Caring for People with Diabetes in Emergency Situations
There are a number of important questions regarding care for people with diabetes in emergency situations such as a hurricane. Here are the most important issues to ensure proper care for yourself or your loved one who has diabetes:
Identify Yourself as Having Diabetes
The most important priority should be to identify yourself or your loved one as having diabetes so you can get the care you need. Tell emergency workers that you have diabetes and what you need to manage it, such as what medications and testing supplies you need. Let them know about any complications you have that require special care, such as heart or kidney problems.
Know Your Rights
As a person with diabetes, you have rights under federal law: the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. These rights include the right to receive reasonable accommodations so that you can receive the benefit of community or government programs and resources. If you are being turned away from shelter because you have a diabetes service animal, require the use of sharps, or for any reason related to your diabetes, please contact the American Diabetes Association at 1-800-DIABETES for help.
Get Enough Fluids
One of the most important things you can do is to make sure you take in enough fluid to meet your body’s needs. Your fluid needs may be even higher in an emergency if power outages lead to high temperatures without working air conditioning or if you exert yourself by walking more than usual.
Dehydration is an even bigger risk if your blood glucose levels rise (hyperglycemia) because of a shortage of medication. During hyperglycemia, the body needs more fluids than usual to help it flush excess glucose from the body through urination. Plain water is the best choice for staying hydrated, and other sugar-free fluids will also work.
Watch Out for Hypoglycemia
Your blood glucose can go too low if you take certain medications, particularly insulin and also medications called sulfonylureas. If you are at risk for hypoglycemia, you should keep something containing sugar with you at all times—such as glucose tablets, fruit juice or hard candy—to treat hypoglycemia if it occurs.
Dealing with a Lack of Food
If you don’t have access to food, you may need to adjust how much medication you take to avoid hypoglycemia. If you use insulin, you will need less than usual if you don’t have any food, and certain other medications may need to be reduced as well.
If you don’t have access to your medications, you may need to eat less, particularly if you use insulin. If you have type 1 diabetes and don’t have insulin, you should consume as few carbohydrates (sugar or starches) as possible. If your usual type and brand of insulin is not available, talk to a doctor or pharmacist about what adjustments you need to make. In an emergency, pharmacies or medical personnel may be able you to provide you with medication without a prescription.
Watch Out for Infection
People with diabetes are at higher risk for infections of the feet if they have nerve and blood vessel problems. You should do what you can to avoid walking through contaminated water or injuring your feet. Check your feet regularly, and seek immediate medical attention if you see a problem.