Diabetics put at risk amid hurricane exodus

Like many other diabetics fleeing Hurricane Katrina, Mike Carubba came close to running out of drugs until an informal volunteer group in Baton Rouge, La., replenished his insulin supply.

Drugstores and government shelters didn't have much on hand, he said, a common complaint among evacuees with the metabolic disease who say government officials did not adequately prepare for their care.

''I feel like it was on the back burner, which isn't good for a lot of people if they didn't get their insulin and went into a diabetic coma," said Carubba, a retired Loyola University dean, who spoke last week by telephone from a Holiday Inn in Baker, La.

Tales like Carubba's have been common since the Gulf Coast was struck by two hurricanes.The American Diabetes Association estimates 205,000 people with diabetes were forced to evacuate their homes because of Katrina and Rita. It is one of the most common medical conditions among displaced Gulf Coast residents. Hospitals and medical-supply companies have been scrambling to get drugs and parapher-nalia to patients, some of whom are now scattered throughout the country.

Steven Smith, a Louisiana State University endocrinologist, ran an impromptu warehouse and distribution center for diabetes supplies from his research building's gym in Baton Rouge.

''The system was really overwhelmed," he said.

Diabetes is a disorder of the body's ability to make or use insulin, the hormone produced by the pancreas to convert food into energy. It can be brought on by an unhealthy diet, lack of exercise, or genetics. Health officials say an increasingly obese US population is driving up diabetes rates.

If untreated, the disease can lead to circulation problems, comas, or even death. It causes blood-sugar levels to deviate, which can damage blood vessels and cause other complications.

To keep blood-sugar levels stable, patients use artificial insulin supplied in vials or pen-like injection devices. They also need syringes, needles, and alcohol to clean their skin. Some must test their glucose levels several times a day, which involves drawing a finger prick of blood with a lancet.

Making sure diabetics had access to medical supplies was a top concern of the US Food and Drug Administration in response to the hurricanes, officials said. The agency still maintains a Web page with instructions for people who couldn't refrigerate their medicines or were forced to use a different brand of insulin.

The impromptu arrangements were unusual for the FDA, an agency steeped in procedure. Agency officials and many volunteers regard the effort to aid diabetics as a success story, and the American Diabetes Association says it does not know of any deaths associated with drug or supply shortages.

But at the same time, the experiences of recent weeks are causing emergency planners to rethink what sort of medical care is needed for mass evacuations of populations that are heavier than ever and more prone to diabetes.

In 2003, 11 percent of Mississippi residents had been diagnosed with diabetes, according to the National Center for Chronic Disease Prevention's most recent statistics, compared with 7.2 percent nationally. The rate was 8.5 percent in Louisiana and 8.1 percent in Texas, according to the federal agency.

The figures had already made diabetes a central focus of experiments at the Pennington Biomedical Research Center in Baton Rouge before the recent disasters struck. After the hurricanes, scientists at the center abandoned their research tasks to focus on helping diabetic evacuees and to coordinate offers of assistance from the center's commercial contacts.

For instance, a supplier of diabetes therapeutics, Amylin Pharmaceuticals Inc., sent the institution $50,000 after contacting Pennington researcher Eric Ravussin, a member of the company's scientific advisory board.

Novo Nordisk Inc., a large insulin supplier, said it has sent $4 million worth of products to 118 clinics and shelters across the three states, including a form of injectable insulin that doesn't require refrigeration. Bayer Corp. donated hundreds of blood-glucose monitors. Abbott Laboratories, Medtronic Inc., and Eli Lilly and Co., also have donated products to the center and others.

At the Pennington center, volunteers have used the donations to assemble about 5,000 kits with 30-day insulin supplies. Many were sent to Texas following Hurricane Rita evacuations.

In Ocean Springs, Miss., nurse K.C. Arnold said she knew of several patients hospitalized with diabetes-related problems after Katrina, and of supply shortages at a medical clinic where about 20 percent of the patients were diabetic.

Another one of Arnold's patients, John Burdine, said he had a harrowing experience when floodwaters swept through his home in Diberville, Miss., near Biloxi. He stashed his infusion pump and insulin vials on top of a tall kitchen cabinet to keep them out of the foul water, then swam and climbed to his roof. For 30 minutes he watched cars, trees, and buildings bobbing past.

''I saw stuff flying, I saw stuff floating, it was unreal," he said. When the waters receded a short time later, Burdine returned to his house and waded through the muck. He found his diabetes kit, dry and intact.

''I knew I could swim; my concern was that I could get back to my supplies," Burdine said.

Ross Kerber can be reached at kerber@globe.com.