Prep Your Health: How to Manage Diabetes in an Emergency

A woman tests her blood sugar using a blood glucose meter.

November is National Diabetes Month

About 34.2 million Americans live with diabetes, meaning their bodies don’t make enough insulin or can’t use the insulin they make to turn food into energy. In either case, the result is too much sugar in the bloodstream. Over time, this can cause serious health problems such as heart disease, vision loss, and kidney disease.(1)

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant).(1)

There isn’t a cure yet for diabetes, but losing weight, eating healthy food, and being active can help. Taking medicine as needed, getting diabetes self-management education and support, and keeping healthcare appointments can also reduce the impact of diabetes on your life.(1)

Emergency Preparedness

The everyday self-management of diabetes can be challenging, but it is doable with support from your healthcare team, family, teachers, and others, along with education, self-care, and personal preparedness. Self-managing diabetes during a disaster or emergency is more difficult but not impossible if you are prepared.

Emergencies and disasters can have widespread and long-lasting impacts on the availability of medical supplies, medications, and services. For all these reasons, it is important that you prepare your health by having an emergency supplies kit.

Gather Your Personal Needs

Personal needs are items that you cannot do without in an emergency, starting with the basics of food and water.

Because hypoglycemia (low blood sugar) can happen quickly and must be treated immediately, people with type 1 diabetes are encouraged to keep items that contain sugar (e.g., glucose tablets, juice boxes, honey, hard candy) with them at all times, including during an emergency.

Hypoglycemia is most often caused by too much insulin, waiting too long for a meal or snack, not eating enough, or getting extra physical activity. Hypoglycemia symptoms are different from person to person but can include shakiness, dizziness, difficulty concentrating, blurred vision, sweating, and weakness or fatigue.(2)

Prepare Your Prescriptions

Managing blood sugar levels and making sure your body gets enough energy can be tough during an emergency. Be prepared in case supplies and medicines are hard to get and to store.Having type 2 diabetes increases your risk of severe illness from COVID-19. Based on what we know at this time, having type 1 or gestational diabetes may increase your risk of severe illness from COVID-19.

  • Contact your doctor or pharmacist to talk about creating an emergency supply of prescription medications. Some states have emergency prescription laws that may allow pharmacists to dispense insulin in emergency situations.
  • During an emergency, you may need to use a different insulin brand or type instead of your regular insulin. You should work with your doctor if you need to switch insulin brands or types, but that might not be possible in crisis conditions. In that case, follow this emergency guidance from the Food and Drug Administration (FDA), monitor your blood sugar closely, and contact your doctor as soon as possible.(3)
  • Invest in a cooler and reusable cold packs to help keep medicines cold. Try to keep your insulin as cool as possible, but make sure not to freeze it. Insulin that has been frozen can break down and will be less effective.(3)
  • If you use an insulin pump, you may be able to substitute another short-acting insulin for your usual insulin (see FDA’s emergency guidance). Check the instructions for your pump to see which insulin types will work. The FDA guidance also explains which insulin types you can use instead of your usual insulin if you need to switch from using your pump to using injectable insulin (taken with a needle).(3)

Store Medical & First Aid Supplies

Having an emergency supplies kit with medical and first aid supplies can be vital during an emergency when you might not be able to go out and buy more.

  • Call a diabetes educator to get support and guidance on how to buy diabetes supplies, including single-patient-use insulin pens and syringes, and store them properly.
  • People with diabetes are more vulnerable to infections. Pay careful attention to the health of your feet and keep a fully stocked first aid kit ready to treat any wounds.
  • Have extra supplies for your insulin pump or continuous glucose monitor, supplies to check your blood sugar (i.e., testing strips, lancets), and extra batteries for your devices.

Making sure you have an emergency supplies kit ready with supplies can seem daunting, but a little prep can help lessen the stress during an emergency.

Resources

References

 

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Home Health Program Seeks to Improve Access to Support Services, Information

A male paramedic performs a health check outside on a man sitting in a chair.
Paramedics bring visual and educational materials and equipment to check patients’ vitals, conduct blood tests, and administer EKGs during Mobile Integrated Healthcare Program home visits. This photo was taken in 2016 before the COVID-19 pandemic. (Photo credit: JOHN STARKS/DAILY HERALD, 2016)

In observance of National Preparedness Month, the Center for Preparedness and Response (CPR) will publish posts in September that highlight ways people and organizations are helping to “create community” where they live.

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

Paramedics in Elgin, Ill., stop at the home of an elderly man who was recently discharged from the hospital for uncontrolled diabetes. They first check the man’s vitals, including blood pressure and blood sugar levels, and then review information about his condition and treatment plan with him.

As part of the Mobile Integrated Healthcare (MIH) Program at Advocate Sherman Hospital, a free support program offered primarily to elderly patients with chronic diseases who need additional home health support, these paramedics are helping to narrow the health literacy gap.

Paramedics use weekly one-on-one home visits to help optimize health outcomes among community residents whose low levels of health literacy could put them at increased risk of getting COVID-19. CDC defines health literacy as an individual’s ability to understand basic health information and services to make informed health decisions.

Beyond providing sources of information, MIH paramedics bring a personal touch, serving as an additional support system for patients. This is part of the reason why Sara Larson, a nurse at Elgin Family Physicians, refers patients to the program.

“This program makes patients feel like someone cares about them,” said Larson. “It makes a big difference to see patients’ realities in their homes and adapt their care accordingly.”

Home visits are also opportunities for patients to review their health information and ask questions outside of the hospital, she added.

MIH works with patients who have been hospitalized at least once for chronic obstructive pulmonary disease, diabetes, asthma, pneumonia, or heart failure. It is the only hospital-based paramedicine program in the state.

Tina Link, manager of community outreach at Advocate Sherman and MIH program director, said the program was started to reduce the number of visits to emergency departments for issues that could be managed at home. Issues such as getting prescription refills and not knowing what medication to take.

“There’s a knowledge deficit,” she said. “Some patients don’t know where to go or who to ask. But they know the hospital is open and someone will take care of them.”

Paramedics teach patients how to navigate the health care system so they can understand their conditions and make informed decisions about their care. The goal of the program is to reduce unnecessary hospital admissions and decrease costs.

Last year, MIH successfully lowered hospital readmission rates for their program participants by 58%, according to data provided by Advocate Sherman.

The COVID-19 pandemic has amplified the importance of this program. Both the elderly and patients with certain underlying medical conditions are at increased risk for severe illness from COVID-19, according to CDC.

“Especially with COVID-19, we don’t want people in the hospital who don’t need to be here,” said Jill League, community wellness coordinator at Advocate Sherman, who actively oversees the MIH program. “We want our patients to know how to control their condition so that they can stay home, stay healthy, and have a better quality of life.”

In the five years since the program’s establishment, Link and League agree this year is one of the most impactful. After the onset of the pandemic in March, they said they immediately integrated COVID-19 information into MIH’s curriculum. Paramedics cover COVID-19 signs and symptoms, safety guidelines, and how to self-quarantine.

Program participants have been responsive to this mission. Link said she has noticed patients becoming more conscious of their health and behaviors. They acknowledge that their medical history may put them at increased risk for severe illness from COVID-19 and are eager to work with the paramedics to better understand their health.

“COVID-19 does not just target a certain population,” said Link. “It’s new for everyone and we’re all at risk, so we’re all in this together.” The universality of the pandemic encouraged patients not only to keep themselves healthy but also to protect their neighbors.

MIH has navigated the barriers of limited mobility and uncertainty this summer to offer patients safe, personalized health care in their own homes. Paramedics wear appropriate personal protective equipment and follow proper hygiene protocols between home visits, as recommended by the CDC.

Advocate Sherman’s intervention has not only successfully improved health literacy in Elgin but also has bridged together providers and patients to shape a resilient, well-informed community during these unprecedented times.

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