Diabetes care: After the Great East Japan Earthquake

Abstract

PREFACEThe Great East Japan Earthquake and subsequent tsunami destroyed large parts of Japan's Tohoku district. Special efforts were made regarding the prompt distribution of medical supplies, including insulin, for diabetic patients. However, many diabetic patients in the shelters lost their blood glucose control as a result of the unfavorable living environment. The high-calorie food provided led to severe postprandial hyperglycemia. Furthermore, mental stress can aggravate diabetic control and these patients require special mental care. We have a few suggestions to propose in preparation for future disasters based on the experience gained from our shelter visits during this disaster. First, people in the affected areas had no way of accessing such information in the early days after the disaster. Therefore, we should consider the practical means of distributing important information in various situations. Second, guidelines and manuals for both diabetic patients and healthcare providers need to be created for the various situations that occur in the event of a natural disaster. We already have a few, but situations vary and several guidelines are required to cover different conditions. Manuals for the prescription of antidiabetic agents will be useful, especially for doctors who are not specialized in diabetes. Third, patients should be educated beforehand as to what to do and what to be prepared for in the case of a disaster; each of the various situations that might be encountered should be covered. Lectures about these issues might be included in educational classes for diabetic patients organized by each medical institution. (J Diabetes Invest, doi: 10.1111/jdi.12025, 2013

Emergency and disaster preparedness for chronically ill patients: a review of recommendations

“…Although the ADA statement encourages the teaching of self-management skills, 14 Kishimoto and Noda 6 emphasized the importance of educating patients as well as local medical staff who do not specialize in diabetes, as it is not easy for patients to adjust their medications without assistance.…”

“…For the management of patients with diabetes during and after a disaster, Kishimoto and Noda 6 , 19 provided practical recommendations for different types of diabetes from their experience during the GEJE. As insulin injections are indispensable for the survival of patients with type 1 diabetes and some patients with type 2 or other types of diabetes, dissemination of information about how such patients could obtain insulin injections is critical.…”

“…As insulin injections are indispensable for the survival of patients with type 1 diabetes and some patients with type 2 or other types of diabetes, dissemination of information about how such patients could obtain insulin injections is critical. 6 The discontinuation of insulin injections can lead to serious consequences in patients with type 1 diabetes; therefore, such patients should keep extra insulin and injection kits in multiple places, such as at home, at the office, and at school, in preparation for a sudden-onset disaster. 6 For patients with type 2 diabetes who are using insulin, the pathophysiological conditions of the patients can be diverse and require individualized care, including mental health care.…”

Noncommunicable Diseases After the Great East Japan Earthquake: Systematic Review, 2011–2016

“…Six articles describing preexisting metabolic diseases were identified. [32][33][34][35][36][37] The results of comparison between preearthquake and post-earthquake metabolic indexes, such as blood glucose levels and BMI and blood pressure, differed among the studies. [32][33][34][35] However, most people with diabetes faced difficulties related to glycemic control because of inappropriate diet, less daily motion, difficulty of access to health care, and mental stress.…”

“…[32][33][34][35] However, most people with diabetes faced difficulties related to glycemic control because of inappropriate diet, less daily motion, difficulty of access to health care, and mental stress. [33][34][35][36][37] Medical teams were unable to obtain the information about what treatments the patients had received before the disaster because many had lost their medicine, medication records, and insulin kits. 37 Moreover, that lack of information made glycemic control more difficult.…”