Contributor: Frank Lavernia, MD

Thankfully, South Florida was spared a hurricane in 2018. But my thoughts are always on preparation for future years, especially due to obvious climate changes with higher wind and water damage in the last few years. Preparation for these natural disasters cannot begin soon enough, and keeping diabetes medications safe is at the top of the list.

Historically, two weeks’ worth of medication should get someone through an immediate crisis. If one month’s worth is possible to obtain, it can ease potential concern. Injectables such as insulin and GLP-1 RA can be kept at room temperature (56-80 degrees F) if they will be used within a period of up to one week. Medicine that will not be used within 7 - 10 days can be stored and transported in a waterproof cooler with cooled gel packs that should keep the medicine useable for up to 2 weeks.

Keep a cooler in the closet, always ready to go with a taped sign reminding you to get all of your injectable supplies (insulin, GLP-1RA, glucagon kit) and gel packs out of the refrigerator before you rush out the door from home to go to a shelter.

During stressful times and when you least expect it, you might have periods of time requiring heavy physical exertion, missed meals, and/or emergency meals that may have high carbohydrates. These can lead to hypoglycemic or hyperglycemic events. To keep track of blood glucose and how it’s trending, a blood glucose meter, strips, and lancing device or CGM (continuous glucose monitor) and sensors should also be packed and ready to go.

For those who use an insulin pump, pack pump cartridges, infusion sets, prep wipes, and extra batteries, and also consider a backup method of insulin delivery and long-acting insulin to replace daily basal insulin dose. Insulin pens can fit that bill. They're convenient, provide accurate dosing, and produce less waste than syringes. Pens also require disposable needles. Having extra syringes and vials and/or insulin pens and needles on hand, as well as a protective container for sharp disposals, would be helpful.

Alcohol wipes can come in handy if washing or bathing is difficult or not possible at the time. Glucose tablets, ketone test strips (especially for type 1), and granola bars will be helpful. Always be aware of expiration dates on any supplies and medications.

Following the Scout motto of always being prepared, a few more tips:

• Wear a medical ID (bracelet, necklace, shoe tag, etc.) in case of loss of consciousness.
• Keep a complete list of medications with doses and when to take them, as well as phone/contact information for your current physician, pharmacy, and an emergency contact person outside of the immediate hurricane area.
• Include the web address for your most recent labs, medical records, and/or prescriptions on the list above if possible.
• Insurance cards and info will help expedite coverage.
• Consider laminating the list and cards, and storing them with meds in the cooler.

Being prepared with your diabetes medications, supplies, and crucial health information can help calm nerves and reduce glucose variability in case of needed evacuation, or even if evacuation is not necessary.

 

Dr. Lavernia has been a practicing diabetologist in South Florida for more than 35 years. He was the founder and director of the North Broward Diabetes Center in Florida. He is an adjunct faculty member of the National Diabetes Education Initiative (NDEI), Vascular Biology Working Group (VBWG), and for the Coalition for the Advancement of Cardiovascular Health (COACH). He is also a member of the American Diabetes Association, American Association of Clinical Endocrinology, European Association for the Study of Diabetes, and the National Hispanic Medical Association. He is a member of the DiabetesSisters Board of Directors.