{"id":11375,"date":"2010-10-26T08:10:56","date_gmt":"2010-10-26T12:10:56","guid":{"rendered":"http:\/\/asweetlife.org\/?p=11375"},"modified":"2015-12-27T15:44:26","modified_gmt":"2015-12-27T20:44:26","slug":"the-imperfect-miracle-of-insulin","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=11375","title":{"rendered":"The Imperfect Miracle of Insulin"},"content":{"rendered":"

After all the years of living with my husband<\/a>, I know him well.\u00a0 So I know that when I hear him say the word, “shit,” I don’t need to pay any attention to it.\u00a0 It’s a sign of a minor annoyance.\u00a0 If I hear more than one shit<\/em>, however, I know something is up.\u00a0 And the night, about two years ago, when I heard a chain of at least 10 shits<\/em>, I panicked before I even knew what was wrong.<\/p>\n

I’d been right to panic.\u00a0 It was close to midnight, and instead of injecting himself with Lantus (nighttime insulin), Mike had picked up the wrong pen and injected himself with Apidra, fast-acting insulin.\u00a0 He’d taken twenty units, his Lantus dose.\u00a0 It was enough to cover at least 200 grams of carbohydrate.<\/p>\n

\"\"<\/a><\/p>\n

“You have to go to the E.R.,” I said.<\/p>\n

“What for?” Mike answered.<\/p>\n

Not really sure what the protocol would be in such a situation, I guessed.\u00a0 “A glucose drip!”<\/p>\n

“No,” Mike said.\u00a0 “I’ll just stay up and eat.”\u00a0 He wasn’t hungry at all, but there was no other choice.<\/p>\n

We both stayed up that night.\u00a0 All night.\u00a0 We set a few alarms in case we fell asleep.\u00a0 We had a plate of fruit on the table, a bottle of test strips, a couple of glucometers<\/a>, and I was looking for the glucagon kit<\/a>, just in case.\u00a0 I was sure we had one.\u00a0 But we didn’t.<\/p>\n

To anyone who doesn’t know first-hand what it’s like to be insulin dependent, this might not sound like such a big deal.\u00a0 Just eat something, right?\u00a0 Have a few bowls of ice cream, some candy.\u00a0 But diabetes and insulin dosing are anything but simple.\u00a0 As my friend Elizabeth Snouffer of Diabetes24-7<\/a> wrote, “The toughest aspect of having insulin dependent diabetes is managing the side effects of insulin therapy.”<\/p>\n

Even when you think you know what your insulin requirements are, they can vary depending on what you ate in your previous meal, how much of it was fat, and how much protein, and how fast it breaks down in your body, and how much you’ve moved, how much you’ve slept, how much stress you are under, what altitude you’re in, if you’ve lost a few pounds, and so on…\u00a0 And here’s the thing about insulin, while it saves us and we can’t live without it, it can also kill us.<\/p>\n

There’s a general misconception that the problem with insulin therapy is that it requires an injection. \u00a0 It’s true, shots aren’t fun, but they’re the least of the problems with insulin.\u00a0 The biggest problem with insulin is that \u00a0it’s one of the most dangerous drugs around.\u00a0\u00a0 There aren’t very many drugs in patients’ hands\u00a0 (are there any others?) that are self-dosed, and that if you take a little too much of, can lead you to have a seizure, fall unconscious, or even die.\u00a0 Insulin therapy is crude.\u00a0 Even in the most responsible hands, mistakes happen.\u00a0 Mike’s case was nothing more than human error. He was exhausted, distracted, and stressed.\u00a0 Those aren’t good excuses, I know.\u00a0 He knows.\u00a0 We feel lucky he realized his mistake immediately. (And by the way – why, Sanofi aventis, why, why, why are your insulin pens identical?\u00a0 Why can’t the Lantus pen have a different texture, say, little raised bumps like a piece of Lego?\u00a0 People use it at night.\u00a0 People who can’t see well take insulin.\u00a0 Why don’t you think of these things?) \u00a0 Sometimes there are mechanical errors with insulin pens, pumps, and infusion sets.\u00a0 And sometimes, things go wrong for no reason at all. Sometimes blood sugar levels don’t behave the way you expect them to because diabetes is a wild beast that, even when you think you’ve got it tamed and trained, can lash out at you in full force.\u00a0 And that lashing can bring tragic surprises.<\/p>\n

Just a few days ago a child lost her life to something known as dead-in-bed syndrome<\/a>.\u00a0 Though the exact cause of this syndrome is not known, according to the Children With Diabetes website “nighttime hypoglycemia is a likely prerequisite of the event, but that the death is sudden and probably caused by cardiac arrhythmia.”<\/p>\n

I did not know the child who passed away, and I don’t know her family.\u00a0 I don’t know anything about them, other than the fact that their daughter had type 1 diabetes, and that she was very well cared for, and despite the excellent care, she died in her sleep.\u00a0 Without knowing\u00a0 more than that about this family, I still feel a bond with them, as I know many others living with diabetes do.\u00a0 Someone fell victim to the fear we all live with – the fear of not waking up in the morning.\u00a0 And it was a child.<\/p>\n

The children who live with diabetes and the people who take of them are heroes.\u00a0 Strong, brave, and resilient.\u00a0 They never get a minute off.\u00a0 Any my heart goes out to the family who did everything right, and still, it wasn’t enough.<\/p>\n

As our featured story<\/a> today tells you, the New York Historical Society is celebrating the miracle of insulin.\u00a0 So is a new book, Breakthrough.\u00a0 I join them in this celebration, but with a touch of\u00a0 bitterness.\u00a0 I’ll really celebrate when there is a safe therapy for type 1 diabetes.\u00a0 Not to mention a cure, or at least a real means of prevention.<\/p>\n

To avoid ending on a depressing note, I’m embedding this Sesame Street video, What I Am<\/em>, which I first saw a link to on dblogger Bernard Farrell’s<\/a> Facebook page. \u00a0It may be a chain of cliches, but they are happy, uplifting ones, and I’ll take that any day over a chain of shits<\/em>.\u00a0 To all of us living with diabetes, and especially the children, what you are is strong!<\/p>\n

[youtube]http:\/\/www.youtube.com\/watch?v=cyVzjoj96vs&NR=1[\/youtube]\n

\n

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