ODP162 Assessing Emergency Preparedness in Patients with Type 1 Diabetes at a Single Academic Institution During the COVID-19 Pandemic
Authors: Babey Muriel , Hsiao Victoria , Masharani Umesh , Shey Susan , Mehta Paras , Koh Eileen 
Published: November 2022

Abstract

Background
After natural disasters, patients with diabetes (DM) have been shown to have increases in hemoglobin A1c levels and emergency room visits for hypoglycemic and hyperglycemic emergencies. Early in the COVID-19 pandemic, DM medication refills decreased and patients indicated challenges with accessing outpatient insulin and supplies. In response, the Diabetes Disaster Response Coalition recommended that patients have a DM emergency preparedness plan in place. In our type 1 diabetes (T1D) clinic, no standardized protocol existed to determine whether patients had an emergency plan. We created a voluntary 3-question survey for patients to complete which would prompt providers to address medication deficiencies and provide education on what to do in setting of pump failure.

Objectives
Implementation of a standardized survey to assess DM emergency preparedness during clinic visits will reveal and address medication and patient knowledge gaps. At least 50% of patients seen in the T1D clinic will complete the survey during the intervention period Methods: We designed our intervention with consideration for clinic workflow and provider and patient ease of use. The pilot intervention period was from November 2020 to May 2021. Data was collected on survey completion and measures performed by the clinician to address medication and pump knowledge deficiencies. Our intervention steps are outlined below: Prior to the visit, patients received a secure message with a 3-question survey asking whether they had an emergency kit, 2 weeks of medications and supplies, and for patients on an insulin pump, whether they felt comfortable transitioning from pump to basal-bolus regimen. Clinicians were notified of which patients were eligible to complete the survey. During the visit, clinicians reviewed completed surveys, prescribed medications and supplies, and educated patients on approaching pump failure if applicable. Patients were provided a handout with an emergency supply checklist and insulin storage tips.

Results
Over the intervention period, 212 patients received the survey. Of these, 129 (60.8%) completed and discussed survey answers with their endocrinologist. 54.3% of these patients did not have an emergency kit and 48.8% did not have at least 2 weeks of supplies. Additionally, 43.4% were prescribed medications and diabetes equipment during the clinic visit, the most common being basal insulin and glucagon. Of the 79 patients using an insulin pump, 44.3% did not know how to independently transition to a basal-bolus regimen and were provided education during the visit.

Conclusions
Our intervention assessed and addressed important gaps in emergency preparedness in our patients with T1D. Over half of participants did not have an emergency kit, and many needed additional prescriptions and education on approaching DM emergency situations. Similar interventions should be pursued for all patients with DM to prevent psychological stress, morbidity, and mortality during future natural disasters.
Presentation: No date and time listed