How to Prepare for Emergencies
When Hurricane Harvey hit in 2017, Maryanne Strobel, MSN, RN, CDE, was among a group of health care professionals in Texas who were caring for people who had been displaced by the storm. Some of those people had blood glucose levels in their goal range; others needed immediate attention to manage their blood glucose. But there was another important distinction among the evacuees with medical conditions: Some were prepared for the emergency, and others weren’t.
“Some people came into the shelters with a copy of their prescription or a bottle of medication or an insulin pen and the box it came in,” says Strobel, who is now the disaster preparedness chair for the Texas chapter of the American Association of Diabetes Educators. As a result, their prescription details were easily accessible. “When we saw them again the next week,” she says, “those were the people who were doing much better.”
That’s the thing about disasters: Nothing is certain during a large-scale crisis. But planning ahead—and factoring diabetes into your prep work—can alleviate some of the pressure. You’ll be less stressed about your health at a time when you suddenly have other things to worry about. Here’s what you should know.
Some emergency preparedness rules apply to everyone, but when you have a chronic condition such as diabetes, it’s especially important to take them seriously. The Centers for Disease Control and Prevention suggests focusing on the specific type of disaster that’s most likely to occur in your area, whether it’s a hurricane, earthquake, or something like a terrorist attack. Use that information to decide on the safest spots to shelter yourself within your home—a basement during a tornado, for instance. It’s a smart idea to review escape routes and pinpoint a family meet-up spot in case you get displaced. Fire safety experts suggest practicing evacuation twice a year.
Also key: a survival kit, which should include a three-day supply of food and water, personal items (such as soap and toothbrushes), a flashlight, and a radio, among other items. (See “Build Your Go Kit,” below.) Everyone needs these, regardless of health status. But if you have diabetes, that’s only the beginning of your list.
No one likes to focus on worst-case scenarios, but briefly doing so can help you stay safe if things go awry, says Marina Chaparro, MPH, RD, CDE, a registered dietitian, certified diabetes educator, and national spokesperson for the Academy of Nutrition and Dietetics. “During an emergency, your world might not function as it normally does,” she says. “Cell phones might not work, which would mean you can’t access contacts in your phone. The pharmacy might be closed. If you don’t have your medication, you could get really sick.” Planning ahead can help you sidestep these problems. It might even save your life.
Chaparro speaks from both professional and personal experience: She’s had type 1 diabetes since age 17, and she lives in a hurricane-prone area of Florida. Her top tip: Make sure you have at least two weeks’ worth of your medications in case of emergency; a 30-day supply is even better.
If that’s not possible—to build up an extra supply, your doctor will have to write another prescription and your health insurance might not cover it—then at least make sure you pick up refills as soon as you’re able so you’re never down to just a few pills. Another good idea: If you’re not already getting a 90-day supply of medication each time you refill, call your insurance company and ask for one. Many companies allow this (sometimes through mail-order programs), and it’s an easy way to make sure you always have extra medication on hand.
Because insulin and some other injectable diabetes drugs, such as the type 2 medication exenatide (Byetta), need to be kept cool, you’ll also have to plan for safe storage of your meds in the event of an emergency. You can keep opened insulin at room temperature for 28 days, but “room temperature” really means between 56 and 80 degrees, says Chaparro. So if you live in a hot climate and the air conditioning goes out during a storm, you’ll need a way to keep opened insulin cool. Consider buying a Frio case for your emergency kit: Soak it in water, and it’ll cool down—and stay that way for a few days. Another option is to keep gel packs in your freezer so they’re ready to go in a pinch.
Other essentials include sources of fast-acting glucose, such as glucose tablets or gels; a glucagon kit; an extra glucose meter and test strips; ketone test strips; backup supplies for your pump or continuous glucose monitor (CGM); a list of all your medications and doses; and a hard copy of all emergency contacts (including your doctor’s office and pharmacy). It’s also wise to add a letter from your physician detailing your condition and the drugs and supplies you require, along with copies of recent lab test results.
Strobel suggests packing everything in a waterproof box. Stash it in a cool, dry place such as a hallway closet, and apply some reflective tape to the outside so you can find it easily during a power outage. Every six months—perhaps when you set your clocks forward or back—check your kit to see if any items with expiration dates (including oral medication, glucose test strips, and food items) are nearing the end of their usefulness. Aim to remove and use them before they expire and replace them with fresh ones. If you use injectable drugs such as insulin that can’t be stored in your kit because they need to be refrigerated, tape a note to the top of your box to remind yourself to grab them on the way out the door.
Hopefully you won’t ever need to find out whether you’re adequately prepared for a crisis, but don’t let that lull you into complacency. “If you can do everything [that’s recommended to prepare for a disaster], that’s awesome. But if you can’t, do what you can,” says Strobel. “It will give you peace of mind.”
Build Your Emergency Go Kit
Use this handy checklist to create your in-case-of-emergency supply box.
- Three-day supply of water (1 gallon of water per person per day)
- Three-day supply of food (such as meal replacement bars and tuna pouches; if you’re packing cans, include a manual opener)
- Fourteen- to 30-day supply of your medication
- Gel packs or Frio case for medications that need refrigeration
- Glucose meter, extra batteries, test strips, and lancets
- Sources of fast-acting glucose (such as glucose tablets, gels, or drinks)
- Glucagon kit, if prescribed by your doctor
- Ketone test strips
- Sharps container for used needles, syringes, and lancets=
- Backup supplies for your insulin pump and continuous glucose monitor (CGM)
- Alcohol swabs (use before blood glucose checks if you can’t wash your hands)
- Pen and notepad to record blood glucose readings and track symptoms
- Personal care items (such as soap, toothbrushes and toothpaste, baby wipes, contact lenses, and glasses)
- First aid supplies (adhesive bandages, ointment, etc.)
- Emergency blanket and a loud whistle (to help rescuers locate you)
- Flashlight, battery-powered radio, extra batteries, extra cell phone charger
- Emergency contact list (including family members, health care providers, and your pharmacy)
- List of your medications (names and doses)
- Letter from your doctor detailing your condition and what you need to manage it
- Most recent laboratory test results (such as A1C and kidney and liver function; if your results are in a patient portal, it doesn’t hurt to jot down your password, but don’t count on being able to access it during an emergency)
- Copy of your health insurance card
- Change of clothes, especially underwear
- Comfortable walking shoes and a change of socks
- An extra set of your house and car keys
- Extra cash