Caring for diabetes patients over months with no power

Diabetes is a serious condition in Puerto Rico and after Hurricane María concern for those living with the condition peaked.

In addition to widespread devastation, Hurricane María left communities with no power for months on end after it pummeled the island on September 20th of 2017. Lack of power endangered insulin dependent diabetes patients who must maintain their medication refrigerated. Two non-profit organizations joined resources to serve this critical population in the immediate aftermath and over the course of the many months of disaster management. Along the way, they kept connecting with other groups to provide critical supplies and education to patients living with diabetes throughout Puerto Rico, particularly in the more isolated mountain towns.

In the first days after María, when there was little or no connectivity, no power and a curfew, those at the Puerto Rican Association of Diabetes, an organization with 30 years of history, and the Pediatric Diabetes Foundation, founded in 2000, called on partners and donors for insulin donations.  People with diabetes are found in high numbers in Puerto Rico. Sixteen out of a 100 people are diagnosed with the contidion and it is the third cause of death on the island, according to Department of Health statistics.

Meanwhile, the president of the Board of the Puerto Rican Diabetes Association, Dr. Luis A. Pérez, an epidemiologist, created a protocol to provide relief to this population.  As insulin donations arrived, both organizations, the Association and the Foundation, worked together to coordinate donation to patients around the island. Patients also flocked to the offices of both organizations to obtain insulin donations.  Insulin was also distributed to doctors who collaborated in missions and to other organizations participating in the relief effort, recalled Mariana Benítez, executive director of the Pediatric Diabetes Foundation. She recalled that Dr. Pérez himself and other volunteers would use their cars to distribute the life-saving medication in the most isolated communities in Puerto Rico’s central mountainous region, at a time where roads were blocked, unsafe and no communication existed in the area.

“We wanted to make sure that those with diabetes could control their emotions” amid all the destruction, said Brenda Padilla, executive director of the Puerto Rican Diabetes Association. A person with diabetes who is not able to manage emotions can suffer spikes in blood sugar levels. 

Education was also important. Most people did not know that insulin can be kept out of the refrigerator for 28 days if left in a cool place and is not exposed to light.  In the absence of power and the initial scarcity of food, particularly fresh food, nutritional information became key to maintaining the condition under control.

Aside from distributing insulin and providing nutritional education, Brenda said the Association also recommended that patients with diabetes wear socks to keep their feet and shoes dry.  Since they may lose sensation in their extremities, it is important to protect their feet from cuts that can lead to infections that are difficult to control due to the condition.

The Foundation has 3 locations around the island to provide families with services, its main office in front of the San Jorge’s Children’s Hospital in Santurce, San Lucas Hospital in Ponce, and Third Presbyterian Church in Aguadilla.  A fourth location in Humacao will be reestablished on October 2018, since it was damaged due to the Hurricane. 

In addition, the Foundation has an alliance with 13 hospitals in Puerto Rico and when they diagnose a child or teenager with diabetes the Foundation sends a kit with supplies to their room, essential in order for them to be discharged from the hospital.  Among the many services provided by the Foundation, is teaching children with diabetes to inject themselves with insulin and instruct them, their families and school personnel on proper nutrition and management of the condition and provide psychological therapy.

Yet, Mariana was particularly concerned for children diagnosed with Type 1 Diabetes during the aftermath of the Hurricane.  Often symptoms of Type I diabetes in children could be mistaken for those of a flu or virus.  Mariana explained a tell-tale sign is that children with Type I diabetes are often very thin because they have lost weight for no apparent reason, tend to urinate with frequency and complain of constant thirst.

“Every year there are about 200 new cases of diabetes Type I among children in Puerto Rico referred to us”, she said. During this period, the Foundation made sure to be in contact with hospitals to continue with the program for newly diagnosed pediatric patients.  Diabetes kits were sent to hospitals.

As the needs of this population mounted, both organizations turned to United for Puerto Rico for relief and recovery funds. The Pediatric Foundation received $103,149 to provide supplies and medication to children and youth with Type I diabetes.  Whereas, the Puerto Rican Diabetes Association received $95,000 in funds to purchase insulin and Frio Insulin Coolers.  Jointly they were able to distribute thousands of insulin vials and more than 2,000 Frio Coolers to keep the insulin cool in an emergency.

Moreover, they have prepared a disaster protocol, strengthened alliances throughout Puerto Rico to be better prepared for a future emergency.  They have built-up insulin supplies that are safely stored, as well as continue with their educational drives so that patients are better equipped to deal with a future emergency.  For more information on the work carried out by these organizations, please visit http://diabetespr.org/ and http://www.fundacionpediatricadiabetes.org/.

icrossingAdminCaring for diabetes patients over months with no power