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Emergency Preparedness for Diabetes

Like everyone else, those of us who have diabetes need to prepare for emergencies. But because we have more and different needs, we have to do more than just think about what could go wrong. Sadly, that’s what most people do.

Some people have set aside stores of food and water. But only about 10 percent of American households are prepared for an emergency. Yet climate change and increasing weather extremes are creating more and more emergencies.

The United States experienced an average of 50 natural disasters each year in the previous decade — more than 560 in total — according to the records that the Federal Emergency Management Agency, or FEMA, keeps of “major disaster declarations.” Already in the first three years and 10 months of this decade FEMA declared 280 major disasters, an average of more than 73 per year.

Whether we have diabetes or not, to survive on this planet we all need air, water, and food. Some experts have a “rule of three” that says we can live three minutes without air, three days without water, and three weeks without food. While your mileage may vary, this approximate rule has the virtue of being easy to remember.

While we have a constant need for air to breathe, we can’t reasonably expect to keep a storehouse full of it, nor are we likely to require it. We can and must deal with the need for water that we must have every day, emergency or not. This is the critical need that we must address first.

In an emergency we can expect to lose our purified tap water. Especially if you live in the desert no water may be there. In either case, having a store of water on hand makes sense.

How much? “There’s an old urban myth that you should drink at least eight glasses of water a day,” I wrote with Jennie Brand-Miller in my first book, What Makes My Blood Glucose Levels Go Up…and Down? “It appears to lack any scientific proof;” the Mayo Clinic agrees. The clinic recommends about 13 cups a day for an average man and about nine cups for an average woman, but again your mileage may vary.

How long to we need to prepare for? Who knows. But the standard guideline, like this one for a city in Maine, is that we need to be self-sustaining for at least 72 hours during an emergency. For a man that’s three 24-hour days times 13 8-ounce cups or 104 fluid ounces or 84 percent of a gallon.

That doesn’t sound enough to me and probably isn’t, because among other things it doesn’t include anything for necessities like washing or brushing our teeth. I’m not good with numbers, which is why I am a writer, working with words. So please correct me if I am wrong! In any case, I make sure to have at least five gallons of filtered tap water on hand all the time, and I think that is is a reasonable amount to have per person. I keep most of this water in the Reliance brand containers that I use for camping trips.

Unlike food, we don’t have to constantly replenish our stock of water when it gets old. The water that comes out of our taps is already much older than we are!

So the first rule for our emergency food supply has to be replenishing it regularly. We need to keep it fresh, watching the expiration dates if the products you store have them. In particular, we can’t rely on food that needs to be frozen or refrigerated, because in an emergency the power may go out.

The second rule for us has to be storing food that will be healthy. People with diabetes have considerably different food requirements than the common run of the mill type. Specifically, the food that we have for an emergency has to be food that won’t unduly raise our blood sugar level.

That means foods that we can keep on hand for several months must be low in carbohydrates — and that we must like eating them. For me it’s the foods that I keep on hand all the time in my small kitchen pantry.

Specifically, I always have canned salmon, sardines, mackerel, and tuna on hand. I buy it by the case from VitalChoice, which in my experience offers unsurpassed quality.

Except for tuna, these fish are all high in the most healthy fat, omega-3. But I make sure to keep extra-virgin olive and coconuts oils on hand for my salads. While we may have to forego salad in an emergency, we always need fats like these to survive, particularly if we follow a very low-carb diet, as I do.

I always have plenty of chia seeds on hand for my salads and several other meals. In an emergency I will eat them by the tablespoon. Of course, almondsare a wonderful snack food, too. Although I freeze them for crunch, even if our refrigerator is no longer working, almonds at room temperature are just as healthy.

You probably have other healthy and tasty products in your pantry that will serve you well in an emergency, and if so, you might want to consider having more of the same on hand. I know that my list of emergency foods is a short one that would get boring pretty soon, but I will have a lot more to be concerned about then. Besides, almost all of us can afford to lose a few pounds, and any of us can fast for a lot more than 72 hours if necessary.

Many of us who have diabetes also need to have adequate supplies of our medication on hand. Nowadays, insurance companies are limiting how much we can have on hand, so you may need to regularly negotiate this with them.

Some of our medications, especially insulin, shouldn’t get awfully hot. If you regularly refrigerate any of your medications, you need to be prepared with a backup. At a minimum, you will need to keep a lot of ice cubes on hand. And you may also want to consider a device that people use for traveling with insulin, a Freo cooling wallet.

When the power fails, we may also not be able to heat any of our food or drink, as one of my friends and neighbors, Nancy, reminded me this morning. At a minimum that would mean no tea or coffee, which would ruin the day for almost all of us. But I am prepared with the Jetboil camp stove that I always have in my vehicle. Just make sure that you also have enough fuel canisters on hand to tide you over in an emergency.

With it you can also boil water that is polluted to make it drinkable. You will need to bring it to a full rolling boil for at least a minute and let it cool down for 30 minutes before using it, the New York State Department of Health says.

Finally, even if you do all this, it may not be enough. New research shows that “it is the personal ties among members of a community that determine survival during a disaster.”

That’s one reason why I reached out to Nancy this morning as I worked on this article. If and when we experience an emergency, Nancy and I are prepared to share and help each other.

Thanks, too, to my reader and correspondent, Laurel, for suggesting this topic, and to my sister, Liz, who quite a while ago encouraged me to do more than just think about this issue.

People put off preparing for emergencies because we are so busy these days. Planning for trouble also naturally makes us anxious. But by following these simple steps you might save your life.

This article is based on an earlier version of my article published by HealthCentral.

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  • Virginia at

    Dear David,
    Interesting post! I just read a news item about a lawsuit in New York on behalf of disabled people who weren’t included in NY’s emergency plan. Our senior community has a high percentage of disabled people, and we do the best we can to include them in all our CERT (Community Emergency Response Team) activities. But I have never read anything before about special needs of people with diabetes. Thanks so much for writing about it; I’ll be following up.