According to the American Diabetes Association there are 25.8 million people with diabetes and 79 million people with pre-diabetes; I am one of the 25.8 million. For a few different reasons, diabetes is also one the hardest diseases to prepare for in terms of a survival situation.

I have done plenty of research and I was able to find some good information, in bits and pieces, scattered across the web. I’ll try to put it all together, in hopes that I can help those with or those caring for someone with diabetes learn how to prepare for living with diabetes in a survival situation.

Disclaimer: I am not a doctor; all information provided is based off my own research and personal experience. I would advise you to use the information I give here as part of your research. Instead of covering what diabetes is, what insulin is or the different kinds of it, I am just going to cover the difficulties in term of preparedness.
 
 
Insulin

Insulin is the chief reason this disease is difficult to prepare for. Many of the modern delivery systems (pens) make it very handy, but also cause a very short shelf life. Because of this, building a supply of insulin can be difficult. Insulin also has to be kept in temperatures less then 86F and above freezing at 32F.
 
 
Shelf Life

Here is a Chart for Insulin Storage and Expiration. The top chart is for the insulin pens, some of which have a shelf life of as little as 7-10 days, with the longest going as far as 28-30 days. The bottom chart is for bottled insulin; the left column is the one that is most interesting to me. It points out that insulin that is refrigerated properly (not frozen) will last until the expiration date on the package, which is often 1-2 years after purchase.
 
 
Keeping It Cool

As I write this, the Midwest is going through a nasty heat wave, with temps in the low 100’s and a heat index of around 115 F. Right now we’re sitting in an air-conditioned room (praise God). If there were an extended loss of power, it could take as little as a few hours or as long as a few days for the insulin to reach temperatures that make is unsafe for use.

Here are a few ideas that I have come across through my online travels and a fantastic product that could very well be a game changer in terms of preparing for diabetes in a survival situation.

One option is to buy a small fridge that runs on propane and a few cylinders of propane. Another option I saw was to store it in the toilet tank, as that water is often cooler then the air around it (that’s why toilets sweat). If you have no other good option, as a last ditch plan you could dig a hole a few feet deep as the temperature should be within limits.

The option that I like the most is one I discovered recently, FRIO Insulin Cooling Wallet

“The principle is simple. To activate the wallet, immerse it in cold water for 5-15 minutes. Crystals contained in the panels of the wallet then expand into a gel, which remains cool for several days — relying on the process of evaporation for cooling. Just towel dry the outside and it’s ready to go! To use it again, put the FRIO® back in water — it can be reactivated over and over again”….” FRIO® wallets keep insulin safe for a minimum of 45 hours”

I don’t own one of these, mostly because I’m not insulin dependent, but I might be buying one as a gift.

New insulin requires no refrigeration
Everything I know about this I have learned from this article. If their claims hold true, this discovery is huge. Here are just the first two paragraphs.

“A young Monash University chemist and her colleagues have successfully strengthened insulin’s chemical structure without affecting its activity. Their new insulin won’t require refrigeration.

They have just filed a series of patents with the support of their long term commercial partner ASX-listed Circadian Technologies who are now negotiating with pharma companies to start the long process of getting the invention out of the laboratory and into the homes of people with diabetes.”
 
 
What Kind of Insulin?

When it comes to building up a supply of insulin, while convenient, the pens’ short shelf life throws them out. This leaves the vial. As stated above, vials of insulin that are not punctured can last one to two years. If preparing for insulin dependent diabetes is a big concern, you may want to talk to your doctor about switching to this type of insulin.
 
 
Purchasing Insulin

I came across a chart that shows state-by-state requirements on whether you need a prescription for insulin or syringes. I want to preface what I am about to say with this: I am not making a brand recommendation; I am just passing along something I read while researching this article. That being said, on one of the forums I saw, there was a user that mentioned they have found that Walmart sells a generic brand of Novalin called Relion. They claimed that Novalin is normally $45+ a bottle while Relion is only $24. I checked a few on-line sources and found this to be true.

This insulin should be rotated just like anything else. Start out slow and increase your store of it as your budget and fridge space allow. I think it would be a good idea to have at least a 90 day supply on hand, but seeing as the shelf life is a year or two, you could get a year supply and just keep rotating it.
 
 
Can Syringes Be Reused?

I think we all know that sharing a syringe is a dangerous thing to do, but can you reuse it yourself and, if so, for how long? Here is a six page article called “A Look at the Reuse of Insulin Needles”. Here is a study done on “Multiple Use of Disposable Insulin Syringe-Needle Units”. Here are some of the details:

“Fourteen insulin-dependent diabetics were asked to use their insulin syringe-needle units three times in succession to determine the efficacy and safety of this practice. The mean duration of time each patient participated in the study was 20.4 weeks, and a total of 2,000 injections were taken. No signs of infections at the injection site were observed. Multiple use of disposable insulin syringe-needle units appears to be safe and cost-beneficial.”

While researching, I also found instructions on how to sharpen used syringes. However, I can’t find the site now and doing a search directly brings up way too many drug related sites.
 
 
Non-Insulin Dependent Diabetics

Doctors have told me that if your parent has diabetes you have a 50% chance of getting it and if their parent has it, you have a 75% chance. That being the case, I have also heard two doctors say most type two diabetics do not need to be diabetics. There is a real chance that with life style changes the diabetes can be controlled with diet and exercise or even completely reversed. I kick myself for not making the lifestyle changes that I have had to make because of the diabetes sooner. I fall into the 25% that is genetically predisposed but I am really trying to reverse it with diet and exercise.

I have heard doctors say that the medications for type 2 diabetics only help a little, that the real help comes from, you guessed it, diet and exercise. The plus here is that storing up a large supply of type II diabetes meds isn’t nearly as important as storing insulin for our type 1 brothers and sisters. I recommend that you have a store of type II diabetes medication on hand. I have also read that Cinnamon as well as Apple Cider Vinegar can aid in keeping blood sugar levels low.
 
 
Another Useful Site

Bay Medical has an article on their site that has some good information. It is called “Caring for Diabetes During A Disaster”. Some of their food storage items they selected could be improved, but over all it’s good info. They also mention a glucose tablet or hard candy, I think this is a must for any diabetic. I carry the tablets as part of my EDC (Every Day Carry).

 
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Podcasts and Youtube and Blogs, oh my!

In the last article I covered what I believe to be the most important item in first aid; training. In this article I’ll cover Podcasts about first aid, survival medicine and other related topics

Disclaimer: I am not a doctor; all information provided is based off my own research and personal experience. I would advise you to use the information I give here as part of your research.

I have listened to a few different Podcasts where the host of the Podcast has interviewed a medical professional. Sometimes that professional has a Youtube channel or a blog as well. I’ll link the Podcast in case you would like to listen as well as cover some of the high points. I’ll also link their Youtube or other ways to connect with them. Some of these I listened to at a time when I could take better notes than others. I did not transcribe these interviews and they are not word-for-word, but they will be close to the speaker’s intent.

Matt Brasik Today’s Survival show- 135
Bob Mayne of “Today’s Survival Show” interviewed Matt Brasik of Midwest Disaster Medical. Matt covers ways to get Red Cross training as well as training from other places. He also recommends building a supply of the prescription medications you take every day

Matt lists some over-the-counter medications that belong in your first aid kit. I’ll cover some below. He also explains that Wal-Mart and Target both sell generic prescriptions for $4.00 for a 30-day supply and $10 for a 90-day supply. He goes on to say that many insurance companies will only let you get a minimum prescription but if your doctor writes out a paper prescription and you pay cash, the insurance company can be left out of the transaction.

Some of the OTC meds he recommends are stool softeners, pain relievers, Metamucil, Benadryl, Orajel and the one I thought was the most interesting was Primatine Mist. He said the active ingredient in both Primatine Mist and in an Epipen is epinephrine. In an Epipen there is.3mg of epinephrine delivered intra-muscularly and in Primatine Mist there is .22mg of epinephrine and id delivered via inhalation. He said he has never used this method, but that Primatine Mist could be used to treat anaphylactic shock; give a few puffs and then maybe some of the Benadryl. You can find out more about Matt at Midwest Disaster Medical.
 
 
The Survival Podcast Episode 565- Lessons from the Haitian Earthquake
In this episode of The Survival Podcast, Jack Spirko interviews Brandon Shelton. Immediately after the earthquake in Haiti, Brandon’s Pastor approached him about taking a few of his friends and going to Haiti to help in the relief effort. In this interview Brandon explains what it was like in the aftermath of the earthquake. He said that after the initial earthquake, the trauma wasn’t killing people, dirty water and diarrhea was. He explains that having Imodium and anti-nausea meds as well as a means to re-hydrate are very important. He also said that being well stocked on food didn’t matter when there were 30 tons of rubble on it. He said the only thing that would have been a big help in this situation was having a BOL (Bug Out Location).

Brandon and some of his friends created Bella Medical Ministries. They have made numerous trips to Haiti and have most recently aided in Joplin. If you feel so moved, you can support Bella Medical Ministries via their website.

 
The Survival Podcast Episode 584- The Patriot Nurse
In this episode of The Survival Podcast, Jack Spirko interviews the Patriot Nurse. In the interview she explains that the three leading killers worldwide are respiratory infections, diarrhea and measles. She explains that it is a good idea to have multiple ways to treat pain and explains that what works for one person might not work for the next. She said that if you can’t store anything else, store Mucinex or it’s generic form. This will help break up the mucus and make it easier to cough out. This in combination with what she calls “percussion therapy” physically pounding on someones back will also helps break up the mucus.

She explains that cough drops are important to store as they help sooth the throat. Bronchitis can occur If you have a cough and your throat becomes irritated, if left untreated. Another important item is a means to create re-hydration, table salt and water, even pedialyte, keeping children hydrated as they don’t have much fluid to lose. She also covers what health care might look like in a large-scale scenario such as a pandemic. Here is one of the videos from the Patriot Nurses Youtube Channel
 
 
The Survival Podcast Episode-685- Dr. Eric Wilke on Survival Medicine
If you only listen to one of the Podcasts I have mentioned, listen to this one. Dr. Wilke covers some of the ways in which to purify water, I cover the same subject in detail in The Storage, Filtration And Purification Of Water Dr Wilke explains that we don’t have the same diseases as third world countries because of our water and sewage treatment systems. He explains that one of the biggest killers in the third world is diarrhea. He explains how to treat viral and bacterial infections.

Fair warning; the next paragraph is a little gross.

In the USA, under normal circumstances, viral infections out-weigh bacterial infections, and antibiotics really aren’t going to help. You need to stay hydrated and wait it out. If the diarrhea is watery, there is no fever and no blood or mucus in the stool, then presume it’s a virus and treat with fluids. If there is blood or associated fever or mucus in the stool or white floating stool, which means your not digesting fat, this is a big tip off that it is Giardia or a bacterial infection. It may go away on it’s own, but antibiotics will help it go away faster and may help with some of the side effects.

He mentions that you will need to push fluids. You need to drink until you are urinating. Sometimes people will be very nauseous and will have to take a teaspoon at a time, almost constantly to stay hydrated.

Dr Wilke also talks about knowing how to clean wounds and how to stop bleeding. He mentions that duct tape can be used in a pinch. Some of the medicines Dr Wilke recommends are Imodium, a means to make re-hydration serums, and meds to ease pain. Jack and Dr Wilke also talk about some unconventional things in medicine, such as the healing properties of honey.

They also spoke about the shelf life of medications. Dr. Wilke talks about an article that was written by Laurie P. Cohen and published in the Wall Street Journal in 2000 called “The Shelf Life Extension program”. The Air force was forecasting spending billions on destroying and replacing medications. They asked the FDA to test the shelf life of medications to see if they could safely use them beyond their expiration date. Dr. Wilke explains that the original study cannot be found. He mentions the article from Laurie Cohen. I couldn’t find the original Wall Street Journal article, but I did find a copy of it that can be found in this article about the Shelf Life Extension Program. I’ll post some of the highlights.

“The testing, conducted by the U.S. Food and Drug Administration, ultimately covered more than 100 drugs, prescription and over-the-counter. The results, never before reported, show that about 90% of them were safe and effective far past their original expiration date, at least one for 15 years past it.

“Joel Davis, a former FDA expiration-date compliance chief, says that with a handful of exceptions – notably nitroglycerin, insulin and some liquid antibiotics – most drugs are probably as durable as those the agency has tested for the military. “Most drugs degrade very slowly,” he says. “In all likelihood, you can take a product you have at home and keep it for many years, especially if it’s in the refrigerator.””

There are many reasons drug companies don’t use the longer expiration dates, most of them have “$” on them. I never bought into the meds loosing all efficacy on or even remotely soon after their expiration date but I wouldn’t have guessed that many of them would have been as potent and effective many years after they were created.

So if the medications are still viable for some years later, what happens when they are no longer viable?

“Only one report known to the medical community linked an old drug to human toxicity. A 1963 Journal of the American Medical Association article said degraded tetracycline caused kidney damage. Even this study, though, has been challenged by other scientists. Mr. Flaherty says the Shelf Life program encountered no toxicity with tetracycline and typically found batches effective for more than two years beyond their expiration dates.”

So meds will last much longer then their expiration dates imply and if they do “go bad” they just lose efficacy? You’ll have to decide for your family, but unless it’s Tetracycline, I don’t think we’ll be throwing away meds just because of an expiration date.

Here is a video from Dr. Wilke’s Survival Medicine Course Youtube Channel.

You can stay connected with Dr. Wilke on the Survival Medicine Blog and at the Survival Medicine Course Youtube Channel

 
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First Aid, CPR and AED training are great to have. This training can prolong life until medical professionals arrive. If there is a hunting accident or a rolled ankle while hiking or on a larger scale, an event like a hurricane or even worse, the training and supplies that you have might be the only aid available.

Disclaimer: I am not a doctor. All information provided is based on my own research and personal experience. I would advise you to use the information I give here as part of your research.
 
Guided First Aid and CPR/AED Training

There are a variety of places to get hands on first aid training. My church offers a first responder course covering first aid and CPR as well as AED, which is where my wife and I got certified. You may have taken a course of this kind in the past but procedures change quickly. As an example, between the time we were certified and the writing of this article, the time span of a little over a year, breaths are no longer given in CPR, only compressions. That’s a pretty big change! The thought is that the compressions alone force enough oxygen into the system. My point is that a refresher course is a good idea, as techniques are always evolving, on top of the fact that certification requires it.
 
The American Red Cross

The American Red Cross offers a large selection of training classes, from baby-sitting, first aid/CPR/AED to wilderness first aid. They offer hands on training as well as some web based.
 
The Emergency Care and Safety Institute

The Emergency Care and Safety Institute offers a wide selection of classes as well, at a glance it looks like they may have more in the way of online training.

A note about both the American Red Cross and the Emergency Care and Safety Institute; they both base their wilderness first aid training on the Boy Scouts of America Wilderness First Aid Curriculum.

I know that there are many types of more advanced medical, wilderness first aid, first responder types of classes available nationwide. I won’t recommend any, as I haven’t taken one. If you have taken a class please feel free to mention it or link to it in the comments.
 
Independent Training

Here are some resources I have found over the years that will provide some independent training:

American Heart Association

The AMA offers a product called CPR Anytime, for $34.95 you can order a Mini Anne® and training DVD. I’m not sure if you can become certified with this method but the knowledge is the important thing. They also call their training DVD “Family & Friends CPR Anytime DVD” so I assume they won’t mind if you lend it to others to get the training.
 
Hesperian Foundation

Here is some of what they say about their organization on their website::
“Hesperian is a non-profit publisher of books and newsletters for community-based health care. Our first book, Where There Is No Doctor, is considered to be one of the most accessible and widely used community health books in the world. Simply written and heavily illustrated, Hesperian books are designed so that people with little formal education can understand, apply and share health information.” Off grid solutions when there is no doctor – Episode 016 has an interview with Mr. David Werner, he tells of the history of “Where There Is No Doctor”.

The Download section of their website has some free documents in PDF format. I have links to the following titles: Where There Is No Doctor, Where There Is No Dentist, A Community Guide to Environmental Health, Where Women Have No Doctor, A Book for Midwives.

While the digital format is good, I personally own at least 3 of the books. There are times when having the actual book might be much more desirable than the digital copy. If you know of any missionaries in third world countries, this book might be an excellent gift.

Mayo Clinic
The Mayo Clinic has an excellent first aid section on their website.
 
Pets

I have come across two pet CPR and First Aid programs;

BART (Basic Animal Rescue Training)
“Veterinary Professionals empowering Fire Fighters and First Responders.” Their mission statement says “BART’s mission is to empower firefighters and other emergency personnel with the training, knowledge and equipment necessary to safely and effectively address the needs of animals encountered in emergency situations,”

Pet Tech
CPR, First Aid & Care For Your Pets. Pet Tech teaches an eight-hour pet first aid class. You can browse the variety of topics covered as well as find a trainer near you on their site.

 
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