Diabetes in Emergency Situations

Presented by MaryAnn Nicolay, BA, DTR.

Health Educator

Program objective:

How to help people with diabetes in emergency situations

Learning objectives:

• Understand basic diabetes management • Discuss emergency needs as related to basic diabetes management • Use tools for determining medication and SBGM needs

What is diabetes?

Risk Factors for developing diabetes

• • • • • Being over 45 years old Having blood relatives with diabetes Being over weight Being a person of color Not exercising • • • • Having high cholesterol or heart disease Having high blood pressure Having diabetes when pregnant Having a baby that weighed over 9 pounds

Symptoms of Diabetes

• Increased hunger • Being very thirsty • Frequent urination • Being very tired • Slow healing wounds • Changes in vision • Tingling or numbness in hands or feet • Unexplained weight loss

Types of Diabetes

• Type 1 diabetes • Type 2 diabetes • Gestational diabetes

Diabetes Management Plan

Healthy Food Choices Physical Activity Checking Blood Sugar Diabetes Medication

Healthy Food Choices

• There is no “diabetes diet” • General Guidelines • Eat 3 meals each day • Eat at about the same time each day • Do not skip meals • Watch the fat!

• Watch your portion size • Learn to read and use food labels

Healthy Food Choices in Emergencies

• Meals every 4-5 hours • Between meal snacks • Carbs at each meal • Fruit, starches / grains, vegetables, milk / yogurt • Serve sugar-free beverages • Serve heart-healthy foods

Meal Ideas

Breakfast Snack Lunch Snack Dinner Snack

Cold cereal/milk, toast, yogurt, fruit, yogurt, bagel w/cream cheese, Deli meat sandwich, soup, salad, fruit, Grilled chicken salad w/low fat dressing, roll or crackers, fruit Baked chicken, mashed potatoes, green beans, roll w/ margarine, fruit cup Fruit, 100 calorie snack packs, graham crackers, peanut butter w/crackers, yogurt, sandwich, ½ cup ice cream, pudding, cheese and crackers, cottage cheese w/fruit, pretzels

Beverage Ideas

Beverages

Milk, sugar-free beverages like coffee or tea w/sugar substitutes, water, crystal light, sugar-free soda pop

Physical Activity

•

Lowers blood sugar

• • • • • • • Lowers blood pressure Lowers cholesterol Helps you sleep Enhances your mood Helps burn fat Helps build muscle Strengthens bones

Physical Activity in Emergencies

• Depending on the nature of the disaster, there may be a change in regular activity • Increase in activity due to repairing damage • Hypoglycemia (low blood sugar) • Decrease in activity due to being away from routine • Hyperglycemia (high blood sugar) • Excessive exercise when blood sugar is over 250mg/dl may cause blood sugar to elevate

Checking Blood Glucose

• Tells what your blood glucose number is NOW • Is used to make changes in how you manage diabetes • How food and activity affects your blood glucose • How well diabetes medicines are working • Effects of stress or illness

Blood Glucose Monitors & Test Strips

Diabetes Medications

• People with diabetes may need to take pills and/or insulin to help manage their diabetes • Taking pills and/or insulin does not mean your diabetes is worse than someone else. • It means that this is the best way to way to manage your diabetes.

Diabetes Medications in Emergencies

• People with diabetes may or may not be taking diabetes medications • Oral medications do not require special storage • Insulin or other injectable medications require special storage and equipment • Syringes • Pen needles • Alcohol swaps • Pump supplies • Sharps container

Insulin Pumps and Pens

Stress and Diabetes

• Coping skills may be inadequate for situation • Decreased sleep • Increased worry • Damage to property • “Where will I go?” • Loss, grief, fear, anger, frustration • Change in priorities • Preoccupation with survival or clean up

Low Blood Sugar

Blood glucose of less then 70mg/dl

Feeling weak or tired Being hungry Feeling sweaty, having chills or cold hands Feeling shaky, anxious or confused Having a fast heart beat, dizziness, or headache Having blurry vision or numb lips Passing out or having seizures

Treating Low Blood Sugar

Follow the Rule of 15 15 grams of quick acting carbohydrate Wait 15 minutes Re-test blood glucose If glucose still below 70mg/dl, retreat

15 grams of carbohydrate

• • • • • ½ cup of juice (any kind or REGULAR soda pop) 4 glucose tablets 2 teaspoons of jam or jelly 6-8 lifesaver candies, chewed up 1 tablespoon of sugar dissolved in water Do not treat low blood sugar with diet soda pop. This will not raise your blood sugar.

Do not treat low blood sugar with chocolate candy. This will not raise your blood sugar quickly enough.

Other Things to Consider in Emergencies

• • Problems with feet • • • Poly-pharmacy • Where to get meds • Other medical conditions • Heart • BP Vision Prosthetic devices Dialysis

When to call for help

Refer to a hospital, clinic or ER when:

• Hypoglycemia that does not respond to treatment • Consecutive blood glucose readings greater than 250 mg/dl • Blood glucose reading greater than 250 mg/dl along with vomiting, rapid breathing, fruit breath, stomach ache

Emergency or Disaster Situations