A well-planned survival kit with correct food, water and medicines will help diabetics maintain good health in case of a hurricane evacuation or other emergency. (Photo by Cheryl Gerber)

If a disaster threatened and you had to evacuate, what would you take with you? Some would grab clothing, family photos and important papers. But for people with serious health conditions such as diabetes, a continuing availability of medications, the right kinds of food and plenty of water are paramount.

Clinical nurse specialist Roberta McDuffie and her colleagues in a long-term diabetes study at Tulane have prepared a "Disaster Survival Guide" that can help diabetics stay healthy during disruptions caused by a hurricane or other emergency.

"The need for a survival kit for diabetes patients became clear after the experience of Hurricane Katrina," says McDuffie, clinical coordinator of the Tulane branch of the nationwide Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The National Institutes of Health-supported study is the nation's largest clinical diabetes and heart disease risk-factor management study. Tulane is one of 70 centers in the trial, with around 195 patients participating locally. Heading the Tulane study is endocrinologist Vivian Fonseca.

Patients in the study were scattered when the storm veered toward New Orleans. Forced to evacuate suddenly, many of the patients were unable to obtain their critically needed diabetes medications for many days. Others who were stranded without adequate food or water became dehydrated, causing their blood sugar levels to rise to dangerously high levels.

Working from a temporary headquarters at her own home and office in Picayune, Miss., McDuffie was able to reassemble the ACCORD staff. The team was eventually able to contact nearly all 200 of the study's participants.

"The survival guide project came about because we found that all of our patients were very stressed at the idea of the coming hurricane season," McDuffie says. "Our purpose was twofold -- to provide assistance in putting together a survival kit that would enable patients to get through the first two to three days, which all our research indicates is the critical period, to manage and control their diabetes during that time, and to help the patients acquire confidence in their ability to manage by making sure they have these preparations pulled together and ready to go."

The ACCORD team began researching what it would cost to assemble a basic kit geared to helping a diabetes patient survive an evacuation.

"Kits of this kind are commercially available," says McDuffie, "But they tend to be very expensive. By shopping at dollar stores, we found that a patient could put together a survival kit for one person for $29 or less."

The kit described in the survival guide may be contained easily in a plastic tub with snap-on lid. The team purchased items for a sample kit, creating a display to educate patients who visit the clinic.

A key item in the kit is the medicine box, which will include the medications that diabetes patients would need to bridge the first several days of an evacuation. The guide suggests including first aid basics such as antiseptic ointment, bandages, aspirin, ibuprofen and antacids. Also on the list are single-serving cans or pouches of foods and ample water.

The guide lists useful items to include that may be difficult to find during an emergency. These include a blanket, simple tools, rope, a tarpaulin, garbage bags, duct tape, a freezer pack and chemical cooling packs (for insulin users).

"It's very disconcerting to be confronted with a disaster of any kind," McDuffie says. Using the guide to plan and prepare in advance can give confidence to patients who otherwise might be fearful of being overwhelmed by a crisis.

"We have provided the guide and we are encouraging patients to put together their own survival kit," McDuffie says. "Certainly, people may want to make some adjustments to the list based on their personal needs. What we tried to include are basic necessities that, first, we learned through research were agreed upon as important, and second, we included things we know would be useful based on what we saw ourselves in the couple of months after Katrina."

For more information or to get a copy of the diabetes survival guide, call the Tulane ACCORD office at 504-988-0200.