Helping Your Clients with Chronic Medical Conditions Prepare For Natural Disasters

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 M.D., 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.

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 glucose levels 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)

Visit www.aace.com.

This article originally appeared in the September 2007 issue of HME Business.

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