By Kathy Spain, R.N., C.D.E., mother of Will, diagnosed age 2
The disaster in the Gulf Coast region has deprived many people with diabetes of necessary medical supplies and life-sustaining insulin. Fortunately, there is help for these vulnerable people. The American Red Cross and other relief agencies have been working to help those with medical problems. Pharmacies, such as Rite Aid, have offered to provide insulin and other supplies desperately needed by storm victims with diabetes, and major pharmaceutical companies and medical device companies have donated medicine and diabetes supplies.
No one with diabetes ever expects to be in a situation where they are unable to get to their supplies, but Katrina has dramatically illustrated that we must always be prepared in case of an emergency.
Here are some simple guidelines to follow when we do not have ready access to medical care or supplies.
To ensure you’re never caught without insulin diabetes-care supplies:
- Keep (and always have with you when you leave home) a small backpack filled with snacks, insulin, insulin administration devices, a waterless hand sanitizer, and blood glucose testing supplies. Include plenty of testing strips and supplies for the treatment of hypoglycemia: glucotabs, juice boxes, glucagon, phenergan suppositories (in case of vomiting), and medical identification.
- Place medical products in plastic containers to keep them dry (e.g., wound care supplies).
- Heat and humidity can alter the function of your blood glucose test kit and your glucose meter. Keep a copy of the relevant portions of your owner’s manuals in your backpack to help ensure the devices continue working properly.
- Always have extra insulin available in your refrigerator that you can grab in an emergency.
- If you wear an insulin pump, include these items in your backpack: pump supplies, such as batteries, insertion sets, tape, and cartridges; written guidelines regarding switching back to shots; bottled water to clean your insertion site.
If you find yourself in a situation where you are without diabetes supplies, first of all, remain calm, since stress is known to cause swings in blood sugar levels. Seek out emergency personnel to assist you in obtaining insulin; and, unless you are feeling hypoglycemic, avoid eating or drinking carbohydrates until you are able to obtain insulin. Keep yourself well hydrated, taking care that you drink only from clean water sources. Upon arrival at a shelter or other temporary location, identify yourself to a health provider or relief organization member to make sure you are evaluated properly.
Guidelines for Carrying Insulin*
Insulin may be left un-refrigerated (between 59-86 degrees F) for up to 28 days and still maintain potency. As a general rule, insulin loses its potency according to the temperature it is exposed to and the length of the exposure. Under emergency conditions, when the storage temperature exceeds 86 F, insulin may still need to be used, but it may have lost some of its potency, which over time could result in less effective blood glucose control.
Patients should try to keep their insulin as cool as possible, avoiding direct heat and sunlight. Do not allow insulin to freeze if its is placed on ice.
Evacuation Do’s and Don’t's*
- Keep your devices out of direct sunlight.
- Use a dry cloth to regularly wipe off devices.
- Do not use disposable devices that are wet (e.g., wound dressings, disposable thermometers, tubing).
- Do not use ice if there is danger of water contamination; use dry ice or instant cold packs instead.
- Wear medical ID bracelets or necklaces at all times.
- Do not use contaminated water to wash hands. Use a waterless hand sanitizer or bottled water.
* Source: U.S. Food and Administration