Basic General Guidelines for Handling Diabetes Supplies During natural Disasters
These guidelines are for informational purposes. Please confirm with your doctor that these recommendations are suitable for you.
Please plan ahead at all times and ensure that your physician prescribes 90 day supplies of your medications and testing supplies whenever feasible. Make sure to contact your physician and pharmacy whenever you have less than 2 weeks of medication or supplies left.
- Unused / unopened insulin products are best kept refrigerated. Avoid temperatures below freezing temperatures or above 86 degrees Fahrenheit.
- Do not use an insulin pen or vial once it becomes frozen, even after thawing.
- If no refrigeration is available, unused / unopened insulin pens or vials can probably be stored at room temperature for 24-72 hours. However, when using, watch for changes in the strength of the medication (repeated unexplained high blood glucose levels). When in doubt, switch vials/pens.
- Should power be lost, insulin which is refrigerated should be removed from the refrigerator after 2 days if power does not return. After 2 days, the refrigerator may become warmer than room temperature.
- Once an insulin vial or pen is used / opened, it should be stored at room temperature.
- If a cooler is used, be sure that ice for the cooler (not dry ice which is too cold) should be in a sealed container (e.g. a zipper type plastic bag). Insulin pens can become damaged from direct contact with moisture. One solution is to put the insulin in a sock or wrap it in a towel to avoid direct contact with the ice.
Other injectable diabetes products: Victoza ®, Bydureon ®, Byetta ® and Symlin ®:
- Opened pens and injection kits may be kept at room temperature. Storage of unopened products follow the guidelines above for cooling/freezing and temperature extremes
Glucose test strips:
- Extremes in heat or cold can affect the accuracy of glucose tests strips. These extremes vary according to the brand of strips but typically exposure of more than 30 minutes of < 45 degrees Fahrenheit or over 90 degrees Fahrenheit may be a cause for concern (check on the label with your specific brand).
- Frozen test strips should be discarded. Do not store tests strips in a cooler/refrigerator or a parked car exposed to extreme cold or heat for a prolonged period of time.
- If you are out and about in the cold with your glucose meter/tests strips best to put in an inside coat pocket.
Oral diabetes medications (pills):
As there are many oral products for the treatment of diabetes, we are providing general guidelines. Please check the package label or confirm with your doctor or pharmacist specifics for your product.
- Most oral medications for treatment of diabetes are best maintained at room temperature, between 68 and 77 degrees F (20 and 25 degrees Celsius).
- Brief storage of medications at temperatures between 59 and 86 degrees F (15 and 30 degrees Celsius) is permitted (less than several hours). Storage away from heat, moisture, and light is best.
- If changes in medication effects are noticed after temperature extremes consider getting new product if possible. Confirm with your doctor/health care provider before doubling a dose as you might take more medication than is safe!
What if all my medication is at risk for not working or is showing reduced effects and I can’t get more?
- Try to reach your health care provider to see if he/she may know of any pharmacies that are open and have supplies.
- Even with reduced potency, your medications may have some effect and you should not discontinue them. Do not borrow a friend’s medication without discussing with a health care provider beforehand.
- Replace questionable medication as soon as possible, and if blood glucose values remain persistently over 300 mg/dl or you are experiencing extreme thirst, nausea/vomiting or dehydration, seek out urgent medical care.
What to eat when the usual foods are unavailable?
- The best food options for people with diabetes are a combination of high fiber carbohydrates, colored vegetables, and lean proteins. Foods less desirable are simple sugars and white starches and fried foods.
- Safe options for travel would include nut butters (presuming no allergies) with high fiber crackers, canned meats or fish like tuna, salmon or chicken, canned vegetables like string beans, low sodium canned soups , hard boiled eggs (if refrigeration available). You should have available a product to treat episodes of low blood sugar, like boxed juices (or even sugar packets).
- Shelters will often have heated prepared meals – we recommend meals that offer a combination of protein and colored vegetables when possible. Limit starches to 1 cup per meal and try to avoid simple sugars.
- If there is little or no choice and options are extremely limited, multiple small meals of high carbohydrate products (like pasta, rice, or bagels) are better than eating 1 or 2 very large meals. If at all possible try to combine with some type of protein if served. Better to eat something than nothing!
Mount Sinai Diabetes Center
5 East 98th Street, 3rd floor
New York, NY 10029