Nutrition

Disaster and Emergency Preparedness

Disaster and Emergency Preparedness Are You Ready? Phyllis Woodson, MS, RD, CDE, Clinical Dietitian
The Strelitz Diabetes Institutes

Remember, a disaster (flood, hurricane, tornado, earthquake, snowstorm or loss of electricity) can occur at any time. Make sure to be prepared, whether you are at home, work, or in transit. The following suggestions are recommended for individuals with diabetes (however, general suggestions would apply to any health problem):

It is recommended to have enough food on hand for 7 days and enough medication/supplies for 2 weeks. Replace stored food items every year.

Keep the most important supplies with you at all times in anticipation of an emergency.

In a September 9, 2005 press release, the American Diabetes Association identified the following critical areas of concern during a disaster:

1. Self-identification as having diabetes
2. Prevention of dehydration, hypoglycemia, and infection (especially of the feet)
3. Availability of medications

Supplies to Have On Hand :
Flashlights, cell phone and batteries, battery- operated radio, candles, first-aid kit, waterproof matches, watch, whistle/noisemaker for search and rescue.
Personal hygiene items.
An extra pair of walking shoes, dry socks, eye glasses.
Eating utensils, disposable plates and cups, manual can opener.

Food
1. Try to maintain regular times of eating, drinking fluids and taking medications.
2. Have at least a 3-day supply of water; each person needs about 1 gallon a day. If storing water, refill plastic containers every 6 months. Only drink water deemed safe to drink or bottled water (with intact seal) or strain water through several layers of paper towels and then boil for 1-3 minutes.
3. If the door has been shut, food will last 4-6 hours in the refrigerator and will keep frozen in a full freezer for 3 days. As long as food has ice crystals it should be safe, but when in doubt thow it out. Do not refreeze food.
4. Keep a supply of food that doesn't require cooking, including non-perishable foods (peanut butter, nuts, crackers, cereal, popcorn, pasteurized milk and juice cartons, non fat powdered milk, canned diet soda, apples, oranges, cans of fruit packed in water or natural juice, canned vegetables and soups, dried fruit, cheese not requiring refrigeration until opened, canned tuna/salmon/turkey/chicken/beans, etc).

Medications/Medical Supplies:
Always remember to wear your medical i.d.
Keep at least a 2 week supply of diabetes medications and supplies, eg glucose meter, lancets, glucose strips, ketone strips, bio-hazard container for used lancets/strips/needles, alcohol swabs, tissues, blood glucose record book, glucagon emergency kit, etc.

Insulin will keep at room temperature (59-86 degrees F, but in hot weather, insulin needs to be kept cool (but not freezing). You can place the insulin in water that has been cooled with ice, but not touching the ice. Most insulins will keep for no more than 28-30 days at room temperature and will last until the expiration date if unopened and refrigerated. If you are on the insulin pump, keep supplies you will need, including a syringe, readily available.

Other supplies:

Glucose tablets
An insulated container for diabetes supplies as needed.
Medication for nausea, vomiting, diarrhea.
A list of all medications, your medical history, emergency contact phone numbers including your physician and pharmacist. Make sure you have adequate prescriptions as needed.
Hand sanitizer.

Small amount of cash.
Important paper, keys, etc, you know what you need.

References:
American Diabetes Association, Diabetes Forecast, February 2006
American Dietetic Association, ADA Times, December 2005
Becton-Dickinson, Planning Your Diabetes Care During Disaster Conditions, 2002
Practical Diabetology, September 2005.