In light of the events in Texas, and due to my own personal interest in such things, I’m starting to brainstorm a thread for emergency preparedness for diabetics… I don’t even really have my own outline drafted up yet but do welcome input as to what all of you would like to see
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Well, once each person has done the likely threat analysis, you arrive at some combination of events you are preparing for. For us, the most likely disaster is the Cascadia earthquake. During this event every bridge across every river around here(except for one recently built bridge) will go down. Traffic will take months to resume. River traffic will be impossible because of the bridges falling etc.
To handle this we have food, water, medicine, camping equipment, batteries, solar panels, etc. stashed at two places in our house in case one area of the house is inaccessible.
For insulin we always have two bags of ice in the freezer in the garage, and a high end cooler. With this we feel we can keep the insulin cold for a couple of weeks.
There are of course many other contingencies in our plan, but this is the basics.
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excellent points about the individual threat assessment.
Keeping insulin cool for 2w imo is essentially negligible considering it’s true lifespan wo refrigeration… although I suppose that varies a lot with season and climate
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I’m in pretty much the same situation as @Chris. Large city, earthquake zone, most of the bridges not earthquake proof and many of the buildings (including the one I live in) built before there were seismic safety guidelines in the building code. So my immediate concern would be not having my building collapse on me (though according to my landlord the building has been seismically upgraded, which is somewhat reassuring).
I was actually revamping my earthquake kit recently (it tends to be a summer project for me), so this topic is timely. In the past I’ve never kept insulin in my earthquake kit, but I do always keep two penfills on me when I’m out and about. I’m paranoid about being stranded at work or at a random bus stop after an earthquake. I added three penfills to the earthquake kit I keep at home, and will rotate those into the little kit in my bag and then into my pen and pump. Fiasp seems a lot more durable than Apidra was, so I’m not too worried about insulin going bad (and should I ever need my earthquake kit, the newest insulin will be in there).
I think if there were a major earthquake I would try to get home or stay home if at all possible. I’ve read that after earthquakes in places like Japan, it took months to get basic services up and running. So I want to have a month or two worth of diabetes supplies, insulin, other medications, food, and water in my apartment. I haven’t actually calculated how long the diabetes supplies I have would last me, but I’d probably be okay as long as I stuck with eating low-carb so my blood sugar stayed relatively stable. Though, if I’m thinking two months, maybe I should get a cooler of some kind. Food I haven’t done so well at, because I find it hard to find low-carb stuff that stores well outside my fridge, so I’d pretty much be living off granola bars, protein powder, chia pudding, and chocolate at this point. I think water I may only have two weeks.
What do people do about water in an earthquake kit meant for evacuating? This is the kit I just added insulin to, because I figured after an earthquake going to the kitchen to get insulin from the fridge is probably not a great idea what with all the glass that’ll be there. But the backpack doesn’t fit nearly enough water in it, especially considering the crazy guideline of having four litres per person per day or something like that. If my backpack is meant to last a minimum of three days, I can’t carry 12 litres of water. (In fact, now I’m thinking I may only have a few days’ worth of water in my apartment…) I do have those water purification tablets, so I’m hoping I’d just be able to find drinkable water that I could purify somewhere. I’ve been thinking I should get one of those Life Straws that supposedly let you drink from muddy puddles…has anyone used one of those?
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I have:
The Sawyer mini is an incredible water filter, which does everything it says it does. Three thoughts:
- It does not deal with viruses. For that, I use:
-
If you need large quantities of water, use a combination Sawyer/ gravity filter (but that has much more bulk)
-
Don’t forget to backflush when you use in very dirty water
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I think there is a bit too much focus on insulin temperature. I did the 2 1/2 months unrefrigerated demo, and the 4 days in a hot car demo. So I just took a vial of insulin out of the refrigerator, and I will leave it unrefrigerated for a whole year. Can someone please remind me 1 year from now to try it?
There is some stuff people often overlook for natural disasters. You are more likely to die from lack of clean water, or any water, than you are from insulin being unrefrigerated. And water issues will kill anyone, not just diabetics. Infection is another big problem.
If you are going to hunker down and wait it out at home:
- water
- water purification system
- (depending on location) - a source of warmth, blankets, firewood
- insulin
- syringes
- a way of defending your fortress
- food, things like MRE’s, noodles, rice, canned goods (make sure you have a non-electric opener)
- a method of cooking that does not involve gas or electricity - firewood works great!
- antibiotics
- first aid kit
- alcohol swabs, bottle of isopropyl alcohol
- carb sources - things like cans of coke which will last forever
I think everything else is a luxury item. Sure a pump is great. And having your Dexcom is great, and if you have them at home, you can still use them. But I personally wouldn’t sweat it out in a disaster if I didn’t have it. Bigger stuff to worry about.
Also, if you have to flee your home, consider - you can use syringes over and over, with no batteries required. The same can’t be said for a pump.
Other than the things a non-D needs, the only extra things a D needs to survive are 1) insulin, 2) an insulin delivery method (preferably syringes for re-usability), and 3) a carb source. Everything else is a luxury.
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I completely agree far too much energy is expended worrying about refrigeration… you can drape your insulin in a towel and pee on it and keep it cool enough in most climates. Insulin dependent diabetics survive in communities around the world without refrigeration.
To my knowledge not a single person has died in Katrina, Harvey, the Japan earthquake, etc because their insulin got too warm
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I don’t know how some of you have used warm insulin with success. Maybe it’s something with Sanofi insulins, but I’ve tried both Apidra and Lantus after sitting out for months and they’ve been way less potent (to the point that I used half an entire penfill one day and was still running high). I’ve also had Lantus overheat.
Fiasp does seem less sensitive, though. But unfortunately, most of what I have left over in my fridge is Apidra and Lantus.
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I wonder how long you can use a pen needle for (I can’t see to use syringes, so would be using pens). I’ve used one for six or seven injections, but after that it starts to hurt (this was also when I was on MDI, when I’d use one to two needles per day). Also, wouldn’t you worry about infection risk more if you were stranded in some shelter with hundreds of other people?
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Jen I’m glad your commenting on this topic before we put together a real thread… how much would you be willing to contribute to the subject in the particular context of being visually impaired?
In honesty, I haven’t done as much with warm basals, or with warm Apidra or warm Fiasp, so I can’t vouch too much for them. But if you get one single vial of Humalog and put it in your kit, I bet it would be okay no matter what you did to it!
Haha, I thought this was the real thread until my last post or two. So I’d be willing to post anything I’ve posted here.
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Well this is the content team thread-- where I get to ask you questions like if you’re willing to discuss the topic from the perspective of a blind person-- before we publish it in the forum that’s visible to the world
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Yep, I’m willing to share anything that might help others. I’ve put blindness-specific stuff in my earthquake kit, just didn’t mention it here because it wasn’t relevant to diabetes specifically.
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Surviving in an emergency isn’t specific to diabetes;)
I think my visual impairment is a large part of why I’d stick to my apartment, as long as the building was safe. I’ve included an extra white cane and low vision aids (near and distance) in my emergency kit. Even so, I think trying to travel through a city in ruins with everything in chaos as someone with low vision would be challenging.
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Lkenive mentioned in the last, foreign mail order pharmacies have told me they consider all insulins to be within spec if they’ve spent less than 28 days in transit before opening them, still having the full 28-56 day room temperature shelf life after opening while having spent up to 28 days in transit…
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Oh, I am sure they are fine. I am just saying I haven’t done as much with them personally as far as using them unrefrigerated.
I have used NPH that I didn’t keep refrigerated for months at a time. So I can vouch for NPH remaining stable. As much as people deride NPH, it is not a bad emergency-prep thing to have on hand. It’s cheap and you can get it without a script. Buy a vial and stash it somewhere.
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Just make sure you store lots of snacks with the vial, so you have something to eat when NPH peaks.
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Agreed it may not be the ideal thing for people in everyday use, but like I said - no script, longevity, and cheap make it a viable emergency item to have.
In fact, you could actually use it as both a basal and mealtime insulin in an emergency, if you just time the peak properly. I did that! I am still alive!
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