Every Thursday morning at 9 AM, the Naomi Berrie Diabetes Center hosts the Diabetes Conference, a lecture series that combines both research and clinical topics and includes speakers drawn from Columbia University faculty as well as visiting diabetes experts from around the country, and in some cases around the world.
Recently, the Berrie Center hosted Drs. Irwin and Michael Redlener, father and son experts on Health Policy and Emergency Medicine, who spoke about a topic of interest to all of us: Disaster Preparedness: Special Considerations for People with Chronic Health Conditions. “It seems like everyday can be an act of emergency preparedness on a day to day basis when you have T1D,” said Michael Redlener, MD, who himself was diagnosed with type 1 diabetes in 2012.
Dr. Redlener, Assistant Professor and Medical Director for Emergency Services and Disaster Preparedness at Mount Sinai St. Luke's and Mount Sinai West, focuses on personal and local preparedness and says that a tremendous segment of the population—perhaps as high as 50 percent, if you include children, older adults, people in poverty and the prison population—will need special consideration in a disaster.
Quoting numbers from the American Diabetes Association (ADA), Dr. Redlener says there will be 5 million people with T1D by 2050, unless there is a cure in the next 30 years. Since people with diabetes are high users of the health care system, (“pharmacy needs were incredible during Hurricane Katrina,” he said) there is all the more reason to be prepared.
Dr. Redlener shared his own personal preparedness tips for emergencies with the audience. “If all the support systems go down,” he said, “and we have to do it individually, at least we’ll be ready through the first 48 to 72 hours.”
Here is some of what he had to say:
1) Download the New York City Emergency Management (NYCEM) alert on your phone, if you haven’t already. “There’s a lot of noise, but it can be helpful for planning and for staying aware,” he said.
2) Check the general guidelines for emergency preparedness that already exist. Dr. Redlener recommends the list that Ready NYC provides that includes items like water, food, flashlights, batteries, battery or crank radio, mobile phone, back-up chargers, all your medication, all your pet’s medication, baby supplies, important papers and a full-tank of gas. You should have enough supplies on hand and ready to go for 3 days.
3) Diabetes supplies: Managing diabetes during an emergency requires “an extra level of thought,” said Dr. Redlener, “on top of the extra level of thought that diabetes management already requires.” Dr. Redlener’s personal preparedness list includes his general diabetes gear and then some.
Pump, plus extra batteries and charger
Glucose meter plus extra batteries and sensor and charger
Insulin plus a reliable cold source for the extra insulin
Blood sugar testing kit including meter, lancets, alcohol swabs, test strips, control solution
Quick-acting sources of glucose
Extra glucagon emergency kits
Plenty of water (to prevent dehydration)
Favorite non-perishable foods
Extra alcohol wipes to wash your hands
Separate container for diabetes supplies
According to Dr. Redlener, the ADA and CDC also have good recommendations online for people with diabetes in a disaster. The ADA suggests keeping enough supplies, including insulin for a week. They also recommend having a backup method of insulin delivery such as pens in case your pump or monitor break. You'll need disposable needles for the pens. The FDA also posts important information regarding insulin storage during an emergency.
4) Dr. Redlener said that he has created a list of people he knows with special needs—in his family, apartment and neighborhood—and recommends that everyone does the same, so no one is left behind.
5) In an emergency, you’ll need good walking shoes to protect your feet from ulcers, he said.
Dr. Redlener suggests talking to your diabetes educator about how to manage your medication safely and effectively—and so it doesn’t run out or expire in a disaster. You can also talk to your diabetes educator in case you need to switch medications. Since getting pharmaceuticals becomes one of the major issues during a disaster, planning in advance to have extra insulin on hand is a requirement.
If you would like to listen to Dr. Redlener’s advice from beginning to end, click here.