People with diabetes were 48 times more likely to become homeless during the COVID pandemic compared to the general population. Living with diabetes and becoming homeless can cause serious problems. For example, there is the immediate challenge of accessing regular meals. Also, it is common for donated food to be of very poor quality. Many homeless shelters do not have the resources to offer highly nutritious food. Evidence suggests that half of homeless people skip a meal daily, and nearly a third go without food for at least one day a week. For those needing insulin, not being able to predict a mealtime can be deadly.
How do I store my insulin?
Diabetes is a demanding disease. The current approach to care focuses on self-management. However, among the homeless, rates of mental health disorders and addiction are high. This negatively impacts a person’s ability to maintain a safe level of glycemic control. It can lead to higher rates of acute uncontrolled diabetes as well as serious long-term complications. For example, this may include an increased risk of leg and foot amputation. In addition, it is difficult for people who are homeless to find places to store their medication. If syringes are required, there is greater risk of robbery and violence. Manufacturers require that insulin be kept between 2 and 8°C (or 35.6°F to 46.4°F). This is very challenging for those without access to a refrigerator.
Brutal reality of diabetes and homelessness
In the U.S., studies suggest that the prevalence of diabetes among the homeless population ranges from 8 to 22%. Currently, the “brutal reality of trying to manage a chronic condition while uncertain of where you will sleep or when you will eat next, can only really be understood by those who live through it.” Diabetes professionals need to consider new approaches to reduce harm for this vulnerable population. This can be based on awareness of the context in which people live.