Medical Preparedness · Chronic Conditions
Diabetes care that holds when systems pause.
Diabetes is a daily routine that depends on a supply chain, a refrigerator, and a pharmacy. When a storm or an outage interrupts any of those, the care does not have to falter. This page is the planning that keeps insulin viable, supplies on hand, and the right information moving with you, arranged calmly, before anything is forecast.
Planning guidance, not medical advice. Work with your doctor, pharmacist, and diabetes care team on your specific medications, devices, and routine.
Planning guidance, not medical advice
This page helps you plan for diabetes continuity during disruptions. It does not provide dosing guidance, sick-day rules, treatment recommendations, or instructions for using any medication or device. Consult your doctor, pharmacist, and diabetes care team about your specific insulin, oral medications, devices, and emergency plan before making any changes to your routine.
What this page covers
The four things a disruption puts between you and steady care.
Managing diabetes well is not fragile. What is exposed during an emergency is the ordinary infrastructure the routine rides on: the pharmacy that refills the prescription, the electricity that keeps insulin cold and powers a pump or monitor, the refrigeration that keeps insulin viable, and the food supply that a diabetic diet depends on. The same storm that knocks out power for everyone puts each of those under pressure at once.
This page is planning you do in advance, at a kitchen table on an ordinary afternoon, not decisions made in the twenty minutes before an evacuation. It covers the supply buffer, insulin storage when the power is out, the documents and identification that travel with you, and who to call when supplies run short. None of it requires medical knowledge to carry out.
What this page does not cover
The general prescription framework (refill buffer, emergency dispensing laws) → Prescription Preparedness
Backup power for a pump, CGM, or refrigerator → Medical Devices and Power
Building a diabetic-appropriate emergency food supply → Food self-reliance
Insulin dosing, sick-day management, blood sugar targets, or symptom guidance, which all belong with your care team
Why the planning is worth it
The value of preparing is not a worst-case story. It is a measured one. After Hurricane Katrina, researchers followed nearly 1,800 adults with diabetes across three health systems, comparing their blood sugar control in the six months before the storm with their first measurement afterward.1
In the group that lost reliable access to its care system, average A1C, the standard measure of longer-term blood sugar control, rose meaningfully over the following months. In the groups that kept access, it held roughly steady. The difference between them was not willpower or the severity of the storm. It was continuity of care.1
That is the whole case for this page in one sentence: the thing worth protecting is access, and access is something you can arrange in advance. Everything below is a way to keep the line to your medications, your supplies, and your care team open when the ordinary paths are interrupted.
Preparation here is quiet and cumulative. A conversation with your pharmacist, a kit assembled once and rotated, a folder that already exists. None of it has to happen under pressure.
1 Fonseca VA, Smith H, Kuhadiya N, et al. "Impact of a Natural Disaster on Diabetes: Exacerbation of Disparities and Long-Term Consequences." Diabetes Care. 2009;32(9):1632-1638. Observational study of 1,795 adults with a pre-storm and post-storm A1C measurement across private, public, and Veterans Affairs health systems in New Orleans. Available via PubMed Central (PMC2732170).
Assemble it once, rotate it
The diabetes kit. A week of supplies you can pick up and carry.
The American Diabetes Association suggests keeping at least a week of diabetes supplies on hand, and building toward two weeks where your prescriptions and budget allow.2 Store them together in a waterproof, easy-to-carry container so that in an evacuation the kit is one item to grab, not a scavenger hunt across the house.3 What belongs in yours depends on how you manage your diabetes; the list below is the common starting point.
Medications and insulin
Monitoring and devices
A pump or CGM that depends on charging is a power question during an outage. See Medical Devices and Power for backup power sizing, and Energy self-reliance for portable power and charging.
Documents and identification
Food, water, and the low-blood-sugar plan
Standard emergency food leans heavy on salt and simple carbohydrates. Building a supply that fits a diabetic diet is its own task. See Medical Diets During Emergencies and Food self-reliance.
2 American Diabetes Association. "Tips for Emergency Preparedness." diabetes.org/tools-resources/disaster-relief. 3 Diabetes Disaster Response Coalition. "Diabetes Preparedness Plan." diabetesdisasterresponse.org. 4 Centers for Disease Control and Prevention. "New Beginnings: Emergency Preparedness" and "Managing Insulin in an Emergency." cdc.gov/diabetes. 5 DDRC Patient Preparedness Plan, adapted from the AACE "My Diabetes Emergency Plan." Accessed September 4, 2026.
When the refrigerator stops
Insulin in the heat, the cold, and the outage.
Insulin is the part of diabetes care most sensitive to a power failure, so it is worth knowing exactly what the manufacturers and the FDA say about temperature. These are storage facts, published so that patients and clinicians can plan. They are not a license to change how you use insulin, which stays a conversation with your pharmacist and prescriber.
Refrigerated is the default
Insulin is normally stored in a refrigerator at roughly 36 to 46 degrees Fahrenheit. Unopened and kept this way, it holds its potency until the expiration date on the package.6
That is why a power outage is a diabetes question, not only an inconvenience. Planning backup power or cold storage for the refrigerator, or a cooler and ice, keeps the default in place during a short outage.
The full protocol for temperature-sensitive medication during an extended outage is in Refrigerated Medications.
The room-temperature window
The FDA notes that insulin in vials or cartridges from the manufacturer, opened or unopened, may be left unrefrigerated between 59 and 86 degrees Fahrenheit for up to 28 days and continue to work.6
Insulin that has been diluted, or removed from the manufacturer's original vial, should be discarded within two weeks.6
Knowing this window is what turns a lost refrigerator from an emergency into a manageable stretch, as long as you can keep the insulin inside that range.
Heat, freezing, and sunlight
Insulin loses effectiveness at extreme temperatures, and the longer the exposure, the less effective it becomes.6 Keep it as cool as possible, out of direct heat and out of direct sunlight.6,7
Insulin that has frozen should not be used, because freezing breaks it down. If you are using ice to keep insulin cool, keep the insulin from freezing against it.6,7
Once proper refrigeration is available again, vials that were exposed to extreme heat should be discarded and replaced.6
If you have to use insulin that got too warm
Under emergency conditions you may still need to use insulin that was stored above 86 degrees. If so, the CDC advises monitoring your blood sugar and letting shelter staff know if it runs high or low, then contacting your doctor once the emergency is over.7 Questions about whether a specific insulin is still suitable belong with your pharmacist or the manufacturer, not with a general rule.
A note on switching insulin products. In a disaster, the insulin available may differ from your usual product. Whether one insulin can substitute for another, and how, is a clinical decision that the FDA has published guidance on for pharmacists and prescribers to use. It is not something to work out on your own from a web page. Keep your pharmacist's and prescriber's numbers in your kit, and use the emergency contacts below to reach diabetes-specific help if you run short.
6 U.S. Food and Drug Administration. "Information Regarding Insulin Storage and Switching Between Products in an Emergency." fda.gov/drugs/emergency-preparedness-drugs. Accessed September 4, 2026. Storage figures reflect the product labels of U.S. insulin manufacturers as summarized by the FDA. 7 Centers for Disease Control and Prevention. "Managing Insulin in an Emergency." cdc.gov/diabetes/articles/managing-insulin-in-emergency.html. Accessed September 4, 2026.
The information that has to move with you
Documents, identification, and the people who should know.
In an evacuation or a shelter, the people helping you have never met you. What lets them help quickly is a small set of written facts and a way to signal that you have diabetes. None of it is clinical. All of it can be prepared in an afternoon.
The written summary
Ask your care team for a written summary of your current diabetes regimen. Keep it with your medication list, your pharmacy, your most recent A1C result, and your allergies, all in a sealed waterproof bag.4,5
The CDC suggests keeping this kind of list, and if you use an insulin pump, writing down its manufacturer and model number in case you need a replacement.4
Medical identification
Wear a medical identification bracelet or carry a card in your wallet that says you have diabetes.2,4 If you are away from home, let colleagues, friends, or travel companions know, and tell them where your emergency supplies are kept.2
In a shelter, tell the staff in charge that you manage diabetes so they can help if your blood sugar runs high or low.7
If a child has diabetes
Keep a copy of the physician's orders that are on file with your child's school or daycare in your kit.2 Confirm which staff members would assist your child during an evacuation, so the plan is not being made for the first time under pressure.2
Broader planning for children is in Children's Medical Preparedness.
This folder is part of something larger
Your diabetes documents belong inside your household's grab-and-go medical records. Build the whole set once and the diabetes page of it takes minutes. See Build a Household Medical Profile and Emergency Medical Documents.
Common questions
The questions people actually ask.
How much diabetes supply should I keep on hand?
The American Diabetes Association suggests at least a week of supplies, building toward two weeks where your prescriptions and budget allow, then rotating them so nothing expires.2 What that includes depends on your care plan, and can span insulin and delivery supplies, oral medications, test strips, lancets, a meter with spare batteries, and a quick-acting source of glucose. Your diabetes care team can help you set the right buffer.
Can I use insulin that was not refrigerated during an outage?
FDA guidance says insulin in vials or cartridges from the manufacturer, opened or unopened, can be kept between 59 and 86 degrees Fahrenheit for up to 28 days and still work.6 Keep it cool but never frozen, and out of heat and sunlight. Insulin that has been diluted or moved out of its original vial should be discarded within two weeks, and heat-exposed vials should be replaced once refrigeration returns.6 If you must use insulin stored above 86 degrees, the CDC advises monitoring your blood sugar and contacting your doctor afterward.7 For your specific formulation, ask your pharmacist.
What belongs in a diabetes go-kit?
A waterproof, easy-to-carry container holding your medications and insulin, delivery supplies, a meter with spare batteries, test strips and lancets, a quick-acting source of glucose, a glucagon kit if prescribed, any pump or CGM supplies, your written care summary, and your documents.2,3 The full breakdown is in the diabetes kit section above.
What documents should travel with me?
A written summary of your current regimen from your care team, your medication and pharmacy list, your most recent A1C, the make, model, and serial number of any insulin pump, your allergies, and your emergency contacts, kept in a sealed waterproof bag.4,5 Wear or carry medical identification so responders know you have diabetes.2,4
Where can I get insulin if I run out during a disaster?
Call 1-800-DIABETES (1-800-342-2383), the American Diabetes Association help line, and see the Diabetes Disaster Response Coalition, which coordinates emergency insulin and supplies during declared disasters.3 Your pharmacist may also provide an emergency supply under your state's emergency dispensing law; the general framework is in Prescription Preparedness. Arranging these contacts before a disaster removes phone calls from an already hard day.
Who to contact
Related guides
Refrigerated Medications
The full outage protocol for insulin and other temperature-sensitive medications.
Medical Devices and Power
Backup power for an insulin pump, CGM, or the refrigerator that holds your insulin.
Prescription Preparedness
The refill buffer, generic names, and emergency dispensing laws that apply to every prescription.
Medical Diets in Emergencies
Building an emergency food supply that fits a diabetic diet, not against it.
"Dig the well before you are thirsty."
Traditional proverb
Go deeper