Managing diabetes during natural disasters and emergencies

Natural disasters such as bushfires, floods, cyclones, and heatwaves are common in Australia and are expected to become more frequent and severe. These events can significantly disrupt diabetes management, making proactive planning essential for client safety and wellbeing. Credentialled Diabetes Educator, Carolien Koreneff, explains why being prepared is extra important for people with diabetes and gives some of her top tips for keeping your clients safe and healthy.

Why preparation matters

Emergencies can interrupt routines, limit access to medications, and increase stress—all of which affect blood glucose management. Research shows that glucose levels often rise after disasters, and people with diabetes who are on insulin face additional challenges. Recovery can take months or even years, so early planning is critical.

Encourage your clients to develop:

• A Diabetes Emergency Plan (similar to a sick-day plan)
• A Diabetes Emergency Kit with essential supplies (see below)

Key components of a diabetes emergency kit

Advise clients to include:

• Identification & documentation: Photo ID, medical history, medication schedule, sick-day plan, and completed disaster plan.
• Medications & devices: 14-day supply of medications (including insulin), injection devices, glucose monitor with ample in-date strips and lancets, continuous glucose monitoring (CGM) supplies, ketone strips, and spare batteries.
• Hypoglycaemia management: Glucose tablets, jelly beans, soft drink or juice poppers, glucagon (if prescribed), and non-perishable snacks, enough to treat multiple hypos.
• Pump users: Pump settings, 14-day supply of consumables, backup insulin and injection devices for injections, and spare batteries.
• Sharps disposal: Empty sharps container.
• Water to prevent dehydration when levels are high

Remind your clients to regularly review and update their kits to prevent infections and ensure readiness.

Top tips

Monitoring and medication guidance

• Encourage frequent blood glucose checks during emergencies.
• Remind clients about dehydration risks and the importance of water intake.
• Discuss ketone checking for those at risk of DKA.
• Remind clients to never share diabetes equipment. If this is unavoidable, they should disinfect equipment with bleach solution (1:10 ratio).

Medication storage tips

• Replace insulin that is exposed to extreme heat, freezing, or if left unrefrigerated for 28 days or more.
• Do not use medications contaminated by floodwater.
• Advise clients to seek telehealth with their local GP or diabetes health professional or call Health Direct (1800 022 222) if supplies run out.

Foot and eye care

Clients with diabetes are at higher risk of infections and delayed healing. Remember to educate your clients on:

• The importance of Daily foot checks and keeping feet dry to prevent trench foot.
• Eye protection from smoke, dust, and chemicals. If they develop pain, redness, or vision changes they should seek urgent care .

Mental health considerations

Disasters increase stress, which can elevate blood glucose levels and may lead to unhealthy coping behaviours. Screen for anxiety, depression, and PTSD, especially in high-risk groups (e.g., those with existing medical conditions or severe losses).

Encourage:

• Regular breaks and healthy sleep
• Balanced meals and hydration
• Social connection and emotional support
• Referral to mental health services (Lifeline, Beyond Blue, MensLine)