People with diabetes should prepare for emergencies

A couple of winters ago, we had a severe blizzard in western South Dakota. One of my patients with diabetes lives in an isolated log cabin in the mountains far from the nearest paved road. Several feet of snow fell. He and his wife have lived in a rural area for most of their lives and are usually well-prepared for such weather. They keep their pantry stocked full of food and their woodpile stacked high with firewood.

This time, however, my patient forgot to refill his insulin before the storm and his supply ran out.

Fortunately, he was able to trudge through the deep snow to the top of a nearby hill where there was reception for his cell phone. He called one of his neighbors who owned a snowmobile. The neighbor kindly picked up some insulin at the local pharmacy and delivered it to their door. What could have been a disaster was averted. It would be a week before their road was plowed and they were able to drive to town themselves.

After Hurricane Katrina hit New Orleans, many began advising their patients to prepare for such emergencies. But what exactly should patients have on hand?

The American College of Endocrinology and Lilly Diabetes partnered to create the Power of Prevention Diabetes Disaster Plan which includes recommendations for items to be included in a diabetes disaster emergency kit. This information is available at: www.powerofprevention.com. People with diabetes are advised to assemble a portable, waterproof, insulated diabetes emergency kit which contains the following:

A detailed medical history including medical conditions and prior surgeries.
Information about past and present medications, any adverse reactions, and diabetes complications.
A list of health care professionals and contact information.
A letter from their diabetes health care professional detailing current diabetes treatment plan, medication regimen (especially for insulin) and most recent laboratory results.
A list of all medications, including current pharmacies, active prescription information and eligible refills.
A 30-day supply of medications for diabetes and all other medical conditions including insulin and oral medications.
A severe hypoglycemia emergency kit (if prescribed their physician).
Supplies for blood glucose testing, including lancets, test strips, at least two glucometers and extra batteries.
A cooler with at least four gel packs for storing insulin.
Empty plastic bottles and/or sharps container for syringes, needles, and/or lancets.
A source of carbohydrate to treat hypoglycemic reactions, such as glucose tablets.
Ideally a 1- or 2-day supply of food that does not require refrigeration (people who live in isolated rural areas such as my patient need to consider having a longer supply of food, whether they have diabetes or not).
A minimum of a 3-day supply of bottled water.
Pen and/or pencil and notepad to record blood glucoses, other test results and new signs/symptoms.
First aid kit and other medical supplies.

Other recommendations include wearing shoes at all times; examining feet for infection; keeping all immunizations, including tetanus, up to date; packing extra clothing; getting a cell phone with extra batteries; and determining a pre-designated meeting place in case they are separated from loved ones.

Disaster knows no boundaries and can happen anywhere, to anyone, at any time. Everyone should try to be ready for unanticipated emergencies. People with diabetes, however, should take extra precautions to make sure they are prepared. Now, my patient always has an extra supply of insulin and other diabetes supplies on hand.