A disaster (flood, hurricane, tornado, earthquake, snowstorm or loss of electricity) - natural or man-made - can occur when you are at home, work or in transit … be prepared. A disaster could affect the area where you live or just your home and can occur in hot or cold weather. The following suggestions are recommended for individuals with diabetes; however, general suggestions could apply to any health condition.

It is recommended to have enough food on hand for seven days and enough medication and supplies for two weeks; some sources say for at least three days. Any disaster kit should be waterproof and insulated, and reviewed and replenished twice yearly. 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 critical areas of concern during a disaster:

• Self-identification as having diabetes
• Prevention of dehydration, hypoglycemia, and infection, especially of the feet
• Availability of medications

In the 2009 Clinical Practice Recommendations, the American Diabetes Association states that "People with diabetes should maintain a disaster kit that includes items important to their diabetes self-management and continuing medical care. The kit should be reviewed and replenished at least twice yearly."

Preparing for a Disaster

General Supplies

• Flashlights, cell phone, batteries, battery-operated radio, candles, first-aid kit, waterproof matches, watch, and whistle/noisemaker for search and rescue
• Personal hygiene items
• An extra pair of walking shoes, dry socks, and eyeglasses
• Eating utensils, disposable plates and cups, and manual can opener

Food

• Try to maintain regular times of eating, drinking fluids, and taking medications
• Have at least a three-day supply of water; each person needs about one gallon per day. If storing water, refill plastic containers every six months
• Drink water deemed safe to drink or bottled water (with intact seal) or strain water through several layers of paper towels and boil for one to three minutes (some sources say for 10 minutes)
• If no electricity, food will last four to six hours in the refrigerator (if the door has been closed) and will stay frozen in a full freezer for three days (if the door has been closed). As long as food has ice crystals it should be safe, but "when in doubt throw it out." Do not refreeze food.
• Keep a supply of food that doesn't require cooking. Don't forget the essential utensils
• Have available less-perishable, long-lasting foods (peanut butter, nuts, crackers, cereal, popcorn, pasteurized milk such as Parmalat and juice cartons with a long shelf life, 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 kept at room temperature but not requiring refrigeration until opened, and canned tuna, salmon, turkey, chicken, beans, etc.).

Medications and Medical Supplies

• Most insulin (opened) will keep for no more than 28-30 days at room temperature (59-86  degrees F) and if unopened/refrigerated will last until the expiration date; if unopened but at room temperature, keep for no more than 28-30 days.
• If on the insulin pump, keep supplies you will need, including a syringe.
• Have glucose tablets or gel for treatment of low blood glucose
• Keep at least a two-week supply of diabetes medications and supplies, such as glucose meter, lancets, glucose strips, ketone strips, bio-hazard container for used lancets, strips, pen needles/syringes, alcohol swabs, tissues, blood glucose record book, and glucagon emergency kit, etc.
• Insulated/waterproof container for diabetes supplies/medications and freezer pack to keep cool but not frozen
• Medication for nausea, vomiting, diarrhea, and antibiotic ointment/cream
• Hand sanitizer
• A list of all medications, photo copy of your medical history, emergency contact phone numbers including your physician, pharmacist, the American Red Cross, and American Diabetes Association
• Make sure you have adequate prescriptions or prescription numbers (generally, any U.S. chain pharmacy will fill a prescription with just the prescription number)
• Wear your medical ID
• Seek medical care if you experience fatigue, weakness, abdominal cramps, decreased urine, fever or confusion.

Other

• Small amount of cash
• Important papers and keys, etc.

References

• American Diabetes Association, 2010. Living with Diabetes.
• American Diabetes Association, Clinical Practice Recommendations 2009.
• American Diabetes Association, February 2006. Diabetes Forecast.
• American Dietetic Association, December 2005. ADA Times.
• Becton-Dickinson, 2002. Planning Your Diabetes Care During Disaster Conditions.
• Center for Disease Control, 2010. Diabetes Care During Natural Disasters, Emergencies, and Hazards
• Diabetes Monitor, 2010. Diabetes Disaster Preparedness.
• Division of Family Health Services, NJ, 2010. Diabetes Disaster Preparedness.
• Katzki, D. & Katzki, L. Diabetes Self-Management, 2009. Disaster preparedness. It's never too early to plan ahead!
• Practical Diabetology, September 2005.