Diabetes Care Providers' Manual for Disaster Diabetes Care.

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received. Based on these and other experiences and lessons reported following the 2011 Great East Japan Earthquake and the 2004 Niigata-Chuetsu Earthquakes, the current "Manual for Disaster Diabetes Care" has been developed by the members of the Committee and other invited authors from relevant specialties. To our knowledge, the current Manual is the world's first to focus on emergency diabetes care, with this digest English version translated from the Japanese original. It is sincerely hoped that patients with diabetes and healthcare providers around the world will find this manual helpful in promoting disaster preparedness and implementing disaster relief.

Assessment of dose selection attributes with audible notification in insulin pen devices.

BACKGROUND: Patients with type 2 diabetes often suffer from impairments in vision as well as manual dexterity. The purpose of this study was to assess the reliability of dose selection and setting of five insulin devices by patients using auditory and sensory confirmation. METHODS: A total of 48 patients (30 men, 18 women; mean +/- SD age 60.5 +/- 14.0 years; hemoglobin A(1c) 8.7 +/- 1.9%) were randomized to test the following devices: NovoPen 3 (Novo Nordisk A/S, Bagsvaerd, Denmark), HumaPen Ergo (Eli Lilly, Indianapolis, IN), Humalog Pen (Eli Lilly), InnoLet (Novo Nordisk), and FlexPen(Novo Nordisk). RESULTS: Significantly more patients detected an auditory confirmation of dose setting when using the NovoPen 3 compared with the Humalog Pen (P < 0.001), HumaPen Ergo (P < 0.001), and InnoLet (P < 0.01). The audible click for the FlexPen was also heard by more patients than for the Humalog Pen (P < 0.001) and HumaPen Ergo (P < 0.01). All patients found that the Flex- Pen provided physical sensory confirmation; the percentage was higher than for those using the Humalog Pen (P < 0.001), HumaPen Ergo (P < 0.001), and InnoLet (P < 0.01). The NovoPen 3 was also associated with a higher percentage of patients who felt the click sensation than with the Humalog Pen (P < 0.001) and HumaPen Ergo (P < 0.01). Patients reported more confidence in setting the correct dose with the NovoPen 3 and FlexPen, and found these the most reliable for dose setting. Sound recordings showed that the NovoPen 3 produced the loudest clicks when setting a dose (P < 0.001 for all comparisons). CONCLUSIONS: The clarity of the click when setting a dose on an insulin delivery device can affect the patient's confidence in selecting the correct dose.