Vivian Fonseca, MD: Hurricane Katrina significantly impacted persons with diabetes
By: Felicia Breedy
A September 16, 2009 Reuters Health article featured Clinical/Translational Award recipient Dr. Vivian Fonseca, MD at Tulane University School of Medicine in New Orleans, LA for his study on the devastating impact of Hurricane Katrina on persons with diabetes. Researchers compared the medical records from patients at a Veterans Administration Hospital (VA), the city’s charity care system and those with private health insurance at a local University Hospital. The medical records contained A1C data measurements on file before and after the hurricane. Of the 1,795 medical records, those in the charity health care system had worse long-term blood sugar control up to twenty-two months after Katrina. Although the VA and Private health insurance carriers did not have a significant change in their blood glucose control, they did have an increase in their levels of LDL or bad cholesterol. All groups experienced an across the board increase in blood pressure.
Dr. Fonseca conducted his research entitled, "Impact of Hurricane Katrina on Diabetes and its Co-Morbidities," with funding from the American Diabetes Association.
Continued testing many months after the natural disaster demonstrated a breakdown in the overall healthcare system in that region. Based on their data, researchers ascertained that the estimated life expectancy was reduced by about four months for charity system patients, about three months for the VA, and less than one month for those with private insurance. Despite the reduced life expectancy, the healthcare costs of the patients still had a substantial economic impact due to the large size of the population affected by Hurricane Katrina. Lifetime healthcare costs were calculated based on a projection of future costs using a well established model called the CORE model. It estimates future costs in a population based on changes in health such as glucose, blood pressure or cholesterol. The lifetime healthcare casts increased across all compared groups with a grand total of $504 million. The study did not account for factors such as those who died after the hurricane or those who relocated permanently from the city. Not accounting for these results may actually cause an underestimation of the effects.
“The real lesson here is that if a major disaster strikes, we should not only think about the short term and acute care, but also plan for taking care of people who have chronic diseases so that their long-term care is not affected”, states Dr. Fonseca. Fonseca adds that persons with diabetes should keep emergency phone numbers, and waterproof kits of syringes, medications, insulin, testing strips and even prepackaged snacks. Dr. Fonseca’s research demonstrates that not only were people with diabetes negatively affected by the hurricane, but these effects and health disparities are still present four years later.
For details about the American Diabetes Association task force statement on disaster preparedness, refer to the September 2007 issue of Diabetes Care.
(Fonseca VA, Smith H, Kuhadiya N, Leger SM, Yau CL, Reynolds K, Shi L, McDuffie RH, Thethi T, John-Kalarickal J., Impact of a natural disaster on diabetes: exacerbation of disparities and long-term consequences. Diabetes Care. 2009 Sep;32(9):1632-8. Epub 2009 Jun 19.)
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