Evaluating emergency preparedness and impact of a hurricane sandy in pediatric patients with diabetes

Rubina Heptulla; Rebecca Hashim; Doreen Newell Johnson; Jeniece Trast Ilkowitz; Gina DiNapoli; Venkat Renukuntla; Jennifer Sivitz

doi:10.1186/s40696-016-0012-9

Evaluating emergency preparedness and impact of a hurricane sandy in pediatric patients with diabetes

Disaster Mil Med. 2016 Feb 3:2:2. doi: 10.1186/s40696-016-0012-9. eCollection 2016.

Authors

Rubina Heptulla¹, Rebecca Hashim², Doreen Newell Johnson³, Jeniece Trast Ilkowitz³, Gina DiNapoli³, Venkat Renukuntla⁴, Jennifer Sivitz⁵

Affiliations

¹ Pediatric Endocrinology and Diabetes, Children's Hospital at Montefiore and Albert Einstein College of Medicine, 3411 Wayne Ave, Suite: 4 M, Bronx, NY 10467 USA.
² Department of Psychiatry and Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA.
³ Pediatric Endocrinology and Diabetes, Children's Hospital at Montefiore, Bronx, NY USA.
⁴ Pediatric Endocrinology and Diabetes, Albert Einstein College of Medicine, Bronx, NY USA.
⁵ Pediatric Endocrinology and Diabetes, Hackensack University Medical Center, Hackensack, NJ USA.

Abstract

Background: Natural disasters have always been associated with significant adverse events including medical and mental health problems. Children with chronic disease such has diabetes have also been believed to be affected to a greater extent by any natural disaster. The purpose of this study was to assess and compare emergency preparedness post-disaster and post-traumatic stress effects of Hurricane Sandy in affected and relatively unaffected populations.

Methods: The study was conducted between February and July 2013. A total of 142 families caring for children with Type 1 Diabetes Mellitus (T1DM) who attended clinics were recruited from hospitals in Bronx, NY (control) and in NJ (affected) by Hurricane Sandy. Subjects were recruited to participate in a survey 3-6 months after the hurricane. Data on demographics, glycemic control and insulin regimens were collected. Families were surveyed for socio-economic status (SES), using Hollingshead questionnaire, general and diabetes preparedness and the Hurricane Related Traumatic Experiences (HURTE) questionnaire was used to evaluate for symptoms of post-traumatic stress.

Results: Ninety-five percent of families reported to be generally well to moderately prepared for the hurricane and 83 % reported to be very well prepared with regards to their child's diabetes during the disaster. There was no difference between the sites for preparedness for the disaster, age or gender. There was a trend toward significance (p < 0.06) in New Jersey subjects as to a greater psychological impact from the hurricane. Poor glycemic control was significantly associated with lower SES (p < 0.008). Most importantly, SES was unrelated to preparedness for diabetes management during the hurricane.

Conclusions: Despite low SES, families were generally well to moderately prepared for hurricane. In children with diabetes, interventional studies should be designed and implemented so that glycemic control remains unaffected, following any major disaster.

Keywords: Diabetes; Disaster; Hurricane; Pediatrics; Preparedness.