence that inflicts widespread destruction, hardship, loss of life, and distress. Natural disasters include fires, floods, tornadoes, earthquakes, and hurricanes. Disaster brings chaos to people and their environments.
Since the lifestyle of the person with diabetes involves schedules and planning, an emergency can be a serious threat to your health. It may be difficult to cope with a disaster when it occurs. You and your family should plan and prepare beforehand, for any event, even if it’s only the loss of electricity for a few hours.
Be Prepared List
- Insulin or pills (include all your daily medications)
- Insulin syringes
- Alcohol swabs, cotton balls, and tissues
- A meter to measure blood glucose
- Urine ketone testing strips
- Lancing device and lancets
- Quick acting carbohydrates (OJ, candy)
- Longer lasting carbohydrates (peanut butter crackers)
- Glucagon Emergency Kit (for insulin users)
- Hard plastic bottle to dispose used lancets and syringes
Helpful Hints about Insulin and Syringes
- Insulin may be stored at room temperature for 30 days
- Insulin should not be exposed to excessive light, heat, or cold
- Regular, Humalog, Novolog, Levemir, Apidra and Lantus insulin should be clear
- NPH and Lente insulin should be cloudy after rotating the bottle
- Although re-use of insulin syringes is not generally recommended, under disaster conditions it may be necessary to re-use your insulin syringes
Things to Remember
- Stress can cause a rise in your blood sugar
- Erratic mealtimes can cause changes in your blood sugar
- Excessive work to repair damage caused by the disaster (without stopping for snacks) can lower your blood sugar
- Check your feet daily for injury, irritation, or infection
- Disaster debris can increase your risk for foot injury. Heat, cold, excessive dampness, and inability to change footwear can lead to infection especially if your blood sugar is high
Always wear a medical alert tag for identification
Food Items to be Prepared and Stored
These supplies should be checked and replaced yearly:
- 1 large box unopened saltine crackers
- 1 jar peanut better
- 1 small box powered milk
- 1 gallon of water per person/per day
- 2 (6 pack) pkg. cheese and crackers
- 1 pkg dry unsweetened cereal
- 6 cans regular soda
- 6 cans diet soda
- 6 cans fruit
- 6 cans of orange or apple juice
- 1 spoon, knife, fork per person
- Disposable cups
- B-D Glucose tablets or small hard candies
- 1 can tuna, salmon, chicken, and nuts, and a mechanical can opener
Food Considerations during a Disaster
Food and water may be limited/contaminated. Discard any food you think may be contaminated. It may be necessary to boil water for 10 minutes before use.
Maintain your meal plan as best you can.
Sugar and sugar containing foods should be avoided.
Avoid products with these (sugar) ingredients: dextrose, sucrose, corn, sweeteners, honey, molasses, sugar and fruit syrup.
Avoid greasy foods.
Try to eat meals and snacks at the same time every day.
Increase food intake during periods of increased activity by either eating between meal snacks before the activity or by carrying additional food with meals.
Carry a fast source of sugar with you at all times:
- 3 B-D Glucose Tablets
- 1 small box of raisins
- Small hard candies
- Tube of decorating icing
Sick Day Rules during a Disaster
Always take your insulin or pills on time or close to it. NEVER OMIT YOUR INSULIN UNLESS PHYSICIAN DIRECTS YOU TO DO SO. Insulin is still good if there is no refrigeration available. Bottles of insulin may be kept at room temperature for one month. Discard unrefrigerated insulin after 30 days.
Keep an extra bottle of insulin on hand at all times.
Eat no later than 30 minutes after taking your insulin. Try to eat on time.
Never skip a meal! If you are unable to eat due to nausea, vomiting, or diarrhea, sip a regular soft drink, eat hard candy, or fruit instead of your regular meal plan. Most importantly do not let yourself become dehydrated, drink plenty of fluids and in-between meals sip diet soda (this will replace water, sodium, and potassium into your body)
GET PLENTY OF REST!
Check your blood sugar. Notify your doctor if your blood sugar average is over 240mg, or if you have been ill for 2 or more days.
If you use insulin, test your urine for ketones when:
- Your blood sugar is over 240mg
- You are vomiting
- You have symptoms of high blood sugar (increased thirst, increased urination, hunger fatigue, stomach pain)