Preparation For Natural Disasters Critical For People With Diabetes, Chronic Medical Conditions

Main Category: Diabetes
Also Included In: Hypertension;  Bones / Orthopaedics;  Cholesterol
Article Date: 04 Sep 2007 - 2:00 PST

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With hurricane season at its peak and continued floods, wildfires, tornadoes and other natural disasters hitting communities across the United States, the American Association of Clinical Endocrinologists (AACE) and Eli Lilly and Company are working together to offer tips for people with diabetes to help them manage their condition even if disaster strikes.

People with chronic medical conditions that require daily medications are among the most vulnerable victims of natural disasters, such as hurricanes, tornadoes, wildfires, blizzards, earthquakes and flooding. These events upset individuals' daily routines and may leave them without access to their homes, health care professionals, medications and/or other medical supplies.

"Hurricane Katrina taught diabetes patients and their health care professionals the importance of being prepared," said Lawrence Blonde MD, FACP, FACE of the Ochsner Clinic Foundation in New Orleans. "Taking the time to prepare a disaster kit in advance is crucial because once a storm or other disaster threatens, there is usually too little time to make all of the necessary arrangements."

Diabetes affects an estimated 246 million people worldwide and more than 20 million in the United States. People using insulin, a hormone that the body needs for the correct use of food and energy, are especially affected by a disruption to their daily routine. People using insulin need to take their medicine every day, often multiple times, to keep blood sugar levels in balance. Meals and therapy routines are often carefully planned.

The chaos of a disaster or catastrophic event can interfere with these routines and result in erratic eating and disrupted timing of medication doses. These disruptions and the stress induced by such an event can both change blood sugar levels and potentially adversely affect the health of people with diabetes.

Recommendations

AACE and Lilly have created several tips to help individuals prepare for disaster. These helpful suggestions can be applied no matter where you live, whether in a hurricane region, tornado alley, earthquake zone or elsewhere, and can be applied broadly to many medical conditions.

Prepare a portable diabetes disaster kit that is both insulated and waterproof containing the following items:

-- List of all medical conditions and prior surgeries.

-- Information about your diabetes, including past and present medications, any adverse reactions to medications, and past and present complications.

-- List of all your health care professionals with their contact information.

-- Letter from your diabetes health care professionals detailing most recent diabetes medication regimen (especially for insulin) and containing most recent laboratory results.

-- List of all medications, which should also include pharmacies and active prescription information and eligible refills.

-- A 30-day supply of medications for diabetes and all other medical conditions. This should include insulin, oral anti-diabetic agents and glucagon emergency kit (if prescribed by your physician).

-- Blood glucose testing supplies including lancets, test strips and preferably at least two glucose meters with extra batteries.

-- A cooler and at least four re-freezable gel packs for storing insulin (do not use dry ice when storing your medication).

-- Empty plastic bottles and/or sharps container for syringes, needles, and/or lancets.

-- Source of carbohydrate to treat hypoglycemic reactions (e.g. glucose tablets). Ideally should also have one or two day's supply of food that does not require refrigeration (e.g. non-perishable).

-- At least a three-day supply of bottled water.

--Pen and/or pencil and notepad to record blood glucoses and any other test results and any new signs/symptoms suggesting medical problems.

-- Additional medical/first aid supplies like bandages, cotton swabs, dressings, and topical medications (antibiotic ointments or creams) to treat cuts or abrasions.

Other recommendations:

-- Make sure that all immunizations including tetanus are updated.

-- Pack extra comfortable clothing including undergarments.

--Take a cellular phone with extra charged batteries for you and family members.

-- Consider choosing a designated meeting place in case you are separated from your family and unable to reach them by phone.

-- Monitor your blood sugar frequently and record your numbers

-- Increase your food intake during periods of excessive physical exertion (such as lifting heavy objects or walking longer-than-usual distances) by eating appropriate snacks between meals

-- Wear shoes at all times and examine your feet often, as people with diabetes are more vulnerable to developing infections. If you have a foot wound, seek medical attention immediately

-- If you are relocated or affected by a disaster, call your doctors as soon as possible to touch base and maintain the continuity of your medical care

--If you are a parent of a child with diabetes, make sure that you clearly identify which school staff members will assist your child in the event of an emergency

-- If you are displaced or need to evacuate, identify yourself immediately as a person with diabetes and report any related conditions so that authorities can provide for proper medical care. Always wear medical alert tags or bracelets that identify you as a person with diabetes

-- Ensure that a relative or close friend, living outside your city or state, has a complete list of your medications and dosage instructions, as well as contact information for your current physician(s)

Tools

Lilly and AACE first teamed up to offer these tips at the start of last year's hurricane season. This year, AACE and Lilly are also teaming up to provide AACE physician members with materials to help educate their patients on disaster preparedness. Posters and tip cards, developed through an educational grant from Lilly, have been distributed to AACE physicians nationwide.

Additionally, AACE and Lilly have developed downloadable tip sheets and other resources, available at http://www.aace.com.

About Diabetes

Diabetes affects an estimated 194 million adults worldwide1 and more than 20 million in the United States2. Approximately 90 to 95 percent of those affected have type 2 diabetes, a condition where the body does not produce enough insulin and/or the cells in the body do not respond normally to insulin. Diabetes is the sixth leading cause of death by disease in the United States and costs approximately $132 billion per year in direct and indirect medical expenses. Type 2 diabetes usually occurs in adults over the age of 40, but is increasingly common in younger people.

According to a 2005 report by the AACE, two-thirds of people with diabetes do not achieve target hemoglobin A1C levels (6.5 percent or less according to AACE recommendations) with their current treatment regimen.3 A1C is an average measurement of blood sugar over a three-month period.

The A1C is the best test to predict the risk for the development of serious diabetes-related complications. Because a high glucose (blood sugar) level over time increases a patient's risk for these complications, it is important to keep an accurate measure of a patient's A1C level. The chaos of a disaster can cause dramatic changes in blood sugar levels due to stress and erratic eating patterns. These changes can potentially adversely affect the health of people with diabetes, thus it is very important for people with diabetes to be able to self monitor their blood sugar levels and to check in with their health care professional as soon as possible after the disaster to assess their level of diabetes control.

About AACE

AACE is a professional medical organization with more than 6,000 members in the United States and 84 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.

About Lilly Diabetes

Through a long-standing commitment to diabetes care, Lilly provides patients with breakthrough treatments that enable them to live longer, healthier and fuller lives. Since 1923, Lilly has been the industry leader in pioneering therapies to help healthcare professionals improve the lives of people with diabetes, and research continues on innovative medicines to address the unmet needs of patients. For more information about Lilly's diabetes products, visit http://www.lillydiabetes.com.

About Eli Lilly and Company

Lilly, a leading innovation-driven corporation, is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers-through medicines and information-for some of the world's most urgent medical needs. Additional information about Lilly is available at http://www.lilly.com.

AACE Diabetes Disaster Plan

References

(1) The International Diabetes Federation Diabetes Atlas

(2)Centers for Disease Control and Prevention, National Diabetes Fact Sheet. Available here

(3)http://www.aace.com/newsroom/press/2005/index.php?r=20050518_2