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What is the Link Between Diabetes and a Changing Climate?

Staff evacuates hospital as fire pushes closer

Like many of you, I have a personal relationship with climate change.

On a blustery day in November 2018, the Camp Fire burned down the hospital and the entire town where I provided diabetes care for over 20 years. In a matter of a short six hours, over 30,000 people who lived in Paradise lost their community and sense of place.

I lost working with my incredible diabetes team and my extended diabetes family. Others lost everything. The Camp Fire has devastated us all in very personal ways. It is considered the deadliest and most destructive wildfire in California history.

Since the town of Paradise was a popular retirement destination, many of those who survived the fiery drive down the hill were frail and elderly. More than 3,000 of them had diabetes and many fled their homes without their meters, insulin, or other critical medications.

With the help of the Red Cross and hundreds of volunteers, we were able to connect most people with needed medications and supplies, but many went without. People with diabetes lost connections to their providers, pharmacies and support systems.

We lost 85 of our beautiful community members due to the fire and thousands of our neighbors dispersed to other states and towns to start their lives over. Over half of our providers moved away and a hospital that provided care to a rural community was suddenly gone. This extreme loss and upheaval reveals the painful truth that we need proactively take action to reduce the frequency and severity of climate disasters and be prepared for future events.

How is climate change impacting diabetes risk?

According to a 2020 article published in the Journal of Community Hospital Internal Medicine Perspectives, climate change, and in particular, increasing global temperatures, is expected to impact the health of people living with diabetes and lead to worse outcomes.

After completing a literature review, the authors concluded that diabetes and climate change are interconnected. Let’s explore how.

Hotter Temperatures Worsen Diabetes Outcomes

People with diabetes are at greater risk of experiencing dehydration and cardiovascular events during periods of extreme heat. With the increasing frequency of extreme heat episodes, there is an associated increased risk of heat-related death and cardiovascular events for people living with diabetes. Several studies reveal that people with diabetes have a higher risk of death on hot days, and are more likely to need emergency care and those with a history of heart disease are most vulnerable.

Shortage of Medical Supplies and Medications

Recent climate disasters, like the Camp Fire, Hurricane Katrina in 2005, and Hurricane Harvey in 2017, resulted in people not being able to access, afford or safely store their medications, including insulin. In addition, we are experiencing supply chain disruptions in D50 (25 grams of glucose in a 50 ml prefilled syringe (50% glucose)) to treat hypoglycemia and certain intravenous fluids are in short supply.

Food Supply Shortages

Extreme weather can result in agricultural production disruptions. In our community, many fields that were once green with trees and crops, now are brown and barren. There is not enough water to keep crops alive and growing. This also means job loss and less money flowing into communities. When the healthy food supply is limited, people living with diabetes may turn to lower-cost, processed foods which are environmentally unfriendly and low in nutrients.

Diabetes and climate change are clearly interconnected. Extreme weather events and rising temperatures will significantly impact people living with diabetes, especially those with cardiovascular disease. The disruption in the supply of life-saving medications (e.g. insulin) due to extreme weather combined with decreased access to healthy foods are difficult issues that require problem-solving by individuals, communities, and government leaders.

We are expecting more intense weather-related events in the future and the question is what can WE do?

As Diabetes Specialists, I believe we can make a difference by leaning into our unique blend of behavior change skills, advocacy, and scientific knowledge

We can take a two-fold approach:

  1. Take action to help slow and reverse climate change – Read our blog on actions we can start taking today.
  2. Help people with diabetes to be prepared for natural disasters. Read our blog on How to Get Ready

A note of hope. Three years after the Camp Fire, people are rebuilding in Paradise. There is a better understanding of the need for preventive forest management and exit routes. However, the longstanding California drought continues to contribute to future fire risk. Water conservation is more important now than ever. We can take action to reverse the heating planet. Read our blog on actions we can start taking today.


10 Ways to Help the Planet

Change isn’t easy. We aren’t going for perfect, we are starting with intention and slowly moving to action, giving ourselves lots of grace along the way. I am excited to share my successes and wrong turns with you on this journey and we would love to hear from you too!

  1. Grow plants native to your area.
  2. Compost kitchen scraps and cut down on waste
  3. Eat more sustainable veggies, fruits, grains and less meat, processed foods.
  4. Drive less and walk more, especially in nature
  5. Think of 3 ways to use less water
  6. Use cold water to wash, hang clothes to dry.
  7. Turn appliances, lights and computers off when not in use.
  8. Purchase used items and re-use everything you can. Swap and trade instead of buying new.
  9. Try to use less plastics
  10. Trade out filament light bulbs for new LED bulbs.

Read more on our blog, Earth Day Secrets to Improving Planet Health

Stay tuned and we share details and resources on each of these 10 Steps over the next few months. And, please send us your stories too at [email protected]. We want to hear from you!

How to Protect the Planet Resources Page


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