Disaster Preparedness and Diabetes

Disaster — the word elicits both emotion and fear.

Disasters are not new — they’ve occurred since the beginning of time. However, they seem to be increasing in frequency and severity.


When the subject of emergency preparedness arises in the Western U.S., the focus almost always is on earthquakes, drought, or wildfires. The discussion is not about if a disaster will strike, but when. In the Southeast, the concern is hurricanes; in the Plains states, tornadoes; in the Northeast, blizzards and ice storms; and in the Midwest (and elsewhere), floods. Natural or manmade — there’s always the possibility disaster can strike. Are you ready for the next disaster?

Having diabetes requires much more planning and gathering of emergency supplies. On top of all the other basic human needs, you have additional issues vital to your survival — the need for proper medication storage and to manage stress, injury, and illness and their effects on blood sugars.

With preparation, you can both survive and maintain control over your diabetes.

The most important part of preparedness is the “pre” — what you do before a disaster hits. Once disaster strikes, communication and transportation systems will be disrupted. Water systems, gas, and electricity may be damaged or experience outages. Infrastructure — medical, police, fire, hospitals, pharmacies — may be damaged or overwhelmed. Picking up a new vial of insulin or syringes from a pharmacy or hospital may be impossible. What do you do then?

Here are some basics for collecting and storing the supplies you’ll need to become self-sufficient in an emergency situation. The goal is to motivate yourself toward your own personal preparedness, so you can pick yourself up and get back to life as usual — as quickly as possible — should a disaster befall you.

Where to stock supplies

Before making a list of the supplies you’ll need in an emergency, think of the various places where you might need them — wherever you and your family members likely would be — and may be stuck — when an emergency strikes.

The most common locations are your home, car, workplace, and/or school. For your home and car, you’ll want to build an emergency kit that includes water, food, first-aid supplies, prescription medicines and diabetes care needs, personal hygiene items, one or more communication devices, and sources of warmth, shelter, tools, and lighting. Keep your home kit in a location not likely to be obstructed or damaged in an emergency. For example, if the most likely disaster to strike your area is a flood, do not store your emergency kit in the basement.

It’s also a good idea to keep a smaller collection of these items in a “go bag” that you can grab quickly if it becomes necessary to leave home in a hurry.

Ask managers in your workplace and your children’s school(s) if they have emergency action plans and appropriate supplies for staff and students. Most states have requirements for school emergency management planning, but it doesn’t hurt to make sure a school is in compliance. If a school or workplace does not have a plan or supplies in place, recommend it get prepared — and offer to help. Until that location is adequately prepared, keep a complete emergency supply kit there as well. If the school or workplace has a plan with adequate supplies, you need only supplement it with your unique needs, such as diabetes supplies.

How much to stock

Simply put, prepare for how many days you want to be able to eat and have water. The rule of thumb is to have, at a minimum, a three-day supply of necessities. Depending on the scope of the disaster, it could easily take that long for assistance to reach your area and, as during Hurricane Katrina in 2005, it could take longer. Assume you will be on your own without running water, power, or community assistance for at least three days. Prepare for longer if you are able.

To calculate how much water, food, and other necessities to have on hand, multiply the daily amount required per person by the number of days for which you are preparing. Then multiply that number by the number of people likely to be at that location when an emergency hits. (For example: 1,200 calories x 3 days x 4 people.) Do not forget your pets in your calculations.

Because food, water, medicines, batteries, and other supplies don’t last forever, you will need to check, replace, or replenish your emergency supplies at least once a year. Set a reminder in your calendar. To improve the odds you won’t get caught with foul water or rotten food, stock up with supplies that have the longest shelf life possible. Water and food that are specially packed to be stored for five years or longer are available.

Many medicines do not have a long shelf life. It is important to ensure you always have an unexpired supply of the medicines you use.


A person cannot survive for more than a few days without water. This makes water the most important item in your disaster survival kit, particularly since your regular water source is highly likely to be cut off following a disaster.

The American Red Cross and FEMA recommend storing one gallon of water per person per day. Half of that is for drinking and half is for cooking and sanitation. Store more if you live in a warm climate. A two-week supply in your home and a three-day supply in your car are optimal. If you are unable to store this quantity, store as much as you can.

The simplest and most reliable method is to use specially packed emergency water with a five-year shelf life. Store bottled water in its original sealed container and adhere to the expiration or “use by” dates on the bottles. Although most experts agree that commercially bottled water doesn’t actually go bad, the water, over time, does pick up flavors from its packaging. These flavors, combined with warm storage temperatures, contribute to the musty taste. If you are uncertain, cannot see the dates or have water that was not commercially bottled, replace it every six months.

In addition to bad odor and taste, contaminated water can contain germs, bacteria, and viruses that can cause illnesses such as dysentery, typhoid, and hepatitis. Treat all water of uncertain quality before drinking it or using it for food preparation or sanitation.

Boiling or chlorination kills most microorganisms but does not remove contaminants such as heavy metals, salts, and most other chemicals. Therefore, before treating water, let suspended particles settle to the bottom or strain them through layers of paper towels or coffee filters.

Learn where to find other sources of water in or near your home. A hot water tank, if you have one, is one of the best sources. There also is water in canned foods, in fresh or frozen fruits and vegetables, and in your pipes. To get to water in your pipes after the faucets have run dry, turn on and leave open the highest faucet in your house. Then turn on the lowest faucet in your house, and more water should come out.

Consider rainwater, streams, rivers, ponds, lakes, or natural springs. Avoid water with floating material, an odor, or a dark color. Before drinking water from any of these sources, purify it by boiling it, distilling it, or adding chlorine or water purification tablets designed for purifying drinking water. (Faucet-mounted or pitcher-style water filters are not sufficient for purifying water from these sources. To learn more about purifying water, visit www.RedCross.org.) Camping equipment and sporting goods stores often sell water purification kits for backpackers. Salt water can be used only if it is distilled first, and you should never drink flood water.

FEMA and the Red Cross do not recommend using water from toilet flush tanks or bowls, radiators, water beds, or swimming pools/spas because chemicals or pathogens may be present.


Daily food intake varies from person to person, but plan to stock at least 1,200 calories per person per day and more for anyone who is pregnant or nursing. Store some foods you eat regularly and are accustomed to, as well as some high-calorie “survival” foods such as food bars and freeze-dried meals.

In the event of a power outage, eat the food from your refrigerator first, followed by food in the freezer. Next, make use of your pantry before delving into your emergency supplies. By following these suggestions, you can easily stretch your three-day emergency kit into a two-week food supply if you are careful not to waste food.

Foods that do not require refrigeration, preparation, or cooking are best. Canned goods are ideal and foods with a long shelf life, such as granola bars, also are good. Put any boxed foods in waterproof storage bags and also keep cooking and eating utensils, a manual can opener, and waterproof matches in your emergency kit. Depending on the circumstances, you may be able to do some cooking on a propane or charcoal grill, in a camping stove, or with Sterno.

Check your stored food supply each year and replace anything that has expired or will expire within the year.

If you have diabetes, be aware that most “survival” foods are high in calories and likely will raise your blood glucose more than your regular meals. The stress of the situation also can elevate your blood glucose. If you need to sustain yourself with emergency foods, read the package labels carefully so you know the size of a single serving, how many calories it provides, and how much carbohydrate it contains. If possible, monitor your blood glucose more frequently than usual. Glucose tabs and gels are the most recommended forms to counteract hypoglycemia; be sure to include some in your emergency stock.


Many parts of the U.S. can be cold for much of the year. If your electricity or gas is cut off, your usual source of heat most likely will be cut off as well. If you have a fireplace, keep a stockpile of wood. This old-fashioned source of warmth could find sudden practicality in an emergency.
Pack blankets and sleeping bags in your kit. You can purchase inexpensive, very compact survival blankets made of Mylar, which reflects back body heat; these are easy to store in a car or “go bag.” Check any fabric emergency blankets annually for mold or moth damage. Keep extra gloves and socks in your kit as well, along with instant heat packs (usually available at camping or sporting goods stores).

Include season-appropriate clothing (hot and cold weather) and at least one complete change of clothing and footwear. Closed-toed shoes or boots are recommended for safety. Rain gear for wet weather is helpful. You also can modify large trash bags into ponchos.

Check and update clothing sizes each year so it is sure to fit when you need it.

Insulin and blood glucose meters are vulnerable to cold. If insulin freezes, it is rendered permanently useless, and meters can stop functioning in very cold temperatures. You may be able to keep your meter warm by placing it inside the clothing you are wearing. An insulated carrying case — the same type used to keep insulin cool — also can help protect insulin from extreme cold.

Shelter and tools

It’s possible your home may become damaged and uninhabitable in a disaster, so set up a buddy system with friends or relatives so you’ll have somewhere to stay. Ideally, you should have both a local buddy and one who lives outside the geographic area. It’s best that the buddy system be reciprocal: That way, both parties stand to benefit.

You also should pack a tent or tarps in your kit for short-term shelter. Your home kit should include basic tools such as a shovel, pry bar, hammer and nails, manual screwdriver and screws, duct tape, marking pen, hard hat, work gloves, safety goggles, dust masks, and a wrench that can be used to shut off your gas and water connections.

Become familiar with how to shut off your gas, water, and electricity. If you don’t know how or where to find the valves, ask your local power company for help. In the event you need to turn your gas off, do not turn it back on yourself. Your gas company will need to do that for you.


Power outages are common after a disaster. Be prepared with a flashlight in your emergency kit, your car. and in at least three rooms of your house. Test the batteries regularly, just as you should for your smoke detectors.

The ideal flashlight for your emergency kit is one that can be powered by battery, electric, solar, or hand crank. In your home, keep a rechargeable flashlight in an outlet so that it is fully charged when the power goes out. Most cell phones have a flashlight app that is quite bright.


Many people now have several ways to communicate, including a conventional telephone line (land line), smart phone (which also can be used to send text messages and e-mails), and computer. Radios and televisions also can be useful for receiving information about disasters and emergency situations. Social media has become an integral way for people to connect and stay informed. Include it in your planning and utilize it as a way to communicate with one another.

While it is unlikely all these devices will become inoperable after a disaster, cell phone towers likely will be jammed and may cease functioning if the power goes out.
Have a land-line telephone that does not rely on electricity for power (one that plugs directly into the phone jack and not into a power outlet). Keep your cell phone charged at all times. If you can’t call, texting may work. You may have better luck with e-mail, so keep your laptop charged. If you are lucky enough to reach (or to be reached by) someone outside the geographic area affected by the disaster, ask that person to relay messages for you, since you may be unable to call out again for some time. Remember to make use of social media to relay and share information

Since it is likely you will have no means of outside communication for hours or days after a disaster, choose a meeting place with your loved ones ahead of time. Also, agree on a second meeting place in case your first choice is not reachable. If you leave your home following an emergency, leave a note on the door saying where you’ve gone and how to reach you.

Pack a radio in your emergency kit that is powered by solar, hand crank, or batteries, and be sure to pack extra batteries. Some radios also come with built-in flashlights and cell phone chargers.

Keep your gas tank at least half full. You may need your car to leave an area. If the power is out, gas pumps will not work. There may be long lines waiting to gas up.
Have cash on hand. You may need cash for the first few days or weeks. A disaster can shut down local ATMs and banks. Without power, credit card machines will not work. Cash should be in small denominations for easier use.

Check your town’s and state government’s websites to learn about local efforts and resources for emergency planning.

Sanitation and hygiene

The last thing you want during or after an emergency is to get sick or to spread a sickness through your household. The best way to avoid that is to keep your hands as clean as possible. If you have running water, wash your hands frequently with soap and water. If you don’t have water, use a waterless hand gel or moist towelettes. Keep a stock of these in your emergency kit.

Remember to include personal hygiene items such as a toothbrush, toothpaste, deodorant, shampoo, comb, brush, contact lens supplies, and feminine supplies in your emergency kit. Travel-size containers are good for stowing in your “go bag.” Place them in a zip style bag in case of leakage.

Also keep a bucket, a portable toilet seat (available from emergency preparedness retailers), toilet paper, and a box of large trash bags in your home kit.

First aid

Maintain basic, well stocked first-aid kits for your home, car and workplace for treating minor injuries. Your first-aid kits should include these items.

• Adhesive bandages of various sizes
• A 50 x 90 sterile dressing
• Gauze roller bandages
• 30 x 30 or 40 x 40 sterile gauze pads
• Elastic bandages
• Antibacterial hand wipes
• Antiseptic wipes (for wound or skin cleaning)
• Several pairs of non-latex gloves
• Adhesive tape
• Antibacterial ointment
• Cold packs
• Scissors
• Tweezers
• CPR breathing barrier

Include small amounts of any over-the-counter medicines you might need, such as aspirin, acetaminophen, ibuprofen, an antihistamine, and throat lozenges. Look through your kits each year to replace expired or soon-to-expire items. If you have a cell phone, download First Aid by American Red Cross for a quick and handy guide to basic first-aid care. There also is an app for Pet First Aid for your BFF (best furry friend).

Diabetes supplies

It is vital that you have an adequate amount of diabetes medicines and supplies throughout an emergency. Have at least a three-day supply in each of your emergency kits, and never run lower than a one-week supply at home. If a medicine needs to be kept cool, however, do not store it in your emergency kit; keep it in the refrigerator (both at home and at work).

Your list of diabetes medicines and supplies likely will include all or some of the following.

• Extra insulin(s)
• Syringes
• Extra glucose meter
• Test strips
• Lancets and lancing device
Insulin pump supplies
• Extra batteries for your blood glucose meter and pump
• A glucagon kit
• Ketone test strips
• Alcohol wipes
• Glucose tablets or gel

Since insulin needs to be kept at a temperature below 86°F, be prepared with a method to keep it cool in the event of a prolonged power outage in hot weather. One option is to have an evaporative cooler such as a FRIO® insulin cooling wallet, which is activated by water, keeps insulin cool for two days, is reusable, and does not require ice packs or refrigeration. With reactivation, this will give you up to one month to get to a new source of insulin.

If you do not have an evaporative cooler, for the first day of a power outage, you can keep medications cool in the freezer (although you should unplug it because it will freeze your medications if power is restored). Or you can use an insulated bag or lunchbox with a cold pack, ice, or frozen food from the freezer. (Don’t place your insulin directly on a cold pack, ice, or frozen food.)

For oral medications, ask your pharmacist for a vial or save one labeled with your name, dosage, medication, and prescribing physician for use in an emergency.

Your emergency kit should include copies of all your prescriptions (including glasses or contact lenses) and a current dosage regimen in case others need to give your medicines to you. For pump users, this should include basal rates, insulin-to-carbohydrate ratios, and correction factors. If you subscribe to a medical identification service, include a printout of all your information. Put this information in a zip style bag or on a flash drive.

Review your plan each year and update it accordingly. Get CPR and first-aid training and keep certifications current.

So what are you waiting for?

Even a simple power outage can turn into a dangerous situation if you’re not prepared. Yet, with adequate supplies of water, food, ways to keep warm (or cool), and supplies to take care of your diabetes, you can survive myriad situations and stay in good health while doing it. You must be able to depend on yourself. Take some time now to assess how prepared you and members of your household are to survive on your own for a few days. Note what steps you need to take, and then take action. By putting together a plan, building a kit, and staying informed, you can enjoy peace of mind, be empowered, and have no regrets.