EMERGENCY MEAL PLANNING FOR DIABETICS

Why do I need an emergency meal plan?

This meal plan is for you to use in case of an emergency or a natural disaster when you may not be able to attend dialysis. It is important to follow a limited diet if dialysis has to be missed. A grocery list and a three-day meal plan for an emergency are included in this fact sheet. This diet is much more strict than your usual diet. This very strict plan is needed to control the buildup of toxins such as potassium, phosphorus, urea and fluids that can be life threatening to you if several dialysis treatments are missed due to the emergency .

What should I expect during an emergency situation?

Many things we depend on daily may not be working during an emergency. You may be without a telephone. Water and electricity may be cut off, keeping you from cooking your meals in the usual way. You may need to use cold or shelf-stable foods until the crisis is over. Food in your refrigerator will keep safely for up to 12 hours and in the freezer for one to two days, if these appliances are opened only when meals are prepared. It is best to eat the foods from your refrigerator and freezer first before using your shelf-stable foods. Distilled water, disposable plates and utensils also should be kept on hand.

How do I prepare myself for an emergency?

As natural disasters may happen without warning, it is good to keep foods with a long shelf-life on hand at all times. If you do stock foods, remember to check dates for freshness and replace regularly.

The following items are important and useful to have on hand in case of an emergency:

  1. this diet sheet
  2. always have a two-week supply of all medicines and vitamins
  3. all of the groceries listed in this guide
  4. diabetics need to have enough insulin and supplies on hand, including extra batteries for the glucometer
  5. emergency phone list with names and phone numbers of your doctor, dialysis unit and the local hospital
  6. radio with extra batteries
  7. flashlight with extra batteries
  8. candles and matches
  9. measuring cups and scale
  10. plastic forks, spoons, knives, plates, bowls and cups
  11. napkins
  12. hand-operated can opener
  13. five gallons of distilled water
  14. refrigerator thermometer.

Is there anything else I should know?

  1. It is very important to follow your diet according to the meal plan given.
  2. Be careful when eating perishable foods to avoid food poisoning. If a jar or can is opened, do not keep it longer than four hours unless refrigerated.
  3. Use a refrigerator thermometer to know if food is stored at a safe temperature (under 40 degrees F, 5 degrees C). If your refrigerator temperature is over 40 degrees F, food will only be safe for four hours. After that time, throw it away.
  4. Use disposable plates and utensils. Throw away after use.
  5. Keep distilled water handy for mixing milk or juice. Mix small amounts of only four ounces at a time.
  6. Limit intake of fluid to two cups or 16 ounces per day. Chew gum to help cope with thirst.
  7. Do not use salt or salt substitute with your meals. Use salt-free foods when possible.
  8. Avoid high-potassium foods. Limit the kinds and portion sizes of fruits and vegetables eaten to those listed in this handout.
  9. If you have diabetes, keep instant glucose tablets, sugar, hard candy, low-potassium fruit juices, or sugared soda pop on hand to treat low blood sugars. Avoid high potassium fruit juices (orange juice).

THREE-DAY DIABETIC GROCERY LIST FOR EMERGENCIES

Item

Amount (per person)

Bread/Cereal (use 6-8 servings per day)

White bread

1 loaf

Dry cereal, unsalted, unsweetened

6 single serve containers or 1 box

Puffed wheat or rice, shredded wheat

Vanilla wafers or

1 box

Graham crackers or

Unsalted crackers

Unsweetened Fruits/Juices (limit to 2-4 servings per day)

Canned or sealed plastic container:
applesauce, pears, peaches, pineapple, mandarin oranges, fruit cocktail

12 single-serve containers

Apple or Cranberry Juice

12 boxes or pouches

Sugar-free powdered drink mix fruit flavored, fruit punch or lemonade
                        or
Sugar-free lemon lime or ginger ale soda

1 canister or 2 packages

6 cans

Fish/Meat (limit to 3 oz. per day) low-sodium, canned:

Tuna, salmon, meat, turkey, chicken

6 small cans

Peanut butter, unsalted

1 jar

Milk (limit to ½ cup per day)

Evaporated milk

3 small cans

Dry milk solids

2 packages

Artificial Sweetener

1 box of packets

Sweets (use only to treat low blood sugar)

Sourballs, hard candies

1 bag

Corn Syrup

1 bottle

White sugar

1 small bag

Jelly

1 jar

Sugared lemon-lime or ginger ale soda.
Limit use of soda to avoid fluid overload

3-12 ounce cans

Fats (use 6 or more servings per day)

Salad or cooking oil

1 bottle

Mayonnaise (perishable after opening)

Individual packets or 3 small jars

Margarine

1 pound

Other

Distilled water

5 one gallon jugs

THREE-DAY DIABETIC MEAL PLAN FOR EMERGENCIES

The sample meal plans given provide about 40-50 grams of protein, 1,500 mg sodium, 1,500 mg potassium, 1,800 calories and less than 500 cc or 16 ounces of fluid for each of the three days. You may make changes within a diabetic exchange group to fit your individual taste. These meal plans are stricter than your normal renal and diabetic diet to keep waste products from building up in your blood during the emergency situation. Fluid is limited to less than 500 cc (two cups or 16 ounces) each day to prevent you from swelling or having shortness of breath. If the disaster should continue for more than three days the meal plan should be repeated.

Day 1

Breakfast

½ cup milk prepared from dry milk and ½ cup distilled water, or mix ¼ cup evaporated milk with ¼ cup distilled water

1 single serving box of cereal (½ to ¾ cup from box)

2 teaspoons artificial sweetener (optional)

½ cup pineapple in unsweetened juice (single serving)

Morning Snack

6 unsalted crackers 1 tablespoon margarine spread on crackers

Lunch

2 slices white bread
¼ cup low-sodium tuna (open new can daily)
1 tablespoon margarine or mayonnaise (individual packet or open new jar daily)
½ cup pears in unsweetened juice (single serving)
½ cup sugar free beverage

Afternoon Snack

5 vanilla wafers

Dinner

2 slices white bread
½ cup (2 oz.) low sodium chicken (open new can daily)
2 tablespoons margarine or mayonnaise (individual packet or open new jar daily)
½ cup peaches in unsweetened juice (single serving)
½ cup unsweetened apple juice (from box or pouch)

Evening Snack

3 graham cracker squares
Note:

  • Use one tablespoon peanut butter if you need a protein source at evening snack.
  • Continue to monitor blood sugar.
  • Follow your protocol for insulin reactions and be sure to keep enough supplies on hand. Best choices for treating low sugars are fluid-free items such as sugar, corn syrup, hard candy, instant glucose, and glucose tablets. Sugared soda and low potassium juices may also be used, but must be counted as part of your two-cup or 16-ounce daily limit.

Day 2

Breakfast

½ cup milk prepared from dry milk and ½ cup distilled water,
or mix ¼ cup evaporated milk with ¼ cup distilled water
1 single serving box of cereal (½ - ¾ cup from box)
2 teaspoons artificial sweetener (optional)
½ cup unsweetened applesauce (single serving)

Morning Snack

5 vanilla wafers

Lunch

2 slices white bread
2 tablespoons low sodium peanut butter
1 tablespoon margarine or mayonnaise (individual packet or open new jar daily)
½ cup mandarin oranges in unsweetened juice (single serving)
½ cup sugar free beverage or soda

Afternoon Snack

6 unsalted crackers
1Tablespoon margarine spread on crackers

Dinner

2 slices white bread
½ cup (2 oz.) low-sodium chicken (open new can daily)
2 tablespoons margarine or mayonnaise (individual packet or open new jar daily)
½ cup pineapple packed in unsweetened juice (single serving)
½ cup unsweetened apple juice (from box or pouch)

Evening Snack

3 graham cracker squares

Note:

  • Use one tablespoon peanut butter if you need a protein source at evening snack.
  • Continue to monitor blood sugar.
  • Follow your protocol for insulin reactions and be sure to keep enough supplies on hand. Best choices for treating low sugars are fluid-free items such as sugar, corn syrup, hard candy, instant glucose, and glucose tablets. Sugared soda and low potassium juices may also be used, but must be counted as part of your two-cup or 16-ounce daily limit.

DAY 3

Breakfast

½ cup milk prepared from dry milk and ½ cup distilled water,
or ¼ cup evaporated milk with ¼ cup distilled water
1 single serving box of cereal (½ - ¾ cup from box)
2 teaspoons artificial sweetener (optional)
½ cup pears packed in unsweetened juice (single serving)

Morning Snack

6 unsalted crackers
1 tablespoon margarine

Lunch

2 slices white bread
¼ cup (2 oz.) low-sodium turkey (open new can daily)
1 tablespoon margarine or mayonnaise (individual packet or open new jar daily)
½ cup peaches packed in unsweetened juice (single serving)
½ cup sugar free drink or soda

Afternoon Snack

5 vanilla wafers

Dinner

2 slices white bread
½ cup (2 oz.) low-sodium chicken (open new can daily)
2 tablespoons margarine or mayonnaise (individual packet or open new jar daily)
½ cup fruit coctail (single serving)
½ cup cranberry juice (from box or pouch)

Evening Snack

3 graham cracker squares
Note:

  • Use one tablespoon peanut butter if you need a protein source at evening snack.
  • Continue to monitor blood sugar.
  • Follow your protocol for insulin reactions and be sure to keep enough supplies on hand. Best choices for treating low sugars are fluid-free items such as sugar, corn syrup, hard candy, instant glucose, and glucose tablets. Sugared soda and low potassium juices may also be used, but must be counted as part of your two-cup or 16-ounce daily limit .

More than 20 million Americans—one in nine adults—have chronic kidney disease, and most don't even know it. More than 20 million others are at increased risk. The National Kidney Foundation, a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. Through its 50 affiliates nationwide, the foundation conducts programs in research, professional education, patient and community services, public education and organ donation. The work of the National Kidney Foundation is funded by public donations.

The National Kidney Foundation wishes to thank its
Council on Renal Nutrition (CRN) for the development of this fact sheet.

If you would like more information, please contact us.

©2014 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.