Hurricane season has hit South Florida horribly with Hurricane Irma and pending Hurricane Jose. Many Floridians were evacuated, without power and some without water or shutters for their home. In a time when natural disasters are imminent there a few things to keep in mind about your diabetes:
- Have enough medication to last for several weeks after the storm. If you are traveling or even staying put, process a refill of your medication or bring extra medications with you to last for several weeks. Lack of power can leave you unable to process refills and lack of gasoline can leave you unable to go pick up refills from your local drug store. So, try to have at least 1 month in extra medication prior to a natural disaster.
- Keep insulin cool. If your power goes out during a storm you need to keep back up insulin pens or vials cool, but not frozen. Plan to have coolers with ice packs available in the event that your refrigerator does not have power. See below article for more details
- Stock up on water. You need to stay hydrated during the storm and need to have clean hands when testing blood sugar levels. Aside from brushing your teeth, flushing toilets, etc. Buy bottled water, fill up bathtubs, fill up Tupperware or bottles of water with tap water while preparing for the storm.
- Seek a shelter or go stay with family if you experience frequent hypoglycemia or do not feel confident in administering your medications yourself. Call 211 or www.2-1-1.org to find local available shelters or try setting up transportation to a local friend or family member’s house if you feel unsafe alone without power.
- Keep non-perishable healthy snacks available such as dry roasted nuts or seeds, kale chips, brown rice cakes, canned chicken or tuna, low fat popcorn and low carbohydrate protein bars. Do not use the hurricane as an excuse to munch on potato chips, cookies and candy!
- Make a plan, tell friends and family your plan and do not take hurricanes, tornados or tropical storms lightly. We know devastation can happen this time of year, but your health and diabetes do not have to suffer.
To learn more about diabetes, health and weight loss call 561-659-6336 ext 8012 to schedule an appointment with a certified diabetes educator today. Please enjoy our September 2017 Living Well with Diabetes Newsletter.
Weight Management, Family Style
By: Dr. Gary Pepper
Weight management is a key component of a healthy lifestyle although keeping one’s weight on track is often a frustrating and perplexing task. To get the whole family involved in the weight management effort may seem almost impossible.
Simply identifying a younger member of the family as overweight can be a challenge. A 2015 study from the U.K. found that 31% of parents underestimated their child’s weight status. For a child who is “very overweight” per government guidelines there was an 80% chance the parent would classify the child as healthy weight. Teens themselves are not very good at identifying themselves as overweight as 80% of overweight teenaged boys and 71% of overweight teenaged girls perceived themselves as normal weight. Recognizing that a child is overweight is crucial to preventing the progression to adult obesity. 72% of overweight kindergartners were obese by the time they reached 8th grade.
Being overweight as a child is more than an issue of esthetics or social acceptance. Children who are obese have a 400% increased risk of developing type 2 diabetes as adults and possess a significantly higher risk of eventually dying from coronary artery disease as adults.
Perhaps overweight parents fail to recognize how their own habits and attitudes toward nutrition influence others in their family. In another study from the U.K. 48% of overweight children had overweight parents while only 13% of overweight children had normal weight parents. The odds of developing obesity if one parent is obese are 3 times normal and increase to 15 fold above average if both parents are obese.
What can be done to influence all family members to adhere to a healthy diet and maintain proper weight? Experts in pediatric obesity are quick to point out that most medical interventions designed to reverse obesity in children and teens including behavioral modification and medications have failed to produce consistently good results. These same experts are unanimous in suggesting that prevention is the key. A study from University of Minnesota in 2014 showed that family meals during which parent and child experience a positive interaction regarding healthy food choices and appropriate portions result in a reduction in risk of the child becoming obese. Conversely, hostile or indulgent interactions during family meals increase obesity chances for the child. An important factor in the success of family intervention in preventing childhood obesity is that adults themselves participate in the healthy eating process and are aware of what constitutes appropriate portions and calorie content of the different food choices.
Patients at PBDES are fortunate to have access to our educational programs and educators who can provide each patient with the skills and information needed to conduct healthy family meals. Please feel free to contact our office for more information about establishing a healthy family meal environment.
Diabetes Checklist During Disasters
By: Ines Enriquez-Cobo RN, CDE, CPT
As a person with diabetes, your daily routine involves schedules and planning. An emergency can seriously affect your health. It may be difficult to cope with a disaster when it occurs. You and your family should plan and prepare beforehand even if the event is a loss of electricity for a few hours.
The first 72 hours following a disaster are the most critical for families. This is the time when you are most likely to be alone. For this reason, it is essential for you and your family to have a disaster plan and kit which should provide for all your family’s basic needs during these first hours.
Emergency Supply Kit
You should safely store the following medical supplies in an emergency supply kit or have them readily available
- Copy of your emergency information, health insurance cards, a list of medications, and names and phone numbers for doctor and pharmacy
- Extra copies of prescriptions for medications that you are already taking
- Glucagon Emergency Kit (if on insulin)
- Insulin or pills (include all medications that you take daily including over-the-counter medications).
- Include an ice pack, if possible, to keep insulin cool
- Insulin syringes
- Insulin pump supplies (if on insulin pump)
- Alcohol swabs
- Cotton balls & tissues
- A meter to measure blood sugar
- Blood sugar diary
- Strips for your meter
- Urine ketone testing strips
- Lancing device and lancets
- Quick acting carbohydrate (for example, glucose tablets, orange juice, etc.)
- Longer lasting carbohydrate sources (for example, cheese and crackers)
- Empty hard plastic bottle with cap to dispose used lancets and syringes (for example, detergent bottle)
- Hand sanitizer
Helpful Hints about Insulin, Pens, Syringes
- Never skip taking your insulin unless your doctor tells you to.
- All insulin that comes in a bottle, except glargine, can stay at room temperature (59° - 86°F) for 28 days.
- Once an insulin bottle is opened, it is only good for 28 days even if it is refrigerated. At the end of 28 days, an open bottle of insulin must be thrown away, even if some insulin is left in the bottle.
- Insulin pens in use can be stored at room temperature according to manufacturer’s directions.
- Insulin pens that are not in use and are refrigerated are good until they have reached their expiration date.
- Insulin should not be exposed to excessive light, heat or cold.
- Regular and Lantus insulins should be clear.
- NPH, Lente, Ultralente, 75/25, 50/50, and 70/30 insulins should be uniformly cloudy before rotating.
- Insulin that clumps or sticks to the sides of the bottle should not be used.
- Although reuse of your insulin syringes is not generally recommended, in life and death situations, you may have to alter this policy. Do not share your insulin syringes with other people.
Things to Remember
- Stress can cause a rise in your blood sugar.
- Erratic mealtimes can cause changes in your blood sugar.
- Excessive work to repair damage caused by the disaster (without stopping for snacks) can lower your blood sugar.
- Excessive exercise when your blood sugar is over 250mg can cause your blood sugar to go higher.
- Wear protective clothing and sturdy shoes to protect your feet if you must go outside after a disaster/event.
- Check your feet daily for an irritation, infection, open sores or blisters.
- Disaster debris can increase your risk for injury.
- Heat, cold, excessive dampness and inability to change footwear can lead to infection, especially if your blood sugar is high.
- Never go without shoes.
Seek emergency treatment if you feel or have
• Fatigue, weakness, abdominal cramps, decreased urination, fever, or confusion.
You should wear diabetes identification AT ALL TIMES.
Sick Day Rules During a Disaster
- Always take your insulin or pills on time or close to it. Never omit your insulin unless your doctor has told you otherwise. Insulin is still good if there is no refrigeration. A used or unused bottle of insulin
- may be kept at room temperature (59° - 86°F) for 28 days. Discard opened unrefrigerated insulin after 28 days.
- Keep an extra bottle of each type of insulin you use on hand at all times.
- Eat within 15 min. or no later than ½ hour after taking your insulin (depending on insulin type) or diabetes medicine. Try to eat on time.
- Never skip a meal. If you cannot eat solid food because of nausea, vomiting, and/or diarrhea, sip regular coke, eat hard candies, fruit or regular soft drinks instead of following your usual meal plan.
- Do not let yourself get dehydrated. Limit or avoid drinks with alcohol.
- Drink plenty of liquids.
- In between meal times, sip water, sparkling water or diet soda. (This will not replace food, but can help you be hydrated.)
- Check your blood sugar. Notify your doctor if your blood sugar average is over 240 mg or if you are ill for 2 days.
- Test your urine for ketones when:
- Your blood sugar average is over 240mg.
- You are vomiting
- You have symptoms of high blood sugar (increased thirst or hunger more than usual, quick weight loss, increased urination, very tired, stomach pain, breathing fast or fruity breath smell).
Call your doctor if your ketone test is moderate or high and/or if you have symptoms of high blood sugar.
• You may need more than your usual amount of insulin on a sick day. Your doctor can guide you in this.
Finally, if you need medical assistance/or are out of all medications and food, and cannot reach your doctor, immediately, go to the nearest hospital or Emergency Medical Center, if possible, or contact the police or 911 if it is an emergency.
Want more information on weight loss?
Then come to our FREE Diabetes Support Group!
Wednesday October 4th at 5:30 P.M.
1515 N. Flagler Drive, Suite 430
West Palm Beach, FL 33401
Dr. Barry Horowitz will be discussing mindful eating
Registered dietitian Jessica Cook will discuss weight loss tips, healthy snack ideas and more!
Will provide Healthy Snacks!
**May bring one guest free of charge!
If interested attending this program please contact our scheduling department at (561) 659-6336 Extension 8001 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended. You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 659-6336 ext. 8012. We would love to hear from you!
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