Living with diabetes requires adherence to a daily self-management schedule of medication, diet, and physical activity to maintain safe blood glucose levels. A natural disaster or other emergency can upset daily routines and compromise access to health care, medications, supplies, safe water, and food, all of which can affect diabetes control. People with diabetes need to prepare in advance by having a plan and supply kit ready in the event of an emergency.

Because each person's situation is different, it is essential to prepare your plan and supply kit with the help of your health care provider, family, and friends. A diabetes emergency plan and supply kit are important tools during and after an emergency to maintain daily diabetes management and to help prevent acute health problems such as low blood glucose (hypoglycemia) and very high blood glucose (hyperglycemia). Both of these conditions can cause serious health problems. There are several key concerns specific to people with diabetes that should be considered when developing an emergency plan and putting together a supply kit. Here are the key items you need to consider before you put together your emergency plan and supply kit:

1. Identify yourself as having diabetes.

Wear visible medical identification to assure you get the care you need. This may be a necklace or bracelet. Do not depend on a card in your wallet or purse or a small decal on your watch. Some people even tattoo a diabetes ID on their wrist where someone would find it when they take their pulse or on their chest where someone might see it when checking their heart.

2. Prevent very high blood glucose.

A major concern is continually high blood glucose, which can cause dehydration. On-going dehydration can lead to dangerous and life-threatening conditions such as ketoacidosis (primarily in type 1 diabetes) and hyperosmolar hyperglycemic nonketotic coma.

3. Stay well-hydrated.

Because hyperglycemia can cause dehydration, stay well-hydrated by drinking adequate amounts of clean water and non-carbohydrate, caffeine-free fluids.

4. Prevent low blood glucose.

Low blood glucose is a short-term complication that can affect persons taking insulin and/or pills that increase the body's ability to produce insulin. Make sure to always carry a quick-acting source of carbohydrate such as glucose tablets or gel.

5. Prevent infection.

People with diabetes are at increased risk of developing circulation and nerve problems, which can increase risk of infection, particularly affecting the feet. To prevent problems, keep your feet clean and never go without shoes. Check your feet daily for sores, cuts, and blisters. Seek immediate medical help if you see signs of infection such as redness, swelling, or oozing from the area.

6. Maintain your normal medication schedule.

Taking diabetes medications as prescribed is critical. To help prevent interruption of treatment, be prepared by keeping a 30-day supply of medications for diabetes and other health conditions. Check with your local pharmacy regarding its service in providing medications during an emergency.

7. Maintain your normal meal and snack plan.

Follow your normal diabetes meal plan as closely as possible to help maintain good blood glucose control. Since electrical power may not be available for a period of time, it is advisable to store at least a three-day supply of water and non-perishable food. Some examples of non-perishable foods include whole grain crackers and dry cereals; peanut butter and nut butters; shelf-stable milk and juice packs; water-packed fruit; bottled water; powdered milk; canned/packaged tuna, salmon, and chicken; canned legumes; canned soups (lower sodium); and unsalted or lightly salted nuts.

Diabetes Emergency Kit

Prepare a portable emergency kit that is insulated and waterproof. Maintain a two-week supply of all items you require to manage your diabetes. Periodically check the kit to be sure it has your current medications and supplies. Check all expiration dates. Also, be sure someone else you trust knows the location of the kit in case you need help and cannot access it yourself.

Have a 30-day supply of all medications to include active prescriptions and eligible refills.

Your supply kit should include the following:

• Personal medical information

• Emergency contact list (including health care providers, pharmacist, family, and friends)

• Written medication plan (name of medicine, dosage, and administration)

• Written meal and snack plan (food groups and carbohydrate choices per meal)

• Extra copies of prescriptions

• Blood glucose meter and strips; extra batteries

• Urine ketone testing strips

• Lancing device and lancets

• Syringes and/or pen needles

• Alcohol and cotton swabs

• Medical/first aid supplies such as topical medications, bandages, dressings, tape, etc., to treat minor injuries

• Quick-acting carbohydrate (glucose tablets or gel, hard candy, raisins, etc.)

• Longer-lasting carbohydrate (crackers, ultra high temperature [UHT] milk packs, etc.)

• Glucagon emergency kit (if on insulin)

• Empty hard plastic bottle with cap to dispose of sharp objects such as used lancets and syringes

• Cooler with sufficient freezer cold packs for storing insulin

• At least a three-day supply of drinking water and food that does not require refrigeration