by George “Joe” Trotter, Jr., BSN, RN, CDCES
Coronavirus. Novel coronavirus. COVID-19. Words we all see daily on our TVs, laptops, social media and discuss in conversations with family, friends, co-workers and clients. It’s 2020s major news... not just here in the U.S., but worldwide.
What can you do to prepare your clients for a possible outbreak or emergency situation?
Listed below are some recommendations you can share to help them stay healthy and prepared to manage their diabetes in a time of crisis/emergency.
1. Understand Best Prevention Strategies
First off, all people with diabetes should understand that protection and education are essential in the prevention of the spread of the coronavirus.
- Avoid contact with people who are sick. Facemasks are not recommended by the Centers for Disease Control and Prevention (CDC) for those who do not exhibit any symptoms of the coronavirus (cough, shortness of breath, fever); however, those who do exhibit symptoms should don a facemask when in public.
- Cover your cough or sneeze. Use a tissue, if available, and throw it in trash after use. If no tissue is available, sneeze into your elbow.
- Avoid touching your eyes, nose and mouth.
- Clean and disinfect surfaces.
- STAY AT HOME WHEN YOU’RE SICK.
- Wash your hands frequently with soap and water for at least 20 seconds. If soap is not available, use a good hand sanitizer (alcohol-based) for a minimum of 15 seconds.
- Wash your hands before eating, after using the restroom, when visibly dirty and upon returning home.
- Avoid shaking hands and opt for an elbow cross or fist bump as a greeting instead.
2. Prepare Medications
Clients should continue to take their diabetes medications (and all medications) as discussed with their provider. Recommend they keep track of all their prescription drugs (insulins, oral medications, etc.) to make certain they will have enough of those medications should an emergency occur and limit supplies. Maybe consider requesting 90-day prescriptions for clients (if this is an option with their health insurance/cost-effective). In response to the coronavirus, Lilly has issued a statement that they have enough insulin in supply, their production has not been affected, and assure that their medications are safe. Other manufacturers have yet to comment.
All clients should keep a list — either written or electronic — of all their medications, both prescription and over the counter. Highly recommend they wear a medical ID alert (necklace, bracelet, etc.) or carry this identification with them at all times.
3. Create a Technology Backup Plan
Discuss a backup plan with your clients who wear an insulin pump/pod and/or a CGM. This would be similar plan for when a pump may malfunction and they are waiting on a replacement. However, this would be for an extended period.
Also, recommend they have a backup glucose monitor and test strips for instances when their CGM is not available — which may happen in an extended emergency.
Access to technology, Wi-Fi and electricity may be limited, so functionality could be in question. Your client would need an MDI regimen, likely basal/bolus, to manage their diabetes without their pump.
Also, recommend they have a backup glucose monitor and test strips for instances when their CGM is not available — which may happen in an extended emergency. They may be able to purchase an over-the-counter monitor and testing supplies for minimal cost, as well as syringes. Pump users should be able to use their current insulin for bolus doses via MDI but would need a long-acting/basal insulin prescription or over-the-counter option to replace their pump basal rate.
4. Have a Diabetes Emergency Kit
Recommend your clients have a diabetes emergency plan in place. This plan should include a “diabetes emergency kit” stocked in their home and include the essentials needed to safely manage their diabetes if a natural disaster/emergency were to occur. You may find an excellent resource with the suggested contents of an emergency kit from the Diabetes Disaster Response Coalition (DDRC) at DiabetesEducator.org/Disaster.
At the end of the day, we want our clients to be as healthy as possible. Work with them to prepare and understand their risk. Check the CDC guidelines often as they continue to be updated. And most importantly, don’t forget to take care of yourself!
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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