Aims: To evaluate the impact of hurricanes Irma/María on changes in glucose abnormalities and diabetes care.

Methods: Participants from the San Juan Overweight Adults Longitudinal Study (SOALS) aged 40-65 years and free of diabetes at baseline completed a follow-up exam. Of these, 324 participants without diabetes were enrolled in the Preparedness to Reduce Exposures and diseases Post-hurricanes and Augment Resilience (PREPARE) study evaluating risk and resiliency factors. Self-reported physician diagnosed diabetes data and blood samples were collected at all three visits. Paired t-tests were conducted to compare within person changes from baseline to follow up (pre-hurricanes) versus follow up to PREPARE visits (post hurricanes), both roughly similar 3 years follow-up periods, for fasting glucose, insulin and HbA1c. PREPARE participants with diabetes (N=56) recruited from another cohort were interviewed.

Results: At baseline, mean age was 54 years (SD=6.84), 77% were women and mean BMI was 33.5 (SD=6.30). The 3-year cumulative incidence of diabetes was 0.012 pre hurricanes and was 0.056 post hurricanes (p=.003). The increase in HbA1c post hurricane (M=0.66%, SD=5.49) was significantly higher than the changes pre hurricane (M=-0.18%, SD=0.23). The changes in fasting insulin post hurricanes (M=1.51uIU/mL, SD=8.69) was also significantly higher than pre hurricanes (M=0.38uIU/mL, SD=5.58). There were no significant differences for glucose. Of the 56 participants with diabetes, 18.9% had problems obtaining and storing insulin (median=112 days). Also, 16.7% had trouble getting good medical care for diabetes or related complications (median= 61 days), and needed to change their healthcare provider/facility, and/or find alternatives for insulin.

Conclusion: Hurricanes had a detrimental impact, increasing the incidence of diabetes, and fasting insulin and HbA1c. Among people with diabetes, hurricanes could disrupt healthcare and medications both short-term and long-term impact.


M. Martinez-Lozano: None. C. Noboa: None. K.J. Joshipura: None.


National Institutes of Health (R21MD013666, U54MD007587, R01DE010111)

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