When the topic of being prepared for disasters comes up, it may conjure extreme images dystopian stories. The idea that one’s everyday routine may be completely uprooted and displaced for weeks to months at a time—if not a lot longer—isn’t at the forefront of most people’s minds. But when the Glu team attended the annual meeting of the American Association of Diabetes Educators in New Orleans last August, one of the most powerful sessions of the week described the impact Hurricane Katrina had on people with diabetes. Even after ten years, the effects of this natural disaster are still felt in the Southeast US today.
Dr. Pamela Allweiss, an endocrinologist who works with the CDC, talked about lessons learned from natural disasters, particularly in being prepared to help people with chronic conditions. Kathleen Kissane, a CDE who specializes in disaster preparedness and works with the Red Cross and Frederick Memorial Hospital in Maryland, spent five weeks in New Orleans after the hurricane. They reported that between 14.6 and 17.3% of people in the shelters had diabetes, and between 48.3 and 58.8% of people were diagnosed with some form of chronic condition. While the numbers generally speak to type 2 diabetes, common elements play a role in how all types of diabetes were cared for overall.
There were a number of challenges in the shelters after Hurricane Katrina:
- One CDE reported only 3 blood glucose meters being available in a single shelter where many people needed to check their blood glucose (BG)
- Due to limited supplies, people were only able to check their BG twice daily
- Insulin was rationed and given on an as-needed basis
- People who relied on basal and short-acting insulin were treated with whatever was on hand, often Regular or NPH insulin (1).
- The food provided tended to be processed and carb-heavy
- People waded through contaminated water to get to shelters, often without shoes, and abrasions exposed to contaminants led to serious infections
With local pharmacies being shut down, a lack of refrigeration, and people having to leave their homes without adequate supplies, there was no way to predict how long people would be displaced. Lack of sleep, the stress of the situation—trying to find family members, and so on—wreaked havoc. Studies published in the following months saw an increase in A1cs, higher blood pressure, and PTSD that complicated matters for many people. (2)
Certified Diabetes Educators (CDEs) and other healthcare professionals shared deeply emotional stories about what they saw in the wake of the storm. Several CDEs who were residents of the Southeast spoke about the continued stress felt in the area, and how PTSD has affected people. In order to alleviate some of this stress during the next disaster, Allweiss and Kissane encouraged the audience to help develop disaster preparedness plans with their patients, take advantage of opportunities to volunteer, and educate others on disaster preparedness.
Lessons from Katrina: Creating your Diabetes Disaster Kit
While events like Hurricane Katrina are rare, various weather (such as recent tornadoes in Texas and record-breaking snowfall in the Northeast last winter) and other emergencies can make access to diabetes supplies and medications difficult. To be prepared for the worst, Allweiss and Kissane suggested keeping the following items on hand at all times:
- Emergency information (local and out-of-town contact list, medical providers, medication list, extra copies of prescriptions)
- Alcohol swabs
- Blood glucose meter
- Lancing device and lancets
- Quick-acting carb sources (glucose tabs)
- Extra prescriptions for insulin and any other meds you may be on
- Empty plastic bottle to put sharps in
- Flashlight with extra batteries
- Extra pair of glasses
- Heavy work gloves
To download a handy checklist, please click here.
If you’ve ever been involved in a similar situation, did you feel prepared to deal with it? What would you share with others about the experience?
- Cefalu, W.T., Smith, S.R., Blonde, L., Fonesca, V. (2006) “The Hurricane Katrina Aftermath and Its Impact on Diabetes Care” Diabetes Care, Vol. 29, No. 1, p. 158-160
- Fonesca, V., Smith, H., Kuhadiya, N., Leger, S.M., et al, (2009) “Impact of a Natural Disaster on Diabetes” Diabetes Care, Vol. 32, No. 9, p. 1632-1638